CHIEF COMPLAINT: Wrist and ankle pain

PRESENT ILLNESS: Mr. [**Known lastname 82685**] is a 45 y/o M with HIV, HCV and prior cellulitis
episodes presents with 4 days of fevers, night sweats shaking
chills and left wrist and ankle pain.  He reportedly gives
himself IM injetions of norflex in his thighs daily and has had
thigh cellulitis in the past requiring drainage in the OR in the
past and a left thigh cellulitis in [**7-/2169**] for which he was sent
home with a PICC line for IV vancomycin.  He denies IV drug use
recently (last in [**1-/2169**]) and his PICC line was pulled in
8/[**2169**].  He has had some recent nasal congestion and has been on
azithromycin but denies sore throat, cough, SOB, dysuria,
frequency, CP, palpitations.  Given his joint pain and fevers he
presented to his PCP who sent him to the ED.

MEDICAL HISTORY: HCV-plans to start theapry in near future per patient
DM -on lantus and aspart sliding scale
HIV per pt last CD4 in 500s (per patient), VL undectable
chronic sinusitis s/p surgery [**4-20**]
migraines
Thigh cellulitis

MEDICATION ON ADMISSION: Venlafaxine XR 150 mg PO DAILY
Oxycodone SR (OxyconTIN) 40 mg PO Q12H
OxycoDONE (Immediate Release)  5 mg PO/NG Q4H:PRN pain
Pseudoephedrine 30 mg PO Q6H:PRN sinus congestion
Omeprazole 40 mg PO DAILY
Lantus 30 units QHS and novolog SS
Albuterol Inhaler 2 PUFF IH Q4H:PRN SOB
Cyclobenzaprine 10 mg PO/NG HS
Gabapentin 600 mg PO/NG Q8H
Norflex *NF* (Orphenadrine Citrate) 30 mg/mL Injection Q6H
migraine
Zolpidem Tartrate 10 mg PO HS:PRN insomnia
Atorvastatin 40 mg PO/NG DAILY
Verapamil SR 240 mg PO Q24H
Clonazepam 2 mg PO/NG [**Hospital1 **]
ValACYclovir 1 gram PO QDAILY
Darunavir 800 mg PO DAILY
RiTONAvir 100 mg PO DAILY
Emtricitabine-Tenofovir (Truvada) 1 TAB PO DAILY
Benadryl 25-50 mg PRn sleep
ASA 81 mg po daily
Trazadone 100mg Po HS prn sleep

ALLERGIES: Bactrim / Sulfa (Sulfonamide Antibiotics) / Clindamycin /
Prochlorperazine / Penicillins / Quinolones

PHYSICAL EXAM: ROS: Denies weight loss, fatigue, visual changes,
lightheadedness, worsening of his HA, diarrhea, constipations,
bledding, bruising, hematuria, orthopnea, PND, LE edema, skin
rash

FAMILY HISTORY: [**Doctor First Name **] any medical problems in his family.

SOCIAL HISTORY: Smokes 1 ppd, no etoh, remote history of IV drug use (had a 2
day relapse in [**2-/2169**]), but denies any drugs currently,
unemployed, used to work in catering management.  Lives with
roommates.
Pyogenic arthritis, forearm,Cellulitis and abscess of leg, except foot,Asymptomatic human immunodeficiency virus [HIV] infection status,Other tenosynovitis of hand and wrist,Chronic hepatitis C without mention of hepatic coma,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Migraine, unspecified, without mention of intractable migraine without mention of status migrainosus,Tobacco use disorder,Unspecified essential hypertension,Need for desensitization to allergens
Pyogen arthritis-forearm,Cellulitis of leg,Asymp hiv infectn status,Tenosynov hand/wrist NEC,Chrnc hpt C wo hpat coma,DMII wo cmp nt st uncntr,Migrne unsp wo ntrc mgrn,Tobacco use disorder,Hypertension NOS,Desensitiza to allergens
Admission Date:  [**2169-10-3**]              Discharge Date:   [**2169-10-13**]

Date of Birth:  [**2124-1-22**]             Sex:   M

Service: MEDICINE

Allergies:
Bactrim / Sulfa (Sulfonamide Antibiotics) / Clindamycin /
Prochlorperazine / Penicillins / Quinolones

Attending:[**First Name3 (LF) 2108**]
Chief Complaint:
Wrist and ankle pain

Major Surgical or Invasive Procedure:
I&D of left wrist abscess on [**2169-10-5**] in the operating room


History of Present Illness:
Mr. [**Known lastname 82685**] is a 45 y/o M with HIV, HCV and prior cellulitis
episodes presents with 4 days of fevers, night sweats shaking
chills and left wrist and ankle pain.  He reportedly gives
himself IM injetions of norflex in his thighs daily and has had
thigh cellulitis in the past requiring drainage in the OR in the
past and a left thigh cellulitis in [**7-/2169**] for which he was sent
home with a PICC line for IV vancomycin.  He denies IV drug use
recently (last in [**1-/2169**]) and his PICC line was pulled in
8/[**2169**].  He has had some recent nasal congestion and has been on
azithromycin but denies sore throat, cough, SOB, dysuria,
frequency, CP, palpitations.  Given his joint pain and fevers he
presented to his PCP who sent him to the ED.

VS on arrival to ED: T 100 HR 108 BP 124/74 R 18 o2 sats 99% on
RA. Pt was given Vanc 1gram IV x 1 and oxycodone. CXR, wrist and
ankle films were unremarkable.  On arrival to the floor patient
reports improvement in the pain in his ankle but worsening
redness, warmth, swelling and pain in his wrist over the course
of the day.  He was taking extra oxycodone and oxycontin over
the past 4 days for the pain with little relief.  He has been
taking all of his medications.  He denies sick contacts.  [**Name (NI) **]
[**Name2 (NI) 82686**] to [**State **] 2 weeks ago, but denies any other
travel.  He denies trauma to the joints, IV drug use.

Past Medical History:
HCV-plans to start theapry in near future per patient
DM -on lantus and aspart sliding scale
HIV per pt last CD4 in 500s (per patient), VL undectable
chronic sinusitis s/p surgery [**4-20**]
migraines
Thigh cellulitis

Social History:
Smokes 1 ppd, no etoh, remote history of IV drug use (had a 2
day relapse in [**2-/2169**]), but denies any drugs currently,
unemployed, used to work in catering management.  Lives with
roommates.


Family History:
[**Doctor First Name **] any medical problems in his family.

Physical Exam:
ROS: Denies weight loss, fatigue, visual changes,
lightheadedness, worsening of his HA, diarrhea, constipations,
bledding, bruising, hematuria, orthopnea, PND, LE edema, skin
rash

Vitals:T 101.3 BP 158/86 HR 105 R 20 O2 sata 93 % on RA
General: Flushed but otherwise comfortable appearing middle aged
male
HEENT:OP clear, MMM, sclera anicteric, scattered excoriations on
face
LN: No cervical or axillary LAD
CV: tachycardic, RR, nl S1S2, I could not appreciate m/g/r
Pulm: Lung CTA b/l
Back: no spinal, paraspinal or CVA tenderness
Abd: Obese, soft, NT/ND, I could not appreciate
hepatospelnomegaly
EXT: Left hand and wrist are edematous and erythamtous and warm,
erythema extend halfway up forearm and the dorsum of the hand.
Most of the erythema is located over the left wrist.  The area
was outlined patient has severe pain in wrist on active and
passive motion. Right wrist is unremarkable.  Left foot is
erythematous. He has full ROM of the ankle and is able to bear
weight. The erythmatous area was outlined.  No LE edema.
Skin: No petechiae, splinter hemmhorhages, osler nodes or
[**Last Name (un) **] lesions
Neuro: AAOx3


Pertinent Results:
CXR: The lungs are clear without consolidation or edema. The
mediastinum is unremarkable. The previously noted right upper
extremity PICC line has been removed in the interval. The
cardiac silhouette is within normal limits for size. No effusion
or pneumothorax is noted. The osseous structures are
unremarkable.
IMPRESSION: No acute pulmonary process.

Left wrist x-ray: 1. No visible acute fracture.
2. Some displacement of the pronator quadratus fat pad volar to
the radius is seen. If there is high degree of clinical
suspicion for fracture, further assessment with MRI is
suggested.

Left ankle x-ray: IMPRESSION: No evidence of traumatic injury or
significant underlying degenerative joint disease. Essentially
normal exam. Please note this is the third in a series of normal
ankle x-rays dating back to [**2169-8-5**].

ECG: sinus rhythm, rate 97, normal PR, no ST-T wave changes.

[**2169-10-11**] 04:34AM BLOOD WBC-6.3 RBC-4.53* Hgb-12.7* Hct-37.9*
MCV-84 MCH-28.1 MCHC-33.5 RDW-14.3 Plt Ct-321
[**2169-10-3**] 01:00PM BLOOD WBC-6.3 RBC-3.97* Hgb-11.3* Hct-33.7*
MCV-85 MCH-28.6 MCHC-33.7 RDW-15.2 Plt Ct-233
[**2169-10-4**] 06:25AM BLOOD Neuts-60.7 Lymphs-26.2 Monos-7.0 Eos-5.1*
Baso-0.9
[**2169-10-4**] 06:25AM BLOOD PT-13.4 PTT-30.9 INR(PT)-1.1
[**2169-10-4**] 06:00PM BLOOD ESR-31*
[**2169-10-11**] 04:34AM BLOOD Glucose-86 UreaN-17 Creat-0.9 Na-138
K-4.4 Cl-102 HCO3-25 AnGap-15
[**2169-10-3**] 01:00PM BLOOD Glucose-148* UreaN-9 Creat-0.8 Na-135
K-4.0 Cl-100 HCO3-26 AnGap-13
[**2169-10-11**] 04:34AM BLOOD ALT-49* AST-27 LD(LDH)-179 AlkPhos-106
TotBili-0.2
[**2169-10-4**] 06:25AM BLOOD ALT-237* AST-211* AlkPhos-122 TotBili-0.4
[**2169-10-11**] 04:34AM BLOOD Calcium-8.9 Phos-4.6* Mg-2.3
[**2169-10-9**] 06:35AM BLOOD Vanco-16.3

BLOOD CULTURES X 2 ON [**10-6**] AND [**10-7**] NO GROWTH.  FINAL.

[**2169-10-5**] 1:28 pm SWAB      LEFT WRIST.
   GRAM STAIN (Final [**2169-10-5**]):
      NO POLYMORPHONUCLEAR LEUKOCYTES SEEN.
      NO MICROORGANISMS SEEN.
   WOUND CULTURE (Final [**2169-10-7**]):    NO GROWTH.
   ANAEROBIC CULTURE (Final [**2169-10-11**]):    NO GROWTH.
   ACID FAST SMEAR (Final [**2169-10-6**]):
      NO ACID FAST BACILLI SEEN ON DIRECT SMEAR.
   ACID FAST CULTURE (Preliminary):
      A swab is not the optimal specimen for recovery of
mycobacteria or
      filamentous fungi.  A negative result should be
interpreted with
      caution.  Whenever possible tissue biopsy or aspirated
fluid should
      be submitted.
      NO MYCOBACTERIA ISOLATED.
   FUNGAL CULTURE (Preliminary):
      NO FUNGUS ISOLATED.
      A swab is not the optimal specimen for recovery of
mycobacteria or
      filamentous fungi.  A negative result should be
interpreted with
      caution.  Whenever possible tissue biopsy or aspirated
fluid should
      be submitted.
   POTASSIUM HYDROXIDE PREPARATION (Final [**2169-10-5**]):
      Test cancelled by laboratory.
      PATIENT CREDITED.
      Inappropriate specimen collection (swab) for Fungal Smear
(KOH).

[**2169-10-5**] 11:40 am SWAB      LEFT WRIST DORSAL TISSUE.
   GRAM STAIN (Final [**2169-10-5**]):
      NO POLYMORPHONUCLEAR LEUKOCYTES SEEN.
      NO MICROORGANISMS SEEN.
   WOUND CULTURE (Final [**2169-10-7**]):    NO GROWTH.
   ANAEROBIC CULTURE (Final [**2169-10-11**]):    NO GROWTH.
   POTASSIUM HYDROXIDE PREPARATION (Final [**2169-10-5**]):
      Test cancelled by laboratory.
      PATIENT CREDITED.
      Inappropriate specimen collection (swab) for Fungal Smear
(KOH).
   FUNGAL CULTURE (Preliminary):    NO FUNGUS ISOLATED.
   ACID FAST CULTURE (Preliminary):
      A swab is not the optimal specimen for recovery of
mycobacteria or
      filamentous fungi.  A negative result should be
interpreted with
      caution.  Whenever possible tissue biopsy or aspirated
fluid should
      be submitted.
      NO MYCOBACTERIA ISOLATED.
   ACID FAST SMEAR (Final [**2169-10-6**]):
      NO ACID FAST BACILLI SEEN ON DIRECT SMEAR.

[**2169-10-4**] 6:00 pm IMMUNOLOGY
                            **FINAL REPORT [**2169-10-7**]**
   HIV-1 Viral Load/Ultrasensitive (Final [**2169-10-7**]):
      HIV-1 RNA is not detected.
      Performed using the Cobas Ampliprep / Cobas Taqman HIV-1
Test.
      Detection range: 48 - 10,000,000 copies/ml.
      This test is approved for monitoring HIV-1 viral load in
known
      HIV-positive patients. It is not approved for diagnosis of
acute HIV
      infection.
      In symptomatic acute HIV infection (acute retroviral
syndrome), the
      viral load is usually very high (>>1000 copies/mL). If
acute HIV
      infection is clinically suspected and there is a
detectable but low
      viral load, please contact the laboratory for
interpretation.
      It is recommended that any NEW positive HIV-1 viral load
result, in
      the absence of positive serology, be confirmed by
submitting a new
      sample FOR HIV-1 PCR, in addition to serological testing.

[**2169-10-4**] 9:46 am URINE    Site: CLEAN CATCH      Source: CVS.
                            **FINAL REPORT [**2169-10-5**]**
   Chlamydia trachomatis, Nucleic Acid Probe, with Amplification
(Final
      [**2169-10-5**]):    Negative for Chlamydia trachomatis by PCR.
   NEISSERIA GONORRHOEAE (GC), NUCLEIC ACID PROBE, WITH
AMPLIFICATION
      (Final [**2169-10-5**]):    Negative for Neisseria Gonorrhoeae by
PCR.

[**2169-10-4**] 6:00 pm IMMUNOLOGY
                            **FINAL REPORT [**2169-10-5**]**
   HCV VIRAL LOAD (Final [**2169-10-5**]):
      56,800 IU/mL.
      Performed using the Cobas Ampliprep / Cobas Taqman HCV
Test.
      Linear range of quantification: 43 IU/mL - 69 million
IU/mL.
      Limit of detection: 18 IU/mL.

[**2169-10-5**] LEFT WRIST PATHOLOGY
1.  Soft tissue, left wrist volar ulna, biopsy (A):
A  Soft tissue, most likely synovium, with acute and chronic
inflammation, reactive change and focal necrosis. See note.
B.  Fibrinopurulent exudate.
2.  Soft tissue, left wrist dorsal, biopsy (B):
Synovium with focal fibrosis, otherwise unremarkable.

Note:
GMS, Gram and [**Doctor Last Name 6311**] stains performed on block A are negative
for fungal and bacterial organisms.
H&E slides reviewed with Dr. [**Last Name (STitle) **]. [**Doctor Last Name **].


Brief Hospital Course:
WRIST AND DORSAL FOOT TENOSYNOVITIS: culture negative, biopsy of
L hand synovium was largely unrevealing.  The patient's urine GC
was negative.  He was treated empirically with vancomycin
initially and symptoms did not completely improve, given GC was
still a possibility he was sent to the ICU for ceftriaxone
desensitization and treated with an empiric 2 week course of
vanc/ceftriaxone.  Discharged on [**10-13**] with 8 remaining days.
Afebrile for > 2 days prior to discharge.  He was set up with
PCP/ID follow up and will follow up with rheumatology in case
his symptoms do not improve.

Diabetes: home medications continued

Anxiety: Continued effexor and clonazepam

HTN, benign: Continued verapamil

Medications on Admission:
Venlafaxine XR 150 mg PO DAILY
Oxycodone SR (OxyconTIN) 40 mg PO Q12H
OxycoDONE (Immediate Release)  5 mg PO/NG Q4H:PRN pain
Pseudoephedrine 30 mg PO Q6H:PRN sinus congestion
Omeprazole 40 mg PO DAILY
Lantus 30 units QHS and novolog SS
Albuterol Inhaler 2 PUFF IH Q4H:PRN SOB
Cyclobenzaprine 10 mg PO/NG HS
Gabapentin 600 mg PO/NG Q8H
Norflex *NF* (Orphenadrine Citrate) 30 mg/mL Injection Q6H
migraine
Zolpidem Tartrate 10 mg PO HS:PRN insomnia
Atorvastatin 40 mg PO/NG DAILY
Verapamil SR 240 mg PO Q24H
Clonazepam 2 mg PO/NG [**Hospital1 **]
ValACYclovir 1 gram PO QDAILY
Darunavir 800 mg PO DAILY
RiTONAvir 100 mg PO DAILY
Emtricitabine-Tenofovir (Truvada) 1 TAB PO DAILY
Benadryl 25-50 mg PRn sleep
ASA 81 mg po daily
Trazadone 100mg Po HS prn sleep

Allergies: Bactrim/sulfa-rash, PCN-rash, clindmycin
-anaphylaxis, compazine-seizure, quinolones-rash

Discharge Medications:
1. Outpatient Lab Work
CBC with differential, Chem 7 (Na, K, Cl, HCO3, BUN, Cr,
glucose), LFTs (AST, ALT, Alk phos, total bilirubin).   To be
drawn [**2169-10-19**]. Results to be faxed to Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] (fax#
[**Telephone/Fax (1) 34420**]) (phone# [**Telephone/Fax (1) 5723**])
2. vancomycin 500 mg Recon Soln Sig: 1250 (1250) mg Intravenous
Q 8H (Every 8 Hours) for 12 days.
Disp:*36 doses* Refills:*0*
3. ceftriaxone in dextrose,iso-os 2 gram/50 mL Piggyback Sig:
Two (2) grams Intravenous Q24H (every 24 hours) for 12 days.
Disp:*12 doses* Refills:*0*
4. venlafaxine 75 mg Capsule, Sust. Release 24 hr Sig: Two (2)
Capsule, Sust. Release 24 hr PO DAILY (Daily).
5. oxycodone 40 mg Tablet Sustained Release 12 hr Sig: One (1)
Tablet Sustained Release 12 hr PO Q12H (every 12 hours).
6. oxycodone 10 mg Tablet Sig: One (1) Tablet PO every 4-6 hours
as needed for pain.
Disp:*40 Tablet(s)* Refills:*0*
7. pseudoephedrine HCl 30 mg Tablet Sig: One (1) Tablet PO Q6H
(every 6 hours) as needed for sinus congestion.
8. omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: Two (2)
Capsule, Delayed Release(E.C.) PO DAILY (Daily).
9. insulin glargine 100 unit/mL Solution Sig: Thirty (30) units
Subcutaneous at bedtime.
10. Novolog 100 unit/mL Solution Sig: as directed units
Subcutaneous QAC AND QHS: per sliding scale.
11. cyclobenzaprine 10 mg Tablet Sig: One (1) Tablet PO HS (at
bedtime).
12. gabapentin 300 mg Capsule Sig: Two (2) Capsule PO Q8H (every
8 hours).
13. Norflex 30 mg/mL Solution Sig: One (1) injection  Injection
four times a day as needed for migraine.
14. zolpidem 5 mg Tablet Sig: Two (2) Tablet PO HS (at bedtime)
as needed for insomnia.
15. atorvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
16. verapamil 120 mg Tablet Sustained Release Sig: Two (2)
Tablet Sustained Release PO Q24H (every 24 hours).
17. valacyclovir 500 mg Tablet Sig: Two (2) Tablet PO QDAILY ().

18. darunavir 400 mg Tablet Sig: Two (2) Tablet PO DAILY
(Daily).
19. ritonavir 100 mg Capsule Sig: One (1) Capsule PO DAILY
(Daily).
20. emtricitabine-tenofovir 200-300 mg Tablet Sig: One (1)
Tablet PO DAILY (Daily).
21. Benadryl 25 mg Capsule Sig: [**1-7**] Capsules PO at bedtime as
needed for insomnia.
22. aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable
PO DAILY (Daily).
23. trazodone 100 mg Tablet Sig: One (1) Tablet PO at bedtime as
needed for insomnia.
24. clonazepam 1 mg Tablet Sig: Two (2) Tablet PO BID (2 times a
day).
25. albuterol sulfate 90 mcg/Actuation HFA Aerosol Inhaler Sig:
Two (2) Puff Inhalation Q4H (every 4 hours) as needed for SOB.
26. EpiPen 0.3 mg/0.3 mL Pen Injector Sig: One (1) pen
Intramuscular once as needed as needed for allergic reaction
characterized by feeling like you are going to faint or throat
closing / trouble breathing for 1 doses.
Disp:*1 epi pen* Refills:*1*


Discharge Disposition:
Home With Service

Facility:
[**Location (un) 511**] Home Therapies

Discharge Diagnosis:
Left wrist cellulitis with multiple abscesses
Left ankle cellulitis


Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.


Discharge Instructions:
You were admitted for infection involving your left wrist and
left ankle. There were pockets of infection around your left
wrist which were incised and drained by Orthopedics on
[**2169-10-5**]. You were treated with intravenous Vancomycin and
Ceftriaxone.

MEDICATION CHANGES:
START taking VANCOMYCIN and CEFTRIAXONE (IV antibiotics)
OXYCODONE dose has been INCREASED temporarily to 10mg every 4
hours as needed for pain

Followup Instructions:
Name: [**Last Name (LF) **],[**First Name3 (LF) **] R.
Location: [**Location (un) **] ASSOCIATES OF [**Hospital1 **] HEALTH
Address: [**Street Address(2) **], 2ND FL, [**Location (un) **],[**Numeric Identifier 2900**]
Phone: [**Telephone/Fax (1) 5723**]
Appointment: Friday [**2169-10-20**] 2:30pm

Department: RHEUMATOLOGY
When: TUESDAY [**2169-10-31**] at 9:30 AM
With: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 4900**], MD [**Telephone/Fax (1) 2226**]
Building: LM [**Hospital Ward Name **] Bldg ([**Last Name (NamePattern1) **]) [**Location (un) 861**]
Campus: WEST     Best Parking: [**Hospital Ward Name **] Garage
{'Pyogenic arthritis, forearm,Cellulitis and abscess of leg, except foot,Asymptomatic human immunodeficiency virus [HIV] infection status,Other tenosynovitis of hand and wrist,Chronic hepatitis C without mention of hepatic coma,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Migraine, unspecified, without mention of intractable migraine without mention of status migrainosus,Tobacco use disorder,Unspecified essential hypertension,Need for desensitization to allergens'}


You are an AI assistant analyzing clinical admission notes from the MIMIC III dataset. Your task is to map symptoms mentioned in the notes to a list of provided ICD-9 LONG_TEXT.



### Clinical text :
CHIEF COMPLAINT: Wrist and ankle pain

PRESENT ILLNESS: Mr. [**Known lastname 82685**] is a 45 y/o M with HIV, HCV and prior cellulitis
episodes presents with 4 days of fevers, night sweats shaking
chills and left wrist and ankle pain.  He reportedly gives
himself IM injetions of norflex in his thighs daily and has had
thigh cellulitis in the past requiring drainage in the OR in the
past and a left thigh cellulitis in [**7-/2169**] for which he was sent
home with a PICC line for IV vancomycin.  He denies IV drug use
recently (last in [**1-/2169**]) and his PICC line was pulled in
8/[**2169**].  He has had some recent nasal congestion and has been on
azithromycin but denies sore throat, cough, SOB, dysuria,
frequency, CP, palpitations.  Given his joint pain and fevers he
presented to his PCP who sent him to the ED.

MEDICAL HISTORY: HCV-plans to start theapry in near future per patient
DM -on lantus and aspart sliding scale
HIV per pt last CD4 in 500s (per patient), VL undectable
chronic sinusitis s/p surgery [**4-20**]
migraines
Thigh cellulitis

MEDICATION ON ADMISSION: Venlafaxine XR 150 mg PO DAILY
Oxycodone SR (OxyconTIN) 40 mg PO Q12H
OxycoDONE (Immediate Release)  5 mg PO/NG Q4H:PRN pain
Pseudoephedrine 30 mg PO Q6H:PRN sinus congestion
Omeprazole 40 mg PO DAILY
Lantus 30 units QHS and novolog SS
Albuterol Inhaler 2 PUFF IH Q4H:PRN SOB
Cyclobenzaprine 10 mg PO/NG HS
Gabapentin 600 mg PO/NG Q8H
Norflex *NF* (Orphenadrine Citrate) 30 mg/mL Injection Q6H
migraine
Zolpidem Tartrate 10 mg PO HS:PRN insomnia
Atorvastatin 40 mg PO/NG DAILY
Verapamil SR 240 mg PO Q24H
Clonazepam 2 mg PO/NG [**Hospital1 **]
ValACYclovir 1 gram PO QDAILY
Darunavir 800 mg PO DAILY
RiTONAvir 100 mg PO DAILY
Emtricitabine-Tenofovir (Truvada) 1 TAB PO DAILY
Benadryl 25-50 mg PRn sleep
ASA 81 mg po daily
Trazadone 100mg Po HS prn sleep

ALLERGIES: Bactrim / Sulfa (Sulfonamide Antibiotics) / Clindamycin /
Prochlorperazine / Penicillins / Quinolones

PHYSICAL EXAM: ROS: Denies weight loss, fatigue, visual changes,
lightheadedness, worsening of his HA, diarrhea, constipations,
bledding, bruising, hematuria, orthopnea, PND, LE edema, skin
rash

FAMILY HISTORY: [**Doctor First Name **] any medical problems in his family.

SOCIAL HISTORY: Smokes 1 ppd, no etoh, remote history of IV drug use (had a 2
day relapse in [**2-/2169**]), but denies any drugs currently,
unemployed, used to work in catering management.  Lives with
roommates. 

### Response:
{'Pyogenic arthritis, forearm,Cellulitis and abscess of leg, except foot,Asymptomatic human immunodeficiency virus [HIV] infection status,Other tenosynovitis of hand and wrist,Chronic hepatitis C without mention of hepatic coma,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Migraine, unspecified, without mention of intractable migraine without mention of status migrainosus,Tobacco use disorder,Unspecified essential hypertension,Need for desensitization to allergens'}
