CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is a 28-year-old
female who underwent a laparoscopic appendectomy on
[**2107-11-30**] for acute appendicitis.  The patient tolerated the
procedure well.  The patient was discharged home in stable
condition.  The patient presents to the emergency room with
fever and left upper quadrant pain on [**2107-12-8**],
postoperative day #8.  She stated that the pain started
approximately one to two days postoperatively and it was
getting progressively worse.  It was exacerbated by deep
breaths.  It radiated to the left shoulder and arm.  She
complained of nausea, but she did not have any emesis.  She
also had anorexia and poor p.o. intake.  She had a fever of
101 at home.  She complained of chills, sweats, as well as
shortness of breath.  On the morning of admission she
developed diffuse maculopapular rash on her face, upper
extremities, back and lower extremities.  The patient felt
that this was related to her Percocet.  The patient went to
her primary care physician and she was told to stop her
Percocet.  With the increase in temperature, as well as one
episode of vomiting and loose stools, the patient presented
to the emergency room for evaluation.

MEDICAL HISTORY: 1.  Asthma.
2.  Hypertension.

MEDICATION ON ADMISSION: 

ALLERGIES: The patient is allergic to SULFA.

PHYSICAL EXAM: 

FAMILY HISTORY: History revealed a grandmother with a
history of PE.

SOCIAL HISTORY: The patient has no smoking habit, occasional
alcohol.
Pneumonia, organism unspecified,Acute respiratory failure,Dermatitis due to drugs and medicines taken internally,Nonspecific abnormal results of other endocrine function study,Hyposmolality and/or hyponatremia,Other specified cardiac dysrhythmias,Asthma, unspecified type, unspecified
Pneumonia, organism NOS,Acute respiratry failure,Drug dermatitis NOS,Abn endocrine study NEC,Hyposmolality,Cardiac dysrhythmias NEC,Asthma NOS
Admission Date:  [**2107-12-7**]       Discharge Date:  [**2107-12-14**]

Date of Birth:                    Sex:

Service:

ADMITTING DIAGNOSIS:  Pneumonia.

DISCHARGE DIAGNOSIS:  Pneumonia.

HISTORY OF THE PRESENT ILLNESS:  The patient is a 28-year-old
female who underwent a laparoscopic appendectomy on
[**2107-11-30**] for acute appendicitis.  The patient tolerated the
procedure well.  The patient was discharged home in stable
condition.  The patient presents to the emergency room with
fever and left upper quadrant pain on [**2107-12-8**],
postoperative day #8.  She stated that the pain started
approximately one to two days postoperatively and it was
getting progressively worse.  It was exacerbated by deep
breaths.  It radiated to the left shoulder and arm.  She
complained of nausea, but she did not have any emesis.  She
also had anorexia and poor p.o. intake.  She had a fever of
101 at home.  She complained of chills, sweats, as well as
shortness of breath.  On the morning of admission she
developed diffuse maculopapular rash on her face, upper
extremities, back and lower extremities.  The patient felt
that this was related to her Percocet.  The patient went to
her primary care physician and she was told to stop her
Percocet.  With the increase in temperature, as well as one
episode of vomiting and loose stools, the patient presented
to the emergency room for evaluation.

PAST MEDICAL HISTORY:
1.  Asthma.
2.  Hypertension.

PAST SURGICAL HISTORY:  History revealed laparoscopic
appendectomy on [**2107-11-30**].

MEDICATIONS:
1.  Albuterol.
2.  Percocet.

ALLERGIES:  The patient is allergic to SULFA.

FAMILY HISTORY:  History revealed a grandmother with a
history of PE.

SOCIAL HISTORY:  The patient has no smoking habit, occasional
alcohol.

PHYSICAL EXAMINATION:  On examination, the patient had a
temperature of 101.2, pulse 120, blood pressure 180/95,
respiratory rate 22, and saturation 94 on room air.  She was
awake, alert, and oriented times three.  She follows
commands.  She appears uncomfortable.  PERRLA.  Sclerae are
anicteric.  HEART:  Heart revealed regular, but tachycardiac.
LUNGS:  Lungs were clear to auscultation bilaterally with
decreased breath sounds.  ABDOMEN:  Soft, obese,
nondistended, but tender in the left subcostal region.  No
peritoneal signs.  EXTREMITIES:  Extremities are warm, well
perfused, no edema, but with a maculopapular rash.  SKIN:
Maculopapular rash on the face, upper extremity, left upper
extremity as well as the lower extremities and back.

LABORATORY DATA:  Labs on admission revealed the white count
of 16.7, hematocrit of 35.3 and platelet count 385,000.  The
SMA 7 revealed the sodium of 129, potassium 3.6.  The amylase
was 375, alkaline phosphatase 190.  Chest x-ray revealed left
pleural effusion and a question of left lower lobe
infiltrate.  CT scan revealed positive left lower lobe
consolidation.  CTA negative for PE.

HOSPITAL COURSE:  The patient was admitted on [**2107-12-8**] with
a diagnosis of postoperative pneumonia.  She was started on
Levofloxacin and Vancomycin.  She remained febrile with
decreased breath sounds at the bases of her lungs
bilaterally.

On [**2107-12-9**] the patient spiked a temperature to 104.  She
became tachypneic into the 40s.  She felt short of breath and
somnolent.  She was started on Tylenol and she was
transferred to a monitored setting.  She was started on
Tylenol and she was bolused with fluid and transferred to a
more monitored unit setting.  In the unit,
....................consultation was obtained as well as
Infectious Disease consultation.  Sputum cultures were sent.
It was decided that the Vancomycin should be discontinued.
She was continued on Levofloxacin and Clindamycin was added
for anaerobic coverage.  Angiography was done, which was
negative.

Diet was advanced.  Given her bump in amylase and lipase,
these labs were followed, which alkaline phosphatase
decreased to 95.  The amylase and lipase decreased to 129 and
152.  The patient continued to have a left lower lobe
consolidation.  It was thought that the patient would be
transferred to the floor on hospital day #4.  The patient had
ruled out for a PE and the vital signs had stabilized.  Of
note, the abdominal CT was negative for evidence of
pancreatitis or gallstones.  The amylase and lipase continued
to improve.  She tolerated p.o. diet.

It was felt that her symptoms was consistent with a drug
eruption by her examination.  She was started on
Triamcinolone cream, as well as Sarna.  The rash improved.

On [**2107-12-14**], the patient was discharged home in stable
condition.  It was found that the amylase and lipase
elevations were not pancreatitis, as clinically, the patient
did not have pancreatitis.




                        DR.[**Last Name (STitle) **],[**First Name3 (LF) **] 02-331

Dictated By:[**Last Name (NamePattern1) 4985**]
MEDQUIST36

D:  [**2108-3-13**]  13:09
T:  [**2108-3-13**]  13:22
JOB#:  [**Job Number 33071**]
{'Pneumonia, organism unspecified,Acute respiratory failure,Dermatitis due to drugs and medicines taken internally,Nonspecific abnormal results of other endocrine function study,Hyposmolality and/or hyponatremia,Other specified cardiac dysrhythmias,Asthma, unspecified type, unspecified'}


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: 

PRESENT ILLNESS: The patient is a 28-year-old
female who underwent a laparoscopic appendectomy on
[**2107-11-30**] for acute appendicitis.  The patient tolerated the
procedure well.  The patient was discharged home in stable
condition.  The patient presents to the emergency room with
fever and left upper quadrant pain on [**2107-12-8**],
postoperative day #8.  She stated that the pain started
approximately one to two days postoperatively and it was
getting progressively worse.  It was exacerbated by deep
breaths.  It radiated to the left shoulder and arm.  She
complained of nausea, but she did not have any emesis.  She
also had anorexia and poor p.o. intake.  She had a fever of
101 at home.  She complained of chills, sweats, as well as
shortness of breath.  On the morning of admission she
developed diffuse maculopapular rash on her face, upper
extremities, back and lower extremities.  The patient felt
that this was related to her Percocet.  The patient went to
her primary care physician and she was told to stop her
Percocet.  With the increase in temperature, as well as one
episode of vomiting and loose stools, the patient presented
to the emergency room for evaluation.

MEDICAL HISTORY: 1.  Asthma.
2.  Hypertension.

MEDICATION ON ADMISSION: 

ALLERGIES: The patient is allergic to SULFA.

PHYSICAL EXAM: 

FAMILY HISTORY: History revealed a grandmother with a
history of PE.

SOCIAL HISTORY: The patient has no smoking habit, occasional
alcohol. 

### Response:
{'Pneumonia, organism unspecified,Acute respiratory failure,Dermatitis due to drugs and medicines taken internally,Nonspecific abnormal results of other endocrine function study,Hyposmolality and/or hyponatremia,Other specified cardiac dysrhythmias,Asthma, unspecified type, unspecified'}
