CHIEF COMPLAINT: CHANGE IN MENTAL STATUS, UTI, SEPTIC SHOULDER

PRESENT ILLNESS: 86 y.o. female.  Admission in mid [**Month (only) **] for septic left
shoulder(MRSA), discharged to rehab on Vanco via PICC and now
presents (after an initial work-up at [**Hospital6 **]) with
change in mental status, dislocated left shoulder, and decreased
urinary output.  She was transferred at the request of her
daughter given that she receives most of her care at [**Hospital1 18**].  She
was A/Ox3 at home. She was found to have +UTI, 6 of 6 bottles of
gram negative rods, Negative Head CT. Vancomycin was continued
dosed by level and levofloxacin given empirically.  Her shoulder
pain responded well to low dose morphine.  On [**7-13**] went to
surgery for shoulder debridement, irrigation and placement.  On
[**7-14**]  transferred to MICU overnight for hypotension, GI bleed
(had guaiac + black stool), refused c-scope, now Guaiac
negative. Gram negative rods determined to be Enterobacter, [**7-15**]
meropenem started.  Pt's mental status markely improved
throughout the course of the Abx and post-surgical intervention.
 She will needed extended Abx tx as an outpt and significant PT
follow-up for her shoulder.  To be placed in Rehab.

MEDICAL HISTORY: CAD (MIBI reversible defect ant/apical not intervened)
CHF (EF 55% with diastolic failure from HTN)
Afib (now in sinus on amio)
CRI (BLC 1.7)
Venous stasis, DVT (s/p IVC filter)
LGIB, diverticulosis
Left Hip replacement
Right TKR
pacer

MEDICATION ON ADMISSION: Nitroglycerin SL 0.3 mg SL ASDIR one tab q5min prn for chest
pain nte 3 tabs
Pantoprazole 40 mg PO Q24H
Nystatin Oral Suspension 5 ml PO QID
Sarna Lotion 1 Appl TP TID
Lumigan 1 drop OD qhs
Amiodarone HCl 200 mg PO QD
Metoprolol 25 mg PO BID
Simvastatin 40 mg PO QD
Polysaccharide Iron Complex 150 mg PO QD
Docusate Sodium 100 mg PO BID
Senna 1 TAB PO BID:PRN
Bisacodyl 10 mg PO QD:PRN
Aspirin 325 mg PO QD

ALLERGIES: Oxycodone

PHYSICAL EXAM: T97.3, BP106/72, P80, R18, O2sat100%RA
HEENT:  left eye cataract, EOMI, right eye PERRL, poor
dentition, No OP erythema, no LAD
CHEST:  CTAB anteriorly
HEART:  RRR, NL S1/S2
ABD:  obese, BS+, NT, ND
EXT:  1+ pitting edema b/l, left anterior shoulder dislocation,
warm, pulses 2+ (radial,DP)
NEURO:  AxOx1, 5+ strength throughout(except left upper
extremity could not be examined secondary to pain), reflexes 2+
throughout (except left upper extremity could not be examined
secondary to pain).  Difficult to assess Pt's sensation given MS
change.

FAMILY HISTORY: unsure of parent's cause of death

SOCIAL HISTORY: Lives in [**Location **].  Family very involved in her care.  No ETOH, Tob,
drugs.  Enjoys gospel music and church.
Other septicemia due to gram-negative organisms,Pyogenic arthritis, shoulder region,Candidiasis of mouth,Diastolic heart failure, unspecified,Atrial fibrillation,Urinary tract infection, site not specified,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage V or end stage renal disease,Diverticulosis of colon with hemorrhage
Gram-neg septicemia NEC,Pyogen arthritis-shlder,Thrush,Diastolc hrt failure NOS,Atrial fibrillation,Urin tract infection NOS,Hyp kid NOS w cr kid V,Dvrtclo colon w hmrhg
Admission Date:  [**2123-7-8**]              Discharge Date:   [**2123-7-23**]


Service: MED

Allergies:
Oxycodone

Attending:[**First Name3 (LF) 3513**]
Chief Complaint:
CHANGE IN MENTAL STATUS, UTI, SEPTIC SHOULDER

Major Surgical or Invasive Procedure:
PROCEDURE: Attempted closed reduction, left glenohumeral
joint. Irrigation and debridement, open, of left glenohumeral
joint
Open anterior reconstruction, left shoulder (modified Bankart
procedure).


History of Present Illness:
86 y.o. female.  Admission in mid [**Month (only) **] for septic left
shoulder(MRSA), discharged to rehab on Vanco via PICC and now
presents (after an initial work-up at [**Hospital6 **]) with
change in mental status, dislocated left shoulder, and decreased
urinary output.  She was transferred at the request of her
daughter given that she receives most of her care at [**Hospital1 18**].  She
was A/Ox3 at home. She was found to have +UTI, 6 of 6 bottles of
gram negative rods, Negative Head CT. Vancomycin was continued
dosed by level and levofloxacin given empirically.  Her shoulder
pain responded well to low dose morphine.  On [**7-13**] went to
surgery for shoulder debridement, irrigation and placement.  On
[**7-14**]  transferred to MICU overnight for hypotension, GI bleed
(had guaiac + black stool), refused c-scope, now Guaiac
negative. Gram negative rods determined to be Enterobacter, [**7-15**]
meropenem started.  Pt's mental status markely improved
throughout the course of the Abx and post-surgical intervention.
 She will needed extended Abx tx as an outpt and significant PT
follow-up for her shoulder.  To be placed in Rehab.

Past Medical History:
CAD (MIBI reversible defect ant/apical not intervened)
CHF (EF 55% with diastolic failure from HTN)
Afib (now in sinus on amio)
CRI (BLC 1.7)
Venous stasis, DVT (s/p IVC filter)
LGIB, diverticulosis
Left Hip replacement
Right TKR
pacer

Social History:
Lives in [**Location **].  Family very involved in her care.  No ETOH, Tob,
drugs.  Enjoys gospel music and church.

Family History:
unsure of parent's cause of death

Physical Exam:
T97.3, BP106/72, P80, R18, O2sat100%RA
HEENT:  left eye cataract, EOMI, right eye PERRL, poor
dentition, No OP erythema, no LAD
CHEST:  CTAB anteriorly
HEART:  RRR, NL S1/S2
ABD:  obese, BS+, NT, ND
EXT:  1+ pitting edema b/l, left anterior shoulder dislocation,
warm, pulses 2+ (radial,DP)
NEURO:  AxOx1, 5+ strength throughout(except left upper
extremity could not be examined secondary to pain), reflexes 2+
throughout (except left upper extremity could not be examined
secondary to pain).  Difficult to assess Pt's sensation given MS
change.

Pertinent Results:
[**2123-7-8**] 12:24AM   LACTATE-1.9
[**2123-7-8**] 11:11AM   SED RATE-125*
[**2123-7-8**] 11:11AM   PT-13.9* PTT-29.9 INR(PT)-1.3
[**2123-7-8**] 11:11AM   PLT COUNT-373
[**2123-7-8**] 11:11AM   WBC-9.0 RBC-3.10* HGB-9.1* HCT-29.3* MCV-95
MCH-29.2 MCHC-30.9* RDW-14.2
[**2123-7-8**] 11:11AM   VANCO-24.0*
[**2123-7-8**] 11:11AM   CRP-24.01*
[**2123-7-8**] 11:11AM   ALBUMIN-2.3* CALCIUM-8.7 PHOSPHATE-4.0
MAGNESIUM-1.8
[**2123-7-8**] 11:11AM   GLUCOSE-79 UREA N-56* CREAT-2.2*# SODIUM-135
POTASSIUM-4.0 CHLORIDE-99 TOTAL CO2-21* ANION GAP-19
[**2123-7-8**] 11:55AM URINE  RBC->1000* WBC-0 BACTERIA-NONE
YEAST-MANY EPI-0
[**2123-7-8**] 11:55AM URINE  BLOOD-LGE NITRITE-NEG PROTEIN-30
GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-6.5
LEUK-SM
[**2123-7-8**] 11:55AM URINE  COLOR-BROWN APPEAR-Cloudy SP [**Last Name (un) 155**]-1.020

[**2123-7-8**] Blood Cx:  ENTEROBACTER CLOACAE 1 of 1 bottles
[**2123-7-9**] Blood Cx:  ENTEROBACTER CLOACAE 2 of 2 bottles
[**2123-7-10**] Blood Cx:  no growth
[**2123-7-17**] Blood Cx:  pending

Sensitivities             set1      set2        set3
CEFEPIME--------------    16 I      <=1 S        2 S
CEFTAZIDIME-----------    32 R      =>2 S        4 S
CEFTRIAXONE-----------  =>64 R     =>64 R     =>64 R
CIPROFLOXACIN---------                2 I      =>4 R
GENTAMICIN------------   <=1 S        4 S     =>16 R
LEVOFLOXACIN----------     1 S        4 I        4 I
MEROPENEM-------------   0.5 S   <=0.25 S   <=0.25 S
PIPERACILLIN---------- =>128 R    =>128 R    =>128 R
TOBRAMYCIN------------     8 I        8 I     =>16 R
TRIMETHOPRIM/SULFA----  =>16 R     =>16 R     =>16 R

[**2123-7-9**] Shoulder Joint Cx:  ENTEROBACTER CLOACAE

SENSITIVITIES: MIC expressed in MCG/ML
CEFEPIME--------------   <=1 S
CEFTAZIDIME-----------     4 S
CEFTRIAXONE-----------    32 I
CIPROFLOXACIN---------     2 I
GENTAMICIN------------     8 I
MEROPENEM-------------<=0.25 S
PIPERACILLIN---------- =>128 R
TOBRAMYCIN------------  =>16 R
TRIMETHOPRIM/SULFA----  =>16 R

[**2123-7-8**] URINE CULTURE (Final [**2123-7-9**]): YEAST.
10,000-100,000 ORGANISMS/ML
[**2123-7-9**] URINE CULTURE (Final [**2123-7-10**]): YEAST.
10,000-100,000 ORGANISMS/ML
LT. SHOULDER MRSA PT WAS ON VANCO,MEREPENIM,& KEFZOL.

[**2123-7-13**] Shoulder swab:  GRAM STAIN (Final [**2123-7-13**]): 2+ ([**1-11**]
per 1000X FIELD):   POLYMORPHONUCLEAR LEUKOCYTES. NO
MICROORGANISMS SEEN. WOUND CULTURE (Final [**2123-7-15**]): NO GROWTH.
ANAEROBIC CULTURE (Preliminary): NO GROWTH



Brief Hospital Course:
This is an 86 year-old female recently admitted in mid [**Month (only) **] with
septic L shoulder (coag + staph) on vanco via Picc, s/p left
shoulder washout and TEE negative for endocarditis.  Admitted
from [**Hospital1 756**] after found to have UTI and altered MS and
transferred here at request of daughter and found to have L
shoulder dislocation, reduced 1 at [**Hospital1 112**] and 2 at [**Hospital1 18**] ED.  At
nursing facility patient also found to have altered mental
status, decreased urine output, and azotemia.

Mental status change/ID: Subsequently, patient found to have
Enterobacter bacteremia with sensitivity only to meropenam.
Patient's mental status improved significantly with IV
antibiotics with some baseline waxing and [**Doctor Last Name 688**].  Recently Mrs.
[**Known lastname 101651**], in addition to her medical issues, suffered the loss of
her husband.  This grieving and possible depression has lead to
some withdrawal.  Would recommend appetitite stimulants,
possible anti-depressants at discretion of physicians at
[**Hospital1 **] to help with mentation.
 **Most importantly, patient will need continued vanco for MRSA
until [**2123-7-29**] and meropenem Enterobacter Cloace until [**2123-8-24**].
She has been blood culture surveillance negative since initial
cultures and has been afebrile with declining WBC.

Shoulder dislocation: s/p debridement, open anterior
reconstruction, and aspiration
of her left shoulder joint now in sling.  Patient's course has
been very complicated, with multiple dislocations, now a chronic
dislocation and severe pain.  Ortho at [**Hospital1 18**] feels that
continued surgical options are limited and recommend sling, with
good pain control.  Patient will need further evaluation, most
likely at [**Hospital6 **] for further options of
management.

CHF with EF 55% with diastolic dysfunction:  Patient with
respiratory distress during this admission.  Gentle diuresis of
Lasix 20 mg PO every other day has kept her in good fluid
balance.  Currently her blood pressure has dropped to 80's/40/s
with good response to fluid but she has maintained hemodynamic
stability after her GI bleed (see below)

GI bleed with anemia: patient hemodynamcially stable, with
stable crits after a brief lower Gi bleed, likely secondary to
diverticulosis -guaiac +, black stool, but patient did not want
colonoscopy.  Her goal crit is >30.

Atrial fibrillation: Has been in sinus on amio. Not on coumadin
secondary to Gi bleed.

CAD: h/o abnormal pMIBI in [**2120**]. Had intermittent Chest pain on
[**7-12**] with ECG demonstrating t-wave inversions in anterior leads.
Per cards fellow, patient was not ruled out, ASA held due to
bleed.  Beta-blocker maintained, with occasional holding for low
BP's. will not rule out. holding ASA secondary to bleed.  Now
stable, without chest pain or associated symptoms.

Pain: pain is now well controlled on current regimen.  Would
recommend continuation.

Nutrition: Patient with decreased PO intake over past 2 days
prior to discharge.  Likely secondary to grieving/depression
with loss of her husband.  Would consider appetite stimulants,
anti-depressants at discretion of treating physician at
[**Name9 (PRE) **]/Dr. [**First Name (STitle) 3510**].
Code status: DNR/DNI
Disposition: Patient to go to [**Hospital1 **] with close f/u with Dr.
[**First Name (STitle) 3510**].  She will likely need further eval by orthopoedics,
possibly at [**Hospital6 **] for further care of shoulder
dislocation.


Medications on Admission:
Nitroglycerin SL 0.3 mg SL ASDIR one tab q5min prn for chest
pain nte 3 tabs
Pantoprazole 40 mg PO Q24H
Nystatin Oral Suspension 5 ml PO QID
Sarna Lotion 1 Appl TP TID
Lumigan 1 drop OD qhs
Amiodarone HCl 200 mg PO QD
Metoprolol 25 mg PO BID
Simvastatin 40 mg PO QD
Polysaccharide Iron Complex 150 mg PO QD
Docusate Sodium 100 mg PO BID
Senna 1 TAB PO BID:PRN
Bisacodyl 10 mg PO QD:PRN
Aspirin 325 mg PO QD

Discharge Medications:
Vancomycin HCl 1000 mg IV Q48H
Meropenem 1000 mg IV Q12H
Pantoprazole 40 mg IV Q24H
Heparin 5000 UNIT SC Q12H
Nitroglycerin SL 0.3 mg SL ASDIR one tab q5min prn for chest
pain nte 3 tabs
Morphine Sulfate 0.5-2 mg IV Q3-4H:PRN
Nystatin Oral Suspension 5 ml PO QID
Sarna Lotion 1 Appl TP TID
Lumigan 1 drop OD qhs
Amiodarone HCl 200 mg PO QD
1. Vancomycin HCl 1000 mg IV Q48H
2. Amiodarone HCl 200 mg Tablet Sig: One (1) Tablet PO QD (once
a day).
Disp:*30 Tablet(s)* Refills:*2*
3. Bimatoprost 0.03 % Drops Sig: One (1) Drop Ophthalmic  qhs
().
Disp:*qs 1 month* Refills:*2*
4. Camphor-Menthol 0.5-0.5 % Lotion Sig: One (1) Appl Topical
TID (3 times a day) as needed.
Disp:*qs 1 month* Refills:*0*
5. Nystatin 100,000 unit/mL Suspension Sig: Five (5) ML PO QID
(4 times a day) as needed.
Disp:*qs 1 month* Refills:*0*
6. Nitroglycerin 0.3 mg Tablet, Sublingual Sig: One (1) Tablet,
Sublingual Sublingual ASDIR (AS DIRECTED).
Disp:*5 Tablet, Sublingual(s)* Refills:*2*
7. Heparin Sodium (Porcine) 5,000 unit/mL Solution Sig: One (1)
injection Injection Q12H (every 12 hours).
Disp:*60 injection* Refills:*2*
8. Morphine Sulfate 0.5-2 mg IV Q3-4H:PRN Pain
9. Pantoprazole 40 mg IV Q24H
10. Meropenem 1000 mg IV Q12H
11. Lasix 20 mg Tablet Sig: One (1) Tablet PO QOD.
Disp:*15 Tablet(s)* Refills:*2*
12. Morphine Sulfate 15 mg Tablet Sig: One (1) Tablet PO Q4-6H
(every 4 to 6 hours) as needed.
Disp:*30 Tablet(s)* Refills:*0*

1. Vancomycin HCl 1000 mg IV Q48H
2. Amiodarone HCl 200 mg Tablet Sig: One (1) Tablet PO QD (once
a day).
Disp:*30 Tablet(s)* Refills:*2*
3. Bimatoprost 0.03 % Drops Sig: One (1) Drop Ophthalmic  qhs
().
Disp:*qs 1 month* Refills:*2*
4. Camphor-Menthol 0.5-0.5 % Lotion Sig: One (1) Appl Topical
TID (3 times a day) as needed.
Disp:*qs 1 month* Refills:*0*
5. Nystatin 100,000 unit/mL Suspension Sig: Five (5) ML PO QID
(4 times a day) as needed.
Disp:*qs 1 month* Refills:*0*
6. Nitroglycerin 0.3 mg Tablet, Sublingual Sig: One (1) Tablet,
Sublingual Sublingual ASDIR (AS DIRECTED).
Disp:*5 Tablet, Sublingual(s)* Refills:*2*
7. Heparin Sodium (Porcine) 5,000 unit/mL Solution Sig: One (1)
injection Injection Q12H (every 12 hours).
Disp:*60 injection* Refills:*2*
8. Morphine Sulfate 0.5-2 mg IV Q3-4H:PRN Pain
9. Pantoprazole 40 mg IV Q24H
10. Meropenem 1000 mg IV Q12H
11. Lasix 20 mg Tablet Sig: One (1) Tablet PO QOD.
Disp:*15 Tablet(s)* Refills:*2*
12. Morphine Sulfate 15 mg Tablet Sig: One (1) Tablet PO Q4-6H
(every 4 to 6 hours) as needed.
Disp:*30 Tablet(s)* Refills:*0*

1. Vancomycin HCl 1000 mg IV Q48H
2. Amiodarone HCl 200 mg Tablet Sig: One (1) Tablet PO QD (once
a day).
Disp:*30 Tablet(s)* Refills:*2*
3. Bimatoprost 0.03 % Drops Sig: One (1) Drop Ophthalmic  qhs
().
Disp:*qs 1 month* Refills:*2*
4. Camphor-Menthol 0.5-0.5 % Lotion Sig: One (1) Appl Topical
TID (3 times a day) as needed.
Disp:*qs 1 month* Refills:*0*
5. Nystatin 100,000 unit/mL Suspension Sig: Five (5) ML PO QID
(4 times a day) as needed.
Disp:*qs 1 month* Refills:*0*
6. Nitroglycerin 0.3 mg Tablet, Sublingual Sig: One (1) Tablet,
Sublingual Sublingual ASDIR (AS DIRECTED).
Disp:*5 Tablet, Sublingual(s)* Refills:*2*
7. Heparin Sodium (Porcine) 5,000 unit/mL Solution Sig: One (1)
injection Injection Q12H (every 12 hours).
Disp:*60 injection* Refills:*2*
8. Morphine Sulfate 0.5-2 mg IV Q3-4H:PRN Pain
9. Pantoprazole 40 mg IV Q24H
10. Meropenem 1000 mg IV Q12H
11. Lasix 20 mg Tablet Sig: One (1) Tablet PO QOD.
Disp:*15 Tablet(s)* Refills:*2*
12. Morphine Sulfate 15 mg Tablet Sig: One (1) Tablet PO Q4-6H
(every 4 to 6 hours) as needed.
Disp:*30 Tablet(s)* Refills:*0*


Discharge Disposition:
Extended Care

Facility:
[**Hospital3 7**] & Rehab Center - [**Hospital1 8**]

Discharge Diagnosis:
Mental status change
Sepsis (shoulder + UTI)
shoulder dislocation
atrial fibrillation
coronary aretery disease,
hyperension


Discharge Condition:
stable

Discharge Instructions:
If Pt experiences significant mental status changes, CP, SOB,
palpitations, GI bleeding she should seek immediate medical
attention.



Followup Instructions:
--on MEROPENEM for ENTEROBACTER CLOACAE (6/6 bottles) continue
until [**2123-8-24**]
--on VANCOMYCIN for MRSA continue until [**2123-7-29**]
--check CBC w/ diff, creatinine, vanco trough, AST, ALT once a
week as outpt and Fax results Dr. [**Last Name (STitle) 17444**] ([**Telephone/Fax (1) 1419**])
--call/page Dr. [**Last Name (STitle) 17444**] before discharge so he can make f/u appt
in his clinic, he will follow the sensitivities to gram neg
rods.
{'Other septicemia due to gram-negative organisms,Pyogenic arthritis, shoulder region,Candidiasis of mouth,Diastolic heart failure, unspecified,Atrial fibrillation,Urinary tract infection, site not specified,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage V or end stage renal disease,Diverticulosis of colon with hemorrhage'}


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: CHANGE IN MENTAL STATUS, UTI, SEPTIC SHOULDER

PRESENT ILLNESS: 86 y.o. female.  Admission in mid [**Month (only) **] for septic left
shoulder(MRSA), discharged to rehab on Vanco via PICC and now
presents (after an initial work-up at [**Hospital6 **]) with
change in mental status, dislocated left shoulder, and decreased
urinary output.  She was transferred at the request of her
daughter given that she receives most of her care at [**Hospital1 18**].  She
was A/Ox3 at home. She was found to have +UTI, 6 of 6 bottles of
gram negative rods, Negative Head CT. Vancomycin was continued
dosed by level and levofloxacin given empirically.  Her shoulder
pain responded well to low dose morphine.  On [**7-13**] went to
surgery for shoulder debridement, irrigation and placement.  On
[**7-14**]  transferred to MICU overnight for hypotension, GI bleed
(had guaiac + black stool), refused c-scope, now Guaiac
negative. Gram negative rods determined to be Enterobacter, [**7-15**]
meropenem started.  Pt's mental status markely improved
throughout the course of the Abx and post-surgical intervention.
 She will needed extended Abx tx as an outpt and significant PT
follow-up for her shoulder.  To be placed in Rehab.

MEDICAL HISTORY: CAD (MIBI reversible defect ant/apical not intervened)
CHF (EF 55% with diastolic failure from HTN)
Afib (now in sinus on amio)
CRI (BLC 1.7)
Venous stasis, DVT (s/p IVC filter)
LGIB, diverticulosis
Left Hip replacement
Right TKR
pacer

MEDICATION ON ADMISSION: Nitroglycerin SL 0.3 mg SL ASDIR one tab q5min prn for chest
pain nte 3 tabs
Pantoprazole 40 mg PO Q24H
Nystatin Oral Suspension 5 ml PO QID
Sarna Lotion 1 Appl TP TID
Lumigan 1 drop OD qhs
Amiodarone HCl 200 mg PO QD
Metoprolol 25 mg PO BID
Simvastatin 40 mg PO QD
Polysaccharide Iron Complex 150 mg PO QD
Docusate Sodium 100 mg PO BID
Senna 1 TAB PO BID:PRN
Bisacodyl 10 mg PO QD:PRN
Aspirin 325 mg PO QD

ALLERGIES: Oxycodone

PHYSICAL EXAM: T97.3, BP106/72, P80, R18, O2sat100%RA
HEENT:  left eye cataract, EOMI, right eye PERRL, poor
dentition, No OP erythema, no LAD
CHEST:  CTAB anteriorly
HEART:  RRR, NL S1/S2
ABD:  obese, BS+, NT, ND
EXT:  1+ pitting edema b/l, left anterior shoulder dislocation,
warm, pulses 2+ (radial,DP)
NEURO:  AxOx1, 5+ strength throughout(except left upper
extremity could not be examined secondary to pain), reflexes 2+
throughout (except left upper extremity could not be examined
secondary to pain).  Difficult to assess Pt's sensation given MS
change.

FAMILY HISTORY: unsure of parent's cause of death

SOCIAL HISTORY: Lives in [**Location **].  Family very involved in her care.  No ETOH, Tob,
drugs.  Enjoys gospel music and church. 

### Response:
{'Other septicemia due to gram-negative organisms,Pyogenic arthritis, shoulder region,Candidiasis of mouth,Diastolic heart failure, unspecified,Atrial fibrillation,Urinary tract infection, site not specified,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage V or end stage renal disease,Diverticulosis of colon with hemorrhage'}
