CHIEF COMPLAINT: 81 y.o. man with PMHx significant for perforated diverticulum
and iliopsoas abscess presented with 2 day history of fever.

PRESENT ILLNESS: Pt. presented to the [**Hospital1 18**] ED from [**Hospital1 102355**].  The patient had been diagnosed with diverticulitis and
left iliopsoas abscess in [**2178-8-31**].  The abscess was
drained; culture of abscess fluid revealed ampicillin-sensitive
enterococcus.  He subsequently developed sepsis syndrome
warranting redrainage of the abscess in [**10-5**]; culture of abscess
fluid at this time revealed VRE, citrobacter, and C tropicalis.
After the appropriate antibiotic course, the patient was
discharged to [**Hospital **] Rehabilitation.  The drain was removed on
[**2178-11-4**] once CT revealed resolution of the abscess.

MEDICAL HISTORY: CAD, HTN, hyperlipidemia, diverticular abscess, atrial
fibrillation, bilateral DVT/PE, rheumatoid arthritis, GI bleed.

MEDICATION ON ADMISSION: ASA 325, Protonix 40, Prednisone 5, Lopressor 25 [**Hospital1 **], Lasix 20,
NPH 4 QAM/SSIR, Nitroglycerin prn

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: T: 102.8 HR 115 BP 122/75 RR 33 O2sat 97

FAMILY HISTORY: Noncontributory.

SOCIAL HISTORY: No etoh, no tob, resided at [**Hospital **] Rehabilitation, previously
lived w/ wife (who is unofficial HCP).
Psoas muscle abscess,Atrial fibrillation,Acute myocardial infarction of other inferior wall, initial episode of care,Diverticulitis of colon (without mention of hemorrhage),Coronary atherosclerosis of native coronary artery,Unspecified essential hypertension,Other and unspecified hyperlipidemia,Rheumatoid arthritis
Psoas muscle abscess,Atrial fibrillation,AMI inferior wall, init,Dvrtcli colon w/o hmrhg,Crnry athrscl natve vssl,Hypertension NOS,Hyperlipidemia NEC/NOS,Rheumatoid arthritis
Admission Date:  [**2178-11-12**]              Discharge Date:   [**2178-11-25**]


Service: SURGERY

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 1481**]
Chief Complaint:
81 y.o. man with PMHx significant for perforated diverticulum
and iliopsoas abscess presented with 2 day history of fever.

Major Surgical or Invasive Procedure:
CT-guided percutaneous drain placement of diverticular abscess.


History of Present Illness:
Pt. presented to the [**Hospital1 18**] ED from [**Hospital1 102355**].  The patient had been diagnosed with diverticulitis and
left iliopsoas abscess in [**2178-8-31**].  The abscess was
drained; culture of abscess fluid revealed ampicillin-sensitive
enterococcus.  He subsequently developed sepsis syndrome
warranting redrainage of the abscess in [**10-5**]; culture of abscess
fluid at this time revealed VRE, citrobacter, and C tropicalis.
After the appropriate antibiotic course, the patient was
discharged to [**Hospital **] Rehabilitation.  The drain was removed on
[**2178-11-4**] once CT revealed resolution of the abscess.

The patient returned on [**11-12**] with a 2 day history of fevers to
102.8F.  He complained of nausea/vomiting times 2 at
presentation but denied bloody emesis.  He denied
pelvic/abdominal pain, chills, shakes, loss of consciousness,
shortness of breath, bright red blood per rectum, or melena. He
was transferred from [**Hospital1 **] for evaluation and suspected
recurrence of the abscess.

Past Medical History:
CAD, HTN, hyperlipidemia, diverticular abscess, atrial
fibrillation, bilateral DVT/PE, rheumatoid arthritis, GI bleed.

Social History:
No etoh, no tob, resided at [**Hospital **] Rehabilitation, previously
lived w/ wife (who is unofficial HCP).

Family History:
Noncontributory.

Physical Exam:
T: 102.8 HR 115 BP 122/75 RR 33 O2sat 97

Constitutional: Pt. lying down.  In mild respiratory distress.
AOx4.
HEENT: PERRL, decreased right lateral rectus muscle function,
NCAT. Decreased neck ROM (unable to fully turn neck to right
secondary to stiffness).  No pain on palpation.  Non-tender
nodes. Question of yellow fungal growth on tongue.
Chest: bilateral rales in lower lobes; decreased breath sounds.
CV: No JVD, no carotid bruits detected, 1-2/6 midsystolic
murmur, otherwise nl S1, S2
Abdomen: Nontender, nondistended, normal bowel sounds.
GU: No pelvic pain, flank/CVA pain on palpation.  Closed wound
at left flank. No erythema, no pus.
MSK: Non-erythematous.  No pedal edema.
Skin: Petechiae on lower extremities bilaterally.
Neuro: CN II-XII grossly intact.


Pertinent Results:
[**2178-11-12**] 06:18PM   PT-13.7* PTT-25.3 INR(PT)-1.3
[**2178-11-12**] 06:18PM   PLT COUNT-199
[**2178-11-12**] 06:18PM   ANISOCYT-2+ MACROCYT-3+
[**2178-11-12**] 06:18PM   NEUTS-84.7* LYMPHS-11.3* MONOS-2.9 EOS-0.7
BASOS-0.3
[**2178-11-12**] 06:18PM   WBC-12.3*# RBC-3.78* HGB-12.3* HCT-36.1*
MCV-96 MCH-32.6* MCHC-34.1 RDW-20.2*
[**2178-11-12**] 06:18PM   GLUCOSE-137* UREA N-61* CREAT-1.4* SODIUM-137
POTASSIUM-5.8* CHLORIDE-102 TOTAL CO2-23 ANION GAP-18
[**2178-11-12**] 06:40PM   LACTATE-3.2*
[**2178-11-12**] 07:30PM URINE  HYALINE-0-2
[**2178-11-12**] 07:30PM URINE  RBC-0-2 WBC-0-2 BACTERIA-MOD YEAST-NONE
EPI-0-2
[**2178-11-12**] 07:30PM URINE  BLOOD-NEG NITRITE-NEG PROTEIN-TR
GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-5.0
LEUK-NEG
[**2178-11-12**] 07:30PM URINE  COLOR-Yellow APPEAR-Clear SP [**Last Name (un) 155**]-1.021
[**2178-11-12**] 11:57PM   K+-5.5*

Brief Hospital Course:
Mr. [**Known lastname 50388**] was admitted to the Crimson Colorectal Surgery
Service after transport from ED and was evaluated as a candidate
for colostomy and colectomy.  He was placed on telemetry, and
was kept NPO with intravenous administration of linezolid,
metronidazole, levofloxacin, and fluconazole.  On HD 2, he
underwent CT-guided placement of a pigtail catheter in his left
lower abdominal quadrant and drainage of 50 cc from the
recurrent iliopsoas abscess; cultures subsequently revealed
pseudomonas, coagulase negative staph aureus, and probable
enterococcus.  He was restarted on a regular diet on HD 3.  On
HD 5, the patient spiked a fever to 103.6, with tachycardia to
the 80's, occasional PVC's, and hypotension (SPB 100-120).  He
was immediately transferred to the Surgical Intensive Care Unit;
subsequent blood culture grew enterococcus in 1 of 3 bottles.
Cardiology work-up on HD 6 revealed an evolving apical MI.  At
this time, the patient was deemed an inappropriate surgical
candidate and his surgery was cancelled.  He was transferred off
the SICU on HD 6 with continued drainage of fluid from his
pigtail catheter.  The drain was repositioned by IR on HD 8, and
upsized on HD 12 to expedite drainage.  The patient will be
discharged to [**Hospital **] Rehabilitation on HD 14 with a PICC line
for long-term IV antibiotic administration.

Medications on Admission:
ASA 325, Protonix 40, Prednisone 5, Lopressor 25 [**Hospital1 **], Lasix 20,
NPH 4 QAM/SSIR, Nitroglycerin prn

Discharge Medications:
1. Heparin (Porcine) 5,000 unit/mL Solution Sig: One (1)
Injection TID (3 times a day).
2. Acetaminophen 325 mg Tablet Sig: One (1) Tablet PO Q4-6H
(every 4 to 6 hours) as needed.
3. Aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable
PO DAILY (Daily).
4. Atorvastatin 10 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
5. Lisinopril 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).

6. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO BID
(2 times a day).
7. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One
(1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours).
8. Potassium & Sodium Phosphates [**Telephone/Fax (3) 4228**] mg Packet Sig: One
(1) Packet PO BID (2 times a day).
9. Methylprednisolone Sodium Succ 1,000 mg/8 mL Recon Soln Sig:
One (1) Recon Soln Injection Q24H (every 24 hours).
10. Heparin Lock Flush (Porcine) 100 unit/mL Syringe Sig: One
(1) ML Intravenous  DAILY (Daily) as needed.
11. Morphine 2 mg/mL Syringe Sig: One (1) ml Injection Q4H
(every 4 hours) as needed for pain. ml
12. Linezolid 600 mg Tablet Sig: One (1) Tablet PO twice a day
for 2 weeks.
13. Fluconazole 100 mg Tablet Sig: One (1) Tablet PO once a day
for 2 weeks.
14. Sodium Chloride 0.9 % Parenteral Solution Sig: Three (3) ML
Intravenous  DAILY (Daily) as needed: Peripheral IV flush as
needed.
15. Insulin Regular Human 100 unit/mL Solution Sig: One (1) per
attached Injection ASDIR (AS DIRECTED).


Discharge Disposition:
Extended Care

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

Discharge Diagnosis:
Diverticulitis


Discharge Condition:
Stable.


Discharge Instructions:
Please call or return if you have a fever >101.4, severe pain,
persistent nausea, vomiting, diarrhea, or constipation.

Followup Instructions:
Please see Dr. [**Last Name (STitle) **] in 2 weeks. Call [**Telephone/Fax (1) 2981**] for an
appointment.

Please follow up with your primary care doctor as directed.



Completed by:[**2178-11-25**]

Name:  [**Known lastname 9333**],[**Known firstname **]                   Unit No:   [**Numeric Identifier 16517**]

Admission Date:  [**2178-11-12**]              Discharge Date:   [**2178-11-25**]

Date of Birth:  [**2097-5-6**]             Sex:   M

Service: SURGERY

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 203**]
Addendum:
Patient was also discharged on Meropenem 1g q8h x 2 weeks.

Discharge Disposition:
Extended Care

Facility:
[**Hospital3 14**] & Rehab Center - [**Hospital1 15**]

                             [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 206**] MD [**MD Number(1) 207**]

Completed by:[**2178-11-25**]
{'Psoas muscle abscess,Atrial fibrillation,Acute myocardial infarction of other inferior wall, initial episode of care,Diverticulitis of colon (without mention of hemorrhage),Coronary atherosclerosis of native coronary artery,Unspecified essential hypertension,Other and unspecified hyperlipidemia,Rheumatoid arthritis'}


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: 81 y.o. man with PMHx significant for perforated diverticulum
and iliopsoas abscess presented with 2 day history of fever.

PRESENT ILLNESS: Pt. presented to the [**Hospital1 18**] ED from [**Hospital1 102355**].  The patient had been diagnosed with diverticulitis and
left iliopsoas abscess in [**2178-8-31**].  The abscess was
drained; culture of abscess fluid revealed ampicillin-sensitive
enterococcus.  He subsequently developed sepsis syndrome
warranting redrainage of the abscess in [**10-5**]; culture of abscess
fluid at this time revealed VRE, citrobacter, and C tropicalis.
After the appropriate antibiotic course, the patient was
discharged to [**Hospital **] Rehabilitation.  The drain was removed on
[**2178-11-4**] once CT revealed resolution of the abscess.

MEDICAL HISTORY: CAD, HTN, hyperlipidemia, diverticular abscess, atrial
fibrillation, bilateral DVT/PE, rheumatoid arthritis, GI bleed.

MEDICATION ON ADMISSION: ASA 325, Protonix 40, Prednisone 5, Lopressor 25 [**Hospital1 **], Lasix 20,
NPH 4 QAM/SSIR, Nitroglycerin prn

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: T: 102.8 HR 115 BP 122/75 RR 33 O2sat 97

FAMILY HISTORY: Noncontributory.

SOCIAL HISTORY: No etoh, no tob, resided at [**Hospital **] Rehabilitation, previously
lived w/ wife (who is unofficial HCP). 

### Response:
{'Psoas muscle abscess,Atrial fibrillation,Acute myocardial infarction of other inferior wall, initial episode of care,Diverticulitis of colon (without mention of hemorrhage),Coronary atherosclerosis of native coronary artery,Unspecified essential hypertension,Other and unspecified hyperlipidemia,Rheumatoid arthritis'}
