chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 85.0
Sex: F
Vaccine: COVID19
Symptoms: Acute kidney injury, Blood creatinine increased, Blood urea increased, COVID-19, Condition aggravated
Clinical narrative: Covid + on 10/28/2021. Received Moderna with 1st dose on 03/06/2021 and 2nd dose 04/02/2021. Per H & P:  Active Diagnoses  Intractable diarrhea which is now become chronic?consult gastroenterologist start Rocephin and Flagyl by intravenous line  COVID-19?ID evaluation we will not place on steroids as she has no signs of pneumonia or respiratory distress and probably has had this for at least a few weeks  Severe life-threatening dehydration?IV fluids, serial BMP  Acute renal failure?IV fluids serial BMP consult nephrology  Hypertension?hold Norvasc bisoprolol and hydrochlorothiazide for now with renal failure and normal blood pressure  COPD?updrafts as needed continue Tudorza  Anxiety?continue Klonopin at bedtime as needed anemia of chronic illness-serial hemoglobin transfuse as needed  hx of lung ca Discussed with the patient and/or designated party the plan of care for the patient in the hospital.   I discussed the risk benefits and alternatives to plan treatment care and procedures.   Patient was given adequate time to verbalize questions and I answered them to the best of my ability.  I reviewed the recommendations by consultants and the patient understood these recommendations.  Reviewed the medical record/ patient is presently on  dvt prophylaxis as appropriate.    Reviewed activity level and encourage the patient to participate in therapy service based on the recommendations.   The patient's diet was reviewed -recommended and adjusted appropriately for the patient's recovery and nutritional support..   Chief Complaint  Evaluation management of intractable diarrhea, renal failure, dehydration History of Present Illness  Is an 86-year-old female with past medical history of hypertension COPD and lung cancer.  For the last few weeks she has been having watery diarrhea.  She was sent in with abnormal labs.  Upon presentation her BUN was 40 with a creatinine of 1.82.  She also had nasopharyngeal swab that tested positive for COVID-19.  She admits to being vaccinated already.  She said she had sick contacts in her house.  She denies any fever or chills.  She says her diarrhea is improved since arriving to the hospital.  She denies abdominal pain.  I spoke to the emergency room physician and coordinate care reviewed all chart records and the patient was admitted to my service
Age: 85.0
Sex: F
Vaccine: COVID19
Symptoms: Dehydration, Diarrhoea, Laboratory test abnormal, Metabolic function test, SARS-CoV-2 test positive
Clinical narrative: Covid + on 10/28/2021. Received Moderna with 1st dose on 03/06/2021 and 2nd dose 04/02/2021. Per H & P:  Active Diagnoses  Intractable diarrhea which is now become chronic?consult gastroenterologist start Rocephin and Flagyl by intravenous line  COVID-19?ID evaluation we will not place on steroids as she has no signs of pneumonia or respiratory distress and probably has had this for at least a few weeks  Severe life-threatening dehydration?IV fluids, serial BMP  Acute renal failure?IV fluids serial BMP consult nephrology  Hypertension?hold Norvasc bisoprolol and hydrochlorothiazide for now with renal failure and normal blood pressure  COPD?updrafts as needed continue Tudorza  Anxiety?continue Klonopin at bedtime as needed anemia of chronic illness-serial hemoglobin transfuse as needed  hx of lung ca Discussed with the patient and/or designated party the plan of care for the patient in the hospital.   I discussed the risk benefits and alternatives to plan treatment care and procedures.   Patient was given adequate time to verbalize questions and I answered them to the best of my ability.  I reviewed the recommendations by consultants and the patient understood these recommendations.  Reviewed the medical record/ patient is presently on  dvt prophylaxis as appropriate.    Reviewed activity level and encourage the patient to participate in therapy service based on the recommendations.   The patient's diet was reviewed -recommended and adjusted appropriately for the patient's recovery and nutritional support..   Chief Complaint  Evaluation management of intractable diarrhea, renal failure, dehydration History of Present Illness  Is an 86-year-old female with past medical history of hypertension COPD and lung cancer.  For the last few weeks she has been having watery diarrhea.  She was sent in with abnormal labs.  Upon presentation her BUN was 40 with a creatinine of 1.82.  She also had nasopharyngeal swab that tested positive for COVID-19.  She admits to being vaccinated already.  She said she had sick contacts in her house.  She denies any fever or chills.  She says her diarrhea is improved since arriving to the hospital.  She denies abdominal pain.  I spoke to the emergency room physician and coordinate care reviewed all chart records and the patient was admitted to my service
Age: 83.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19, COVID-19 pneumonia, Dyspnoea, Hypoxia, SARS-CoV-2 test positive
Clinical narrative: worsening shortness of breath symptoms.
Age: 89.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect dose administered
Clinical narrative: Patient was given .5ml instead of the recommended .25ml
Age: 27.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, Dyspnoea, Headache, Impaired work ability, Influenza
Clinical narrative: At about 10 hours after injection, woke up feeling like severe flu symptoms: pain and weakness all over body, slight shortness of breath, headache, sensitive skin. So severe I could not go to work. This lasted until about 25 hours after injection, then all symptoms subsided quickly within 2 hours.
Age: 27.0
Sex: M
Vaccine: COVID19
Symptoms: Pain, Sensitive skin
Clinical narrative: At about 10 hours after injection, woke up feeling like severe flu symptoms: pain and weakness all over body, slight shortness of breath, headache, sensitive skin. So severe I could not go to work. This lasted until about 25 hours after injection, then all symptoms subsided quickly within 2 hours.
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Acute kidney injury, Addison's disease, Anticoagulant therapy, Atrial fibrillation, Blood culture positive
Clinical narrative: 69 y.o. female being admitted to the medical intensive care unit with new diagnosis of COVID pneumonia, septic shock in the setting of multiple medical problems   The history is obtained from speaking to Patient and her husband at the bedside.  The patient is a 68 year old female history of AS s/p TAVR, Afib on eliquis, OSA/OHS on CPAP, pulm HTN, COPD on 2L oxygen at baseline, DM, Adrenal insufficiency, complex LLE with multiple joint/hardware infections.     She was recently admitted here at Hospital from 09/09/2021 through 09/22/2021 for VRE hardware infection of left lower extremity requiring drain placement and antibiotics.  She presented to Medical Center on 9/9 with fevers and dyspnea. CXR noted pulmonary infiltrates. Patient found to be hypotensive thus given fluid resuscitation and started on norepinephrine. Cultures obtained and empiric abx added. She was transferred to the Intensive Care where she was quickly weaned off norepinephrine. She underwent CT imaging of the LLE showing new large fluid-density collection in the lateral thigh adjacent to the area of postsurgical change. IR consulted for drain placement on 09/11/2021, brown drainage noted and cultures  revealed vancomycin-resistant Enterococcus.  She was transitioned off NE and midodrine was started.  She was ultimately transferred to the hospitalist service.  Other issues during her hospital stay included atrial fibrillation with rapid ventricular response treated with beta-blockers and anticoagulation; troponin leak due to demand ischemia; new left bundle branch block; diastolic congestive heart failure, acute on chronic, with volume overload.  She required hydrocortisone for Addison's disease.  A drain was left in place to drain her complicated left lower extremity hardware for infection, with cultures ultimately growing VRE.  She was ultimately transitioned to chronic suppressive therapy with amoxicillin.     She presents to the emergency room today 10/25/2021 with shortness of breath and cough.  She is also experienced fever to 101 F, significant fatigue, loss of appetite, and diarrhea.  Her husband tells me symptoms have been present for about 1.5 weeks; about 2 weeks ago, she went camping and ?did fine?.  She was hypotensive with a blood pressure as low as 50s over 20s.  She has been started on norepinephrine and responds well to low-dose, currently at 0.02, although two efforts at weaning this off the emergency room have been unsuccessful, with rather abrupt drop in her blood pressure and associated worsening in her mentation.  Chest radiograph showed patchy bilateral airspace disease.  She tested positive for COVID.  She has been treated with empiric broad-spectrum antibiotics, including Zosyn, doxycycline, and vancomycin.   Patient is a fairly limited historian at this time due to clinical condition
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Blood pressure decreased, Bundle branch block left, COVID-19, COVID-19 pneumonia, Cardiac failure acute
Clinical narrative: 69 y.o. female being admitted to the medical intensive care unit with new diagnosis of COVID pneumonia, septic shock in the setting of multiple medical problems   The history is obtained from speaking to Patient and her husband at the bedside.  The patient is a 68 year old female history of AS s/p TAVR, Afib on eliquis, OSA/OHS on CPAP, pulm HTN, COPD on 2L oxygen at baseline, DM, Adrenal insufficiency, complex LLE with multiple joint/hardware infections.     She was recently admitted here at Hospital from 09/09/2021 through 09/22/2021 for VRE hardware infection of left lower extremity requiring drain placement and antibiotics.  She presented to Medical Center on 9/9 with fevers and dyspnea. CXR noted pulmonary infiltrates. Patient found to be hypotensive thus given fluid resuscitation and started on norepinephrine. Cultures obtained and empiric abx added. She was transferred to the Intensive Care where she was quickly weaned off norepinephrine. She underwent CT imaging of the LLE showing new large fluid-density collection in the lateral thigh adjacent to the area of postsurgical change. IR consulted for drain placement on 09/11/2021, brown drainage noted and cultures  revealed vancomycin-resistant Enterococcus.  She was transitioned off NE and midodrine was started.  She was ultimately transferred to the hospitalist service.  Other issues during her hospital stay included atrial fibrillation with rapid ventricular response treated with beta-blockers and anticoagulation; troponin leak due to demand ischemia; new left bundle branch block; diastolic congestive heart failure, acute on chronic, with volume overload.  She required hydrocortisone for Addison's disease.  A drain was left in place to drain her complicated left lower extremity hardware for infection, with cultures ultimately growing VRE.  She was ultimately transitioned to chronic suppressive therapy with amoxicillin.     She presents to the emergency room today 10/25/2021 with shortness of breath and cough.  She is also experienced fever to 101 F, significant fatigue, loss of appetite, and diarrhea.  Her husband tells me symptoms have been present for about 1.5 weeks; about 2 weeks ago, she went camping and ?did fine?.  She was hypotensive with a blood pressure as low as 50s over 20s.  She has been started on norepinephrine and responds well to low-dose, currently at 0.02, although two efforts at weaning this off the emergency room have been unsuccessful, with rather abrupt drop in her blood pressure and associated worsening in her mentation.  Chest radiograph showed patchy bilateral airspace disease.  She tested positive for COVID.  She has been treated with empiric broad-spectrum antibiotics, including Zosyn, doxycycline, and vancomycin.   Patient is a fairly limited historian at this time due to clinical condition
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Cardiac failure congestive, Chest X-ray abnormal, Computerised tomogram abnormal, Condition aggravated, Cough
Clinical narrative: 69 y.o. female being admitted to the medical intensive care unit with new diagnosis of COVID pneumonia, septic shock in the setting of multiple medical problems   The history is obtained from speaking to Patient and her husband at the bedside.  The patient is a 68 year old female history of AS s/p TAVR, Afib on eliquis, OSA/OHS on CPAP, pulm HTN, COPD on 2L oxygen at baseline, DM, Adrenal insufficiency, complex LLE with multiple joint/hardware infections.     She was recently admitted here at Hospital from 09/09/2021 through 09/22/2021 for VRE hardware infection of left lower extremity requiring drain placement and antibiotics.  She presented to Medical Center on 9/9 with fevers and dyspnea. CXR noted pulmonary infiltrates. Patient found to be hypotensive thus given fluid resuscitation and started on norepinephrine. Cultures obtained and empiric abx added. She was transferred to the Intensive Care where she was quickly weaned off norepinephrine. She underwent CT imaging of the LLE showing new large fluid-density collection in the lateral thigh adjacent to the area of postsurgical change. IR consulted for drain placement on 09/11/2021, brown drainage noted and cultures  revealed vancomycin-resistant Enterococcus.  She was transitioned off NE and midodrine was started.  She was ultimately transferred to the hospitalist service.  Other issues during her hospital stay included atrial fibrillation with rapid ventricular response treated with beta-blockers and anticoagulation; troponin leak due to demand ischemia; new left bundle branch block; diastolic congestive heart failure, acute on chronic, with volume overload.  She required hydrocortisone for Addison's disease.  A drain was left in place to drain her complicated left lower extremity hardware for infection, with cultures ultimately growing VRE.  She was ultimately transitioned to chronic suppressive therapy with amoxicillin.     She presents to the emergency room today 10/25/2021 with shortness of breath and cough.  She is also experienced fever to 101 F, significant fatigue, loss of appetite, and diarrhea.  Her husband tells me symptoms have been present for about 1.5 weeks; about 2 weeks ago, she went camping and ?did fine?.  She was hypotensive with a blood pressure as low as 50s over 20s.  She has been started on norepinephrine and responds well to low-dose, currently at 0.02, although two efforts at weaning this off the emergency room have been unsuccessful, with rather abrupt drop in her blood pressure and associated worsening in her mentation.  Chest radiograph showed patchy bilateral airspace disease.  She tested positive for COVID.  She has been treated with empiric broad-spectrum antibiotics, including Zosyn, doxycycline, and vancomycin.   Patient is a fairly limited historian at this time due to clinical condition
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Culture positive, Decreased appetite, Diarrhoea, Drain placement, Dyspnoea
Clinical narrative: 69 y.o. female being admitted to the medical intensive care unit with new diagnosis of COVID pneumonia, septic shock in the setting of multiple medical problems   The history is obtained from speaking to Patient and her husband at the bedside.  The patient is a 68 year old female history of AS s/p TAVR, Afib on eliquis, OSA/OHS on CPAP, pulm HTN, COPD on 2L oxygen at baseline, DM, Adrenal insufficiency, complex LLE with multiple joint/hardware infections.     She was recently admitted here at Hospital from 09/09/2021 through 09/22/2021 for VRE hardware infection of left lower extremity requiring drain placement and antibiotics.  She presented to Medical Center on 9/9 with fevers and dyspnea. CXR noted pulmonary infiltrates. Patient found to be hypotensive thus given fluid resuscitation and started on norepinephrine. Cultures obtained and empiric abx added. She was transferred to the Intensive Care where she was quickly weaned off norepinephrine. She underwent CT imaging of the LLE showing new large fluid-density collection in the lateral thigh adjacent to the area of postsurgical change. IR consulted for drain placement on 09/11/2021, brown drainage noted and cultures  revealed vancomycin-resistant Enterococcus.  She was transitioned off NE and midodrine was started.  She was ultimately transferred to the hospitalist service.  Other issues during her hospital stay included atrial fibrillation with rapid ventricular response treated with beta-blockers and anticoagulation; troponin leak due to demand ischemia; new left bundle branch block; diastolic congestive heart failure, acute on chronic, with volume overload.  She required hydrocortisone for Addison's disease.  A drain was left in place to drain her complicated left lower extremity hardware for infection, with cultures ultimately growing VRE.  She was ultimately transitioned to chronic suppressive therapy with amoxicillin.     She presents to the emergency room today 10/25/2021 with shortness of breath and cough.  She is also experienced fever to 101 F, significant fatigue, loss of appetite, and diarrhea.  Her husband tells me symptoms have been present for about 1.5 weeks; about 2 weeks ago, she went camping and ?did fine?.  She was hypotensive with a blood pressure as low as 50s over 20s.  She has been started on norepinephrine and responds well to low-dose, currently at 0.02, although two efforts at weaning this off the emergency room have been unsuccessful, with rather abrupt drop in her blood pressure and associated worsening in her mentation.  Chest radiograph showed patchy bilateral airspace disease.  She tested positive for COVID.  She has been treated with empiric broad-spectrum antibiotics, including Zosyn, doxycycline, and vancomycin.   Patient is a fairly limited historian at this time due to clinical condition
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Enterococcal infection, Fatigue, Hypervolaemia, Hypotension, Intensive care
Clinical narrative: 69 y.o. female being admitted to the medical intensive care unit with new diagnosis of COVID pneumonia, septic shock in the setting of multiple medical problems   The history is obtained from speaking to Patient and her husband at the bedside.  The patient is a 68 year old female history of AS s/p TAVR, Afib on eliquis, OSA/OHS on CPAP, pulm HTN, COPD on 2L oxygen at baseline, DM, Adrenal insufficiency, complex LLE with multiple joint/hardware infections.     She was recently admitted here at Hospital from 09/09/2021 through 09/22/2021 for VRE hardware infection of left lower extremity requiring drain placement and antibiotics.  She presented to Medical Center on 9/9 with fevers and dyspnea. CXR noted pulmonary infiltrates. Patient found to be hypotensive thus given fluid resuscitation and started on norepinephrine. Cultures obtained and empiric abx added. She was transferred to the Intensive Care where she was quickly weaned off norepinephrine. She underwent CT imaging of the LLE showing new large fluid-density collection in the lateral thigh adjacent to the area of postsurgical change. IR consulted for drain placement on 09/11/2021, brown drainage noted and cultures  revealed vancomycin-resistant Enterococcus.  She was transitioned off NE and midodrine was started.  She was ultimately transferred to the hospitalist service.  Other issues during her hospital stay included atrial fibrillation with rapid ventricular response treated with beta-blockers and anticoagulation; troponin leak due to demand ischemia; new left bundle branch block; diastolic congestive heart failure, acute on chronic, with volume overload.  She required hydrocortisone for Addison's disease.  A drain was left in place to drain her complicated left lower extremity hardware for infection, with cultures ultimately growing VRE.  She was ultimately transitioned to chronic suppressive therapy with amoxicillin.     She presents to the emergency room today 10/25/2021 with shortness of breath and cough.  She is also experienced fever to 101 F, significant fatigue, loss of appetite, and diarrhea.  Her husband tells me symptoms have been present for about 1.5 weeks; about 2 weeks ago, she went camping and ?did fine?.  She was hypotensive with a blood pressure as low as 50s over 20s.  She has been started on norepinephrine and responds well to low-dose, currently at 0.02, although two efforts at weaning this off the emergency room have been unsuccessful, with rather abrupt drop in her blood pressure and associated worsening in her mentation.  Chest radiograph showed patchy bilateral airspace disease.  She tested positive for COVID.  She has been treated with empiric broad-spectrum antibiotics, including Zosyn, doxycycline, and vancomycin.   Patient is a fairly limited historian at this time due to clinical condition
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Left ventricular failure, Legionella test, Lung disorder, Lung infiltration, Lung opacity
Clinical narrative: 69 y.o. female being admitted to the medical intensive care unit with new diagnosis of COVID pneumonia, septic shock in the setting of multiple medical problems   The history is obtained from speaking to Patient and her husband at the bedside.  The patient is a 68 year old female history of AS s/p TAVR, Afib on eliquis, OSA/OHS on CPAP, pulm HTN, COPD on 2L oxygen at baseline, DM, Adrenal insufficiency, complex LLE with multiple joint/hardware infections.     She was recently admitted here at Hospital from 09/09/2021 through 09/22/2021 for VRE hardware infection of left lower extremity requiring drain placement and antibiotics.  She presented to Medical Center on 9/9 with fevers and dyspnea. CXR noted pulmonary infiltrates. Patient found to be hypotensive thus given fluid resuscitation and started on norepinephrine. Cultures obtained and empiric abx added. She was transferred to the Intensive Care where she was quickly weaned off norepinephrine. She underwent CT imaging of the LLE showing new large fluid-density collection in the lateral thigh adjacent to the area of postsurgical change. IR consulted for drain placement on 09/11/2021, brown drainage noted and cultures  revealed vancomycin-resistant Enterococcus.  She was transitioned off NE and midodrine was started.  She was ultimately transferred to the hospitalist service.  Other issues during her hospital stay included atrial fibrillation with rapid ventricular response treated with beta-blockers and anticoagulation; troponin leak due to demand ischemia; new left bundle branch block; diastolic congestive heart failure, acute on chronic, with volume overload.  She required hydrocortisone for Addison's disease.  A drain was left in place to drain her complicated left lower extremity hardware for infection, with cultures ultimately growing VRE.  She was ultimately transitioned to chronic suppressive therapy with amoxicillin.     She presents to the emergency room today 10/25/2021 with shortness of breath and cough.  She is also experienced fever to 101 F, significant fatigue, loss of appetite, and diarrhea.  Her husband tells me symptoms have been present for about 1.5 weeks; about 2 weeks ago, she went camping and ?did fine?.  She was hypotensive with a blood pressure as low as 50s over 20s.  She has been started on norepinephrine and responds well to low-dose, currently at 0.02, although two efforts at weaning this off the emergency room have been unsuccessful, with rather abrupt drop in her blood pressure and associated worsening in her mentation.  Chest radiograph showed patchy bilateral airspace disease.  She tested positive for COVID.  She has been treated with empiric broad-spectrum antibiotics, including Zosyn, doxycycline, and vancomycin.   Patient is a fairly limited historian at this time due to clinical condition
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Mental impairment, Myocardial ischaemia, Purulent discharge, Pyrexia, Resuscitation
Clinical narrative: 69 y.o. female being admitted to the medical intensive care unit with new diagnosis of COVID pneumonia, septic shock in the setting of multiple medical problems   The history is obtained from speaking to Patient and her husband at the bedside.  The patient is a 68 year old female history of AS s/p TAVR, Afib on eliquis, OSA/OHS on CPAP, pulm HTN, COPD on 2L oxygen at baseline, DM, Adrenal insufficiency, complex LLE with multiple joint/hardware infections.     She was recently admitted here at Hospital from 09/09/2021 through 09/22/2021 for VRE hardware infection of left lower extremity requiring drain placement and antibiotics.  She presented to Medical Center on 9/9 with fevers and dyspnea. CXR noted pulmonary infiltrates. Patient found to be hypotensive thus given fluid resuscitation and started on norepinephrine. Cultures obtained and empiric abx added. She was transferred to the Intensive Care where she was quickly weaned off norepinephrine. She underwent CT imaging of the LLE showing new large fluid-density collection in the lateral thigh adjacent to the area of postsurgical change. IR consulted for drain placement on 09/11/2021, brown drainage noted and cultures  revealed vancomycin-resistant Enterococcus.  She was transitioned off NE and midodrine was started.  She was ultimately transferred to the hospitalist service.  Other issues during her hospital stay included atrial fibrillation with rapid ventricular response treated with beta-blockers and anticoagulation; troponin leak due to demand ischemia; new left bundle branch block; diastolic congestive heart failure, acute on chronic, with volume overload.  She required hydrocortisone for Addison's disease.  A drain was left in place to drain her complicated left lower extremity hardware for infection, with cultures ultimately growing VRE.  She was ultimately transitioned to chronic suppressive therapy with amoxicillin.     She presents to the emergency room today 10/25/2021 with shortness of breath and cough.  She is also experienced fever to 101 F, significant fatigue, loss of appetite, and diarrhea.  Her husband tells me symptoms have been present for about 1.5 weeks; about 2 weeks ago, she went camping and ?did fine?.  She was hypotensive with a blood pressure as low as 50s over 20s.  She has been started on norepinephrine and responds well to low-dose, currently at 0.02, although two efforts at weaning this off the emergency room have been unsuccessful, with rather abrupt drop in her blood pressure and associated worsening in her mentation.  Chest radiograph showed patchy bilateral airspace disease.  She tested positive for COVID.  She has been treated with empiric broad-spectrum antibiotics, including Zosyn, doxycycline, and vancomycin.   Patient is a fairly limited historian at this time due to clinical condition
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Septic shock, Staphylococcus test positive, Streptococcus test negative, Troponin increased
Clinical narrative: 69 y.o. female being admitted to the medical intensive care unit with new diagnosis of COVID pneumonia, septic shock in the setting of multiple medical problems   The history is obtained from speaking to Patient and her husband at the bedside.  The patient is a 68 year old female history of AS s/p TAVR, Afib on eliquis, OSA/OHS on CPAP, pulm HTN, COPD on 2L oxygen at baseline, DM, Adrenal insufficiency, complex LLE with multiple joint/hardware infections.     She was recently admitted here at Hospital from 09/09/2021 through 09/22/2021 for VRE hardware infection of left lower extremity requiring drain placement and antibiotics.  She presented to Medical Center on 9/9 with fevers and dyspnea. CXR noted pulmonary infiltrates. Patient found to be hypotensive thus given fluid resuscitation and started on norepinephrine. Cultures obtained and empiric abx added. She was transferred to the Intensive Care where she was quickly weaned off norepinephrine. She underwent CT imaging of the LLE showing new large fluid-density collection in the lateral thigh adjacent to the area of postsurgical change. IR consulted for drain placement on 09/11/2021, brown drainage noted and cultures  revealed vancomycin-resistant Enterococcus.  She was transitioned off NE and midodrine was started.  She was ultimately transferred to the hospitalist service.  Other issues during her hospital stay included atrial fibrillation with rapid ventricular response treated with beta-blockers and anticoagulation; troponin leak due to demand ischemia; new left bundle branch block; diastolic congestive heart failure, acute on chronic, with volume overload.  She required hydrocortisone for Addison's disease.  A drain was left in place to drain her complicated left lower extremity hardware for infection, with cultures ultimately growing VRE.  She was ultimately transitioned to chronic suppressive therapy with amoxicillin.     She presents to the emergency room today 10/25/2021 with shortness of breath and cough.  She is also experienced fever to 101 F, significant fatigue, loss of appetite, and diarrhea.  Her husband tells me symptoms have been present for about 1.5 weeks; about 2 weeks ago, she went camping and ?did fine?.  She was hypotensive with a blood pressure as low as 50s over 20s.  She has been started on norepinephrine and responds well to low-dose, currently at 0.02, although two efforts at weaning this off the emergency room have been unsuccessful, with rather abrupt drop in her blood pressure and associated worsening in her mentation.  Chest radiograph showed patchy bilateral airspace disease.  She tested positive for COVID.  She has been treated with empiric broad-spectrum antibiotics, including Zosyn, doxycycline, and vancomycin.   Patient is a fairly limited historian at this time due to clinical condition
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Ultrasound Doppler abnormal, Ultrasound bladder abnormal, Ultrasound kidney abnormal
Clinical narrative: 69 y.o. female being admitted to the medical intensive care unit with new diagnosis of COVID pneumonia, septic shock in the setting of multiple medical problems   The history is obtained from speaking to Patient and her husband at the bedside.  The patient is a 68 year old female history of AS s/p TAVR, Afib on eliquis, OSA/OHS on CPAP, pulm HTN, COPD on 2L oxygen at baseline, DM, Adrenal insufficiency, complex LLE with multiple joint/hardware infections.     She was recently admitted here at Hospital from 09/09/2021 through 09/22/2021 for VRE hardware infection of left lower extremity requiring drain placement and antibiotics.  She presented to Medical Center on 9/9 with fevers and dyspnea. CXR noted pulmonary infiltrates. Patient found to be hypotensive thus given fluid resuscitation and started on norepinephrine. Cultures obtained and empiric abx added. She was transferred to the Intensive Care where she was quickly weaned off norepinephrine. She underwent CT imaging of the LLE showing new large fluid-density collection in the lateral thigh adjacent to the area of postsurgical change. IR consulted for drain placement on 09/11/2021, brown drainage noted and cultures  revealed vancomycin-resistant Enterococcus.  She was transitioned off NE and midodrine was started.  She was ultimately transferred to the hospitalist service.  Other issues during her hospital stay included atrial fibrillation with rapid ventricular response treated with beta-blockers and anticoagulation; troponin leak due to demand ischemia; new left bundle branch block; diastolic congestive heart failure, acute on chronic, with volume overload.  She required hydrocortisone for Addison's disease.  A drain was left in place to drain her complicated left lower extremity hardware for infection, with cultures ultimately growing VRE.  She was ultimately transitioned to chronic suppressive therapy with amoxicillin.     She presents to the emergency room today 10/25/2021 with shortness of breath and cough.  She is also experienced fever to 101 F, significant fatigue, loss of appetite, and diarrhea.  Her husband tells me symptoms have been present for about 1.5 weeks; about 2 weeks ago, she went camping and ?did fine?.  She was hypotensive with a blood pressure as low as 50s over 20s.  She has been started on norepinephrine and responds well to low-dose, currently at 0.02, although two efforts at weaning this off the emergency room have been unsuccessful, with rather abrupt drop in her blood pressure and associated worsening in her mentation.  Chest radiograph showed patchy bilateral airspace disease.  She tested positive for COVID.  She has been treated with empiric broad-spectrum antibiotics, including Zosyn, doxycycline, and vancomycin.   Patient is a fairly limited historian at this time due to clinical condition
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: Acute myocardial infarction, Chest pain, Coronary artery dissection, Laboratory test
Clinical narrative: On October 02, 2021 I was cooking in my kitchen and had chest pain. It was so bad that I sat down and  my husband called 911. Was transported to local Hospital by ambulance and from there I was flown to another Hospital for a  Non stem Heart attack with a SCAD of a LAD.
Age: 64.0
Sex: F
Vaccine: FLU4
Symptoms: Extra dose administered
Clinical narrative: Dose given two months early.
Age: 36.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Blood test normal, Bone pain, Cold sweat, Fatigue
Clinical narrative: Bone pain throughout body within 6 hours of shot. High fever, headache, nausea, joint pain, cold sweats, exhaustion within 12 hours of shot. lasted 24 hours.
Age: 36.0
Sex: F
Vaccine: COVID19
Symptoms: Headache, Nausea, Pyrexia
Clinical narrative: Bone pain throughout body within 6 hours of shot. High fever, headache, nausea, joint pain, cold sweats, exhaustion within 12 hours of shot. lasted 24 hours.
Age: 17.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain, Acute kidney injury, Acute respiratory failure, Anticoagulant therapy, Aortic dilatation
Clinical narrative: 18 y.o. female who was initially admitted to Hospital with concern for retropharyngeal phlegmon/developing abscess whose course was complicated by shock (sepsis vs cardiogenic), now thought to have MIS-C.    Four days prior to hospital admission, patient developed sore throat and high fever. This was managed with tylenol. She continued to have daily fever with a Tmax 103F prompting her to begin alternating tylenol with ibuprofen yesterday. Her symptoms progressively worsened and has been accompanied by frontal HA, decreased appetite, two days of non-bloody diarrhea, abdominal pain (periumbilical), 1x NBNB emesis, and overall lethargy. She also developed pain with neck motion, swallowing, and opening of her mouth.  Diagnosis: Principal Problem: Multisystem inflammatory syndrome associated with COVID-19 Active Problems: Retropharyngeal abscess AKI (acute kidney injury)  Elevated liver enzymes Septic shock  Hypoxemia Cardiogenic shock  Acute respiratory failure  Acute hypoactive delirium due to another medical condition Lactic acidosis Generalized anxiety disorder Decreased cardiac ejection fraction Coronary artery abnormality  Treatment: Supplemental Oxygen: Nasal cannula, High Flow Nasal Cannula, Bipap Vasoactive medications:  Norepinephrine, Epinephrine, Dobutamine Steroids Anakinra Aspirin, Plavix Heparin drip, Lovenox IVIG
Age: 17.0
Sex: F
Vaccine: COVID19
Symptoms: Atelectasis, Blood fibrinogen increased, C-reactive protein, COVID-19, Cardiogenic shock
Clinical narrative: 18 y.o. female who was initially admitted to Hospital with concern for retropharyngeal phlegmon/developing abscess whose course was complicated by shock (sepsis vs cardiogenic), now thought to have MIS-C.    Four days prior to hospital admission, patient developed sore throat and high fever. This was managed with tylenol. She continued to have daily fever with a Tmax 103F prompting her to begin alternating tylenol with ibuprofen yesterday. Her symptoms progressively worsened and has been accompanied by frontal HA, decreased appetite, two days of non-bloody diarrhea, abdominal pain (periumbilical), 1x NBNB emesis, and overall lethargy. She also developed pain with neck motion, swallowing, and opening of her mouth.  Diagnosis: Principal Problem: Multisystem inflammatory syndrome associated with COVID-19 Active Problems: Retropharyngeal abscess AKI (acute kidney injury)  Elevated liver enzymes Septic shock  Hypoxemia Cardiogenic shock  Acute respiratory failure  Acute hypoactive delirium due to another medical condition Lactic acidosis Generalized anxiety disorder Decreased cardiac ejection fraction Coronary artery abnormality  Treatment: Supplemental Oxygen: Nasal cannula, High Flow Nasal Cannula, Bipap Vasoactive medications:  Norepinephrine, Epinephrine, Dobutamine Steroids Anakinra Aspirin, Plavix Heparin drip, Lovenox IVIG
Age: 17.0
Sex: F
Vaccine: COVID19
Symptoms: Cardiomegaly, Coronary artery disease, Decreased appetite, Delirium, Diarrhoea
Clinical narrative: 18 y.o. female who was initially admitted to Hospital with concern for retropharyngeal phlegmon/developing abscess whose course was complicated by shock (sepsis vs cardiogenic), now thought to have MIS-C.    Four days prior to hospital admission, patient developed sore throat and high fever. This was managed with tylenol. She continued to have daily fever with a Tmax 103F prompting her to begin alternating tylenol with ibuprofen yesterday. Her symptoms progressively worsened and has been accompanied by frontal HA, decreased appetite, two days of non-bloody diarrhea, abdominal pain (periumbilical), 1x NBNB emesis, and overall lethargy. She also developed pain with neck motion, swallowing, and opening of her mouth.  Diagnosis: Principal Problem: Multisystem inflammatory syndrome associated with COVID-19 Active Problems: Retropharyngeal abscess AKI (acute kidney injury)  Elevated liver enzymes Septic shock  Hypoxemia Cardiogenic shock  Acute respiratory failure  Acute hypoactive delirium due to another medical condition Lactic acidosis Generalized anxiety disorder Decreased cardiac ejection fraction Coronary artery abnormality  Treatment: Supplemental Oxygen: Nasal cannula, High Flow Nasal Cannula, Bipap Vasoactive medications:  Norepinephrine, Epinephrine, Dobutamine Steroids Anakinra Aspirin, Plavix Heparin drip, Lovenox IVIG
Age: 17.0
Sex: F
Vaccine: COVID19
Symptoms: Dyskinesia, Echocardiogram abnormal, Ejection fraction decreased, Gallbladder enlargement, Generalised anxiety disorder
Clinical narrative: 18 y.o. female who was initially admitted to Hospital with concern for retropharyngeal phlegmon/developing abscess whose course was complicated by shock (sepsis vs cardiogenic), now thought to have MIS-C.    Four days prior to hospital admission, patient developed sore throat and high fever. This was managed with tylenol. She continued to have daily fever with a Tmax 103F prompting her to begin alternating tylenol with ibuprofen yesterday. Her symptoms progressively worsened and has been accompanied by frontal HA, decreased appetite, two days of non-bloody diarrhea, abdominal pain (periumbilical), 1x NBNB emesis, and overall lethargy. She also developed pain with neck motion, swallowing, and opening of her mouth.  Diagnosis: Principal Problem: Multisystem inflammatory syndrome associated with COVID-19 Active Problems: Retropharyngeal abscess AKI (acute kidney injury)  Elevated liver enzymes Septic shock  Hypoxemia Cardiogenic shock  Acute respiratory failure  Acute hypoactive delirium due to another medical condition Lactic acidosis Generalized anxiety disorder Decreased cardiac ejection fraction Coronary artery abnormality  Treatment: Supplemental Oxygen: Nasal cannula, High Flow Nasal Cannula, Bipap Vasoactive medications:  Norepinephrine, Epinephrine, Dobutamine Steroids Anakinra Aspirin, Plavix Heparin drip, Lovenox IVIG
Age: 17.0
Sex: F
Vaccine: COVID19
Symptoms: Headache, Hepatic enzyme increased, Hypoxia, Immunoglobulin therapy, Lactic acidosis
Clinical narrative: 18 y.o. female who was initially admitted to Hospital with concern for retropharyngeal phlegmon/developing abscess whose course was complicated by shock (sepsis vs cardiogenic), now thought to have MIS-C.    Four days prior to hospital admission, patient developed sore throat and high fever. This was managed with tylenol. She continued to have daily fever with a Tmax 103F prompting her to begin alternating tylenol with ibuprofen yesterday. Her symptoms progressively worsened and has been accompanied by frontal HA, decreased appetite, two days of non-bloody diarrhea, abdominal pain (periumbilical), 1x NBNB emesis, and overall lethargy. She also developed pain with neck motion, swallowing, and opening of her mouth.  Diagnosis: Principal Problem: Multisystem inflammatory syndrome associated with COVID-19 Active Problems: Retropharyngeal abscess AKI (acute kidney injury)  Elevated liver enzymes Septic shock  Hypoxemia Cardiogenic shock  Acute respiratory failure  Acute hypoactive delirium due to another medical condition Lactic acidosis Generalized anxiety disorder Decreased cardiac ejection fraction Coronary artery abnormality  Treatment: Supplemental Oxygen: Nasal cannula, High Flow Nasal Cannula, Bipap Vasoactive medications:  Norepinephrine, Epinephrine, Dobutamine Steroids Anakinra Aspirin, Plavix Heparin drip, Lovenox IVIG
Age: 17.0
Sex: F
Vaccine: COVID19
Symptoms: Left ventricular dysfunction, Lethargy, Lung opacity, Mitral valve incompetence, Multisystem inflammatory syndrome
Clinical narrative: 18 y.o. female who was initially admitted to Hospital with concern for retropharyngeal phlegmon/developing abscess whose course was complicated by shock (sepsis vs cardiogenic), now thought to have MIS-C.    Four days prior to hospital admission, patient developed sore throat and high fever. This was managed with tylenol. She continued to have daily fever with a Tmax 103F prompting her to begin alternating tylenol with ibuprofen yesterday. Her symptoms progressively worsened and has been accompanied by frontal HA, decreased appetite, two days of non-bloody diarrhea, abdominal pain (periumbilical), 1x NBNB emesis, and overall lethargy. She also developed pain with neck motion, swallowing, and opening of her mouth.  Diagnosis: Principal Problem: Multisystem inflammatory syndrome associated with COVID-19 Active Problems: Retropharyngeal abscess AKI (acute kidney injury)  Elevated liver enzymes Septic shock  Hypoxemia Cardiogenic shock  Acute respiratory failure  Acute hypoactive delirium due to another medical condition Lactic acidosis Generalized anxiety disorder Decreased cardiac ejection fraction Coronary artery abnormality  Treatment: Supplemental Oxygen: Nasal cannula, High Flow Nasal Cannula, Bipap Vasoactive medications:  Norepinephrine, Epinephrine, Dobutamine Steroids Anakinra Aspirin, Plavix Heparin drip, Lovenox IVIG
Age: 17.0
Sex: F
Vaccine: COVID19
Symptoms: Multisystem inflammatory syndrome in children, Neck pain, Odynophagia, Oral pain, Oropharyngeal pain
Clinical narrative: 18 y.o. female who was initially admitted to Hospital with concern for retropharyngeal phlegmon/developing abscess whose course was complicated by shock (sepsis vs cardiogenic), now thought to have MIS-C.    Four days prior to hospital admission, patient developed sore throat and high fever. This was managed with tylenol. She continued to have daily fever with a Tmax 103F prompting her to begin alternating tylenol with ibuprofen yesterday. Her symptoms progressively worsened and has been accompanied by frontal HA, decreased appetite, two days of non-bloody diarrhea, abdominal pain (periumbilical), 1x NBNB emesis, and overall lethargy. She also developed pain with neck motion, swallowing, and opening of her mouth.  Diagnosis: Principal Problem: Multisystem inflammatory syndrome associated with COVID-19 Active Problems: Retropharyngeal abscess AKI (acute kidney injury)  Elevated liver enzymes Septic shock  Hypoxemia Cardiogenic shock  Acute respiratory failure  Acute hypoactive delirium due to another medical condition Lactic acidosis Generalized anxiety disorder Decreased cardiac ejection fraction Coronary artery abnormality  Treatment: Supplemental Oxygen: Nasal cannula, High Flow Nasal Cannula, Bipap Vasoactive medications:  Norepinephrine, Epinephrine, Dobutamine Steroids Anakinra Aspirin, Plavix Heparin drip, Lovenox IVIG
Age: 17.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, Pericardial effusion, Pharyngeal abscess, Pleural effusion, Positive airway pressure therapy
Clinical narrative: 18 y.o. female who was initially admitted to Hospital with concern for retropharyngeal phlegmon/developing abscess whose course was complicated by shock (sepsis vs cardiogenic), now thought to have MIS-C.    Four days prior to hospital admission, patient developed sore throat and high fever. This was managed with tylenol. She continued to have daily fever with a Tmax 103F prompting her to begin alternating tylenol with ibuprofen yesterday. Her symptoms progressively worsened and has been accompanied by frontal HA, decreased appetite, two days of non-bloody diarrhea, abdominal pain (periumbilical), 1x NBNB emesis, and overall lethargy. She also developed pain with neck motion, swallowing, and opening of her mouth.  Diagnosis: Principal Problem: Multisystem inflammatory syndrome associated with COVID-19 Active Problems: Retropharyngeal abscess AKI (acute kidney injury)  Elevated liver enzymes Septic shock  Hypoxemia Cardiogenic shock  Acute respiratory failure  Acute hypoactive delirium due to another medical condition Lactic acidosis Generalized anxiety disorder Decreased cardiac ejection fraction Coronary artery abnormality  Treatment: Supplemental Oxygen: Nasal cannula, High Flow Nasal Cannula, Bipap Vasoactive medications:  Norepinephrine, Epinephrine, Dobutamine Steroids Anakinra Aspirin, Plavix Heparin drip, Lovenox IVIG
Age: 17.0
Sex: F
Vaccine: COVID19
Symptoms: Pulmonary imaging procedure abnormal, Pulmonary oedema, Pyrexia, Right ventricular dysfunction, SARS-CoV-2 antibody test
Clinical narrative: 18 y.o. female who was initially admitted to Hospital with concern for retropharyngeal phlegmon/developing abscess whose course was complicated by shock (sepsis vs cardiogenic), now thought to have MIS-C.    Four days prior to hospital admission, patient developed sore throat and high fever. This was managed with tylenol. She continued to have daily fever with a Tmax 103F prompting her to begin alternating tylenol with ibuprofen yesterday. Her symptoms progressively worsened and has been accompanied by frontal HA, decreased appetite, two days of non-bloody diarrhea, abdominal pain (periumbilical), 1x NBNB emesis, and overall lethargy. She also developed pain with neck motion, swallowing, and opening of her mouth.  Diagnosis: Principal Problem: Multisystem inflammatory syndrome associated with COVID-19 Active Problems: Retropharyngeal abscess AKI (acute kidney injury)  Elevated liver enzymes Septic shock  Hypoxemia Cardiogenic shock  Acute respiratory failure  Acute hypoactive delirium due to another medical condition Lactic acidosis Generalized anxiety disorder Decreased cardiac ejection fraction Coronary artery abnormality  Treatment: Supplemental Oxygen: Nasal cannula, High Flow Nasal Cannula, Bipap Vasoactive medications:  Norepinephrine, Epinephrine, Dobutamine Steroids Anakinra Aspirin, Plavix Heparin drip, Lovenox IVIG