chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 72.0
Sex: F
Vaccine: COVID19-2
Symptoms: Constipation, Cough, Culture negative, Cystic fibrosis lung, Dyspnoea
Clinical narrative: A 73 y.o. female patient with history of ILD/Asthma/COPD presented to Doctors Hospital with acute respiratory failure secondary to COVID-19 virus infection.   Acute hypoxemic respiratory failure resolved  Covid-19 Virus Infection Sepsis (POA) Sx onset; 2/10, w cough, SOB, increased WOB Date of covid positive test: 2/21 (Vaccinated & History of covid July '22)   Imaging: CT with extensive fibrotic changes, appears overlying GGO. Bronchiectasis and cystic areas with early honeycombing  Medical therapy: was on steroids, cefepime, vancomycin, lasix. Stop Vancomycin and cefepime as cultures are negative to date Wbc 13.74--15.60 Was on decadron 6mg every day, will continue on discharge  PNA antigens is negative Sputum culture--negative BCx is NGTD     ILD/Asthma COPD Immunocompromised  Follows with pulm, rheum  Recurrent PNA/hospitalization for respiratory failure Immunocompromised on Remicaid Exacerbation 2/2 COVID, doubt bacterial PNA CT: Extensive fibrotic changes noted through BL Lung fields Continue Symbicort, Spiriva. Scheduled albuterol MDI  Decadron for 6 more days  Pulm hygiene (IS/V pep valve)    Constipation  Last bowel movement 2/20 (hard/small)  Started on Senna   HTN/HLD Normotensive on admission Resume blood pressure meds as blood pressure trends up   DM2 Resume Lantus 20 units BID with Humalog sliding scale Diabetic diet Adjust Insulin regimen as needed
Age: 72.0
Sex: F
Vaccine: COVID19-2
Symptoms: Laboratory test normal, Lung opacity, SARS-CoV-2 test positive, Sepsis, Sputum culture
Clinical narrative: A 73 y.o. female patient with history of ILD/Asthma/COPD presented to Doctors Hospital with acute respiratory failure secondary to COVID-19 virus infection.   Acute hypoxemic respiratory failure resolved  Covid-19 Virus Infection Sepsis (POA) Sx onset; 2/10, w cough, SOB, increased WOB Date of covid positive test: 2/21 (Vaccinated & History of covid July '22)   Imaging: CT with extensive fibrotic changes, appears overlying GGO. Bronchiectasis and cystic areas with early honeycombing  Medical therapy: was on steroids, cefepime, vancomycin, lasix. Stop Vancomycin and cefepime as cultures are negative to date Wbc 13.74--15.60 Was on decadron 6mg every day, will continue on discharge  PNA antigens is negative Sputum culture--negative BCx is NGTD     ILD/Asthma COPD Immunocompromised  Follows with pulm, rheum  Recurrent PNA/hospitalization for respiratory failure Immunocompromised on Remicaid Exacerbation 2/2 COVID, doubt bacterial PNA CT: Extensive fibrotic changes noted through BL Lung fields Continue Symbicort, Spiriva. Scheduled albuterol MDI  Decadron for 6 more days  Pulm hygiene (IS/V pep valve)    Constipation  Last bowel movement 2/20 (hard/small)  Started on Senna   HTN/HLD Normotensive on admission Resume blood pressure meds as blood pressure trends up   DM2 Resume Lantus 20 units BID with Humalog sliding scale Diabetic diet Adjust Insulin regimen as needed
Age: 72.0
Sex: F
Vaccine: COVID19-2
Symptoms: White blood cell count increased
Clinical narrative: A 73 y.o. female patient with history of ILD/Asthma/COPD presented to Doctors Hospital with acute respiratory failure secondary to COVID-19 virus infection.   Acute hypoxemic respiratory failure resolved  Covid-19 Virus Infection Sepsis (POA) Sx onset; 2/10, w cough, SOB, increased WOB Date of covid positive test: 2/21 (Vaccinated & History of covid July '22)   Imaging: CT with extensive fibrotic changes, appears overlying GGO. Bronchiectasis and cystic areas with early honeycombing  Medical therapy: was on steroids, cefepime, vancomycin, lasix. Stop Vancomycin and cefepime as cultures are negative to date Wbc 13.74--15.60 Was on decadron 6mg every day, will continue on discharge  PNA antigens is negative Sputum culture--negative BCx is NGTD     ILD/Asthma COPD Immunocompromised  Follows with pulm, rheum  Recurrent PNA/hospitalization for respiratory failure Immunocompromised on Remicaid Exacerbation 2/2 COVID, doubt bacterial PNA CT: Extensive fibrotic changes noted through BL Lung fields Continue Symbicort, Spiriva. Scheduled albuterol MDI  Decadron for 6 more days  Pulm hygiene (IS/V pep valve)    Constipation  Last bowel movement 2/20 (hard/small)  Started on Senna   HTN/HLD Normotensive on admission Resume blood pressure meds as blood pressure trends up   DM2 Resume Lantus 20 units BID with Humalog sliding scale Diabetic diet Adjust Insulin regimen as needed
Age: 5.0
Sex: M
Vaccine: COVID19
Symptoms: No adverse event, Product administered to patient of inappropriate age, Vaccination error, Wrong product administered
Clinical narrative: I accidentally gave a five-year-old the 6m-4y first dose of the Pfizer. There was no adverse reaction or harm to the patient.
Age: 92.0
Sex: F
Vaccine: COVID19
Symptoms: Ammonia normal, Angiogram pulmonary normal, Bedridden, Blood thyroid stimulating hormone, COVID-19
Clinical narrative: MD is a 94 y.o. female retired pediatrician with a history of progressive dementia, depression, with a recent ED 2 weeks ago after a fall and had negative CT work-ups who presented to RMH 2/13/2023 with AMS, SOB for 2 weeks. Hospital course complicated by GOC, need for placement, COVID 19 diagnosis delayed discharge further.    1. Acute Metabolic Encephalopathy: For 2 weeks, although seemingly has had a longer and more severe decline. Sluggish, more somnolent at PCP office.  BMP, CBC, TSH, LFT, ammonia unremarkable. CT of the brain showed no acute new changes. Suspect progressive dementia complicated by COVID + pneumonia. Improved overall.  2. COVID 19: O2 was 88% at PCP office. Imprved in the ED. Stopped decadron 2/14/23. Chest x-ray was clear.  CTPA was obtained which showed no acute PE or pneumonia. Isolation per policy.  3. Dementia: Stopped Seroquel due to drowsiness. Consulted palliative due to concern for advanced dementia that has progressed to lack of appetite, bed bound status, incontinence. Transitioned to CC and medications simplified on discharge to align with GOC.
Age: 92.0
Sex: F
Vaccine: COVID19
Symptoms: Chest X-ray normal, Computerised tomogram head normal, Computerised tomogram normal, Condition aggravated, Decreased appetite
Clinical narrative: MD is a 94 y.o. female retired pediatrician with a history of progressive dementia, depression, with a recent ED 2 weeks ago after a fall and had negative CT work-ups who presented to RMH 2/13/2023 with AMS, SOB for 2 weeks. Hospital course complicated by GOC, need for placement, COVID 19 diagnosis delayed discharge further.    1. Acute Metabolic Encephalopathy: For 2 weeks, although seemingly has had a longer and more severe decline. Sluggish, more somnolent at PCP office.  BMP, CBC, TSH, LFT, ammonia unremarkable. CT of the brain showed no acute new changes. Suspect progressive dementia complicated by COVID + pneumonia. Improved overall.  2. COVID 19: O2 was 88% at PCP office. Imprved in the ED. Stopped decadron 2/14/23. Chest x-ray was clear.  CTPA was obtained which showed no acute PE or pneumonia. Isolation per policy.  3. Dementia: Stopped Seroquel due to drowsiness. Consulted palliative due to concern for advanced dementia that has progressed to lack of appetite, bed bound status, incontinence. Transitioned to CC and medications simplified on discharge to align with GOC.
Age: 92.0
Sex: F
Vaccine: COVID19
Symptoms: Dementia, Dyspnoea, Fall, Full blood count normal, General physical health deterioration
Clinical narrative: MD is a 94 y.o. female retired pediatrician with a history of progressive dementia, depression, with a recent ED 2 weeks ago after a fall and had negative CT work-ups who presented to RMH 2/13/2023 with AMS, SOB for 2 weeks. Hospital course complicated by GOC, need for placement, COVID 19 diagnosis delayed discharge further.    1. Acute Metabolic Encephalopathy: For 2 weeks, although seemingly has had a longer and more severe decline. Sluggish, more somnolent at PCP office.  BMP, CBC, TSH, LFT, ammonia unremarkable. CT of the brain showed no acute new changes. Suspect progressive dementia complicated by COVID + pneumonia. Improved overall.  2. COVID 19: O2 was 88% at PCP office. Imprved in the ED. Stopped decadron 2/14/23. Chest x-ray was clear.  CTPA was obtained which showed no acute PE or pneumonia. Isolation per policy.  3. Dementia: Stopped Seroquel due to drowsiness. Consulted palliative due to concern for advanced dementia that has progressed to lack of appetite, bed bound status, incontinence. Transitioned to CC and medications simplified on discharge to align with GOC.
Age: 92.0
Sex: F
Vaccine: COVID19
Symptoms: Incontinence, Liver function test normal, Mental status changes, Metabolic encephalopathy, Metabolic function test normal
Clinical narrative: MD is a 94 y.o. female retired pediatrician with a history of progressive dementia, depression, with a recent ED 2 weeks ago after a fall and had negative CT work-ups who presented to RMH 2/13/2023 with AMS, SOB for 2 weeks. Hospital course complicated by GOC, need for placement, COVID 19 diagnosis delayed discharge further.    1. Acute Metabolic Encephalopathy: For 2 weeks, although seemingly has had a longer and more severe decline. Sluggish, more somnolent at PCP office.  BMP, CBC, TSH, LFT, ammonia unremarkable. CT of the brain showed no acute new changes. Suspect progressive dementia complicated by COVID + pneumonia. Improved overall.  2. COVID 19: O2 was 88% at PCP office. Imprved in the ED. Stopped decadron 2/14/23. Chest x-ray was clear.  CTPA was obtained which showed no acute PE or pneumonia. Isolation per policy.  3. Dementia: Stopped Seroquel due to drowsiness. Consulted palliative due to concern for advanced dementia that has progressed to lack of appetite, bed bound status, incontinence. Transitioned to CC and medications simplified on discharge to align with GOC.
Age: 92.0
Sex: F
Vaccine: COVID19
Symptoms: Pneumonia, Sluggishness, Somnolence
Clinical narrative: MD is a 94 y.o. female retired pediatrician with a history of progressive dementia, depression, with a recent ED 2 weeks ago after a fall and had negative CT work-ups who presented to RMH 2/13/2023 with AMS, SOB for 2 weeks. Hospital course complicated by GOC, need for placement, COVID 19 diagnosis delayed discharge further.    1. Acute Metabolic Encephalopathy: For 2 weeks, although seemingly has had a longer and more severe decline. Sluggish, more somnolent at PCP office.  BMP, CBC, TSH, LFT, ammonia unremarkable. CT of the brain showed no acute new changes. Suspect progressive dementia complicated by COVID + pneumonia. Improved overall.  2. COVID 19: O2 was 88% at PCP office. Imprved in the ED. Stopped decadron 2/14/23. Chest x-ray was clear.  CTPA was obtained which showed no acute PE or pneumonia. Isolation per policy.  3. Dementia: Stopped Seroquel due to drowsiness. Consulted palliative due to concern for advanced dementia that has progressed to lack of appetite, bed bound status, incontinence. Transitioned to CC and medications simplified on discharge to align with GOC.
Age: 72.0
Sex: M
Vaccine: COVID19-2
Symptoms: Arterial occlusive disease, Cardiac stress test abnormal, Catheterisation cardiac
Clinical narrative: I had stress test, that showed a total occlusion on left interior descending. They had to go in and put a catheter in my heart to open the occlusion. I had a stress test where they monitored my heart before I was released to full exercise. I feel like I am fully recovered.
Age: 43.0
Sex: M
Vaccine: COVID19-2
Symptoms: Audiogram abnormal, Deafness unilateral, Magnetic resonance imaging normal, Tinnitus
Clinical narrative: In Jan 2023 I started experiencing a constant humming sound in my left ear. I visited an ENT and had a audiometry exam. It was confirmed that I have a significant amount of hearing loss in my left ear specifically high pitches. I was diagnosed with Tinnitus and have a follow up scheduled with an Audiology specialist.
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Atrial fibrillation, Blood creatinine normal, COVID-19, Chest pain
Clinical narrative: Assessment and Plan:  77 y.o. female patient of, MD with history of respiratory failure, CHF, A-fib, CAD, CKD, COPD, DM 2, HLD, PulmHTN presented to Medical Center with dyspnea and chest pain.     Acute on chronic respiratory failure with hypoxia Covid-19 Virus Infection Date of onset of symptoms: 2/17/2023 Symptoms present on admission: Dyspnea, chest pain, cough Date of covid positive test: 2/18/2023 Vaccination status: vaccinated Platelets: 115 (2/18) admitted with COVID-19 Baseline 102-115 Imaging: CT dissection without evidence of dissection or PE Oxygen requirements on admission: 4 L Current oxygen requirements: 2 L which is her baseline Medical therapy: steroids continued for 5 more days, will stop remdesivir  Continue Symbicort, DuoNebs, and PRN albuterol PT/OT consulted: Pt declined consult   Chest pain CAD Recent work-up including PET perfusion in November with stable CAD Pain in setting of new COVID infection Troponin minimally elevated at 16, trended flat to 15 EKG without evidence of acute ischemia Monitor symptoms   Abnormal Urinalysis 15 WBC/hpf in ED Denies symptoms of UTI   Hypertension BPs in the ED up to 218/86 with wide fluctuations Resume home antihypertensives  COPD Without acute exacerbation Scheduled Duonebs and PRN Albuterol Continue Symbicort   Prediabetes A1c 5.7 off medications Monitor glucose while on steroids, initiate SSI if needed   HLD Continue home pravastatin   A-fib Paroxysmal Continue metoprolol for rate control Sinus on admission Not anticoagulated   CKD Creatinine stable on admission   Chronic HFpEF Clinically approximately euvolemic Continue home Bumex EF 62% with grade 2 diastolic dysfunction on most recent echo
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Computerised tomogram, Condition aggravated, Coronary artery disease, Cough, Diastolic dysfunction
Clinical narrative: Assessment and Plan:  77 y.o. female patient of, MD with history of respiratory failure, CHF, A-fib, CAD, CKD, COPD, DM 2, HLD, PulmHTN presented to Medical Center with dyspnea and chest pain.     Acute on chronic respiratory failure with hypoxia Covid-19 Virus Infection Date of onset of symptoms: 2/17/2023 Symptoms present on admission: Dyspnea, chest pain, cough Date of covid positive test: 2/18/2023 Vaccination status: vaccinated Platelets: 115 (2/18) admitted with COVID-19 Baseline 102-115 Imaging: CT dissection without evidence of dissection or PE Oxygen requirements on admission: 4 L Current oxygen requirements: 2 L which is her baseline Medical therapy: steroids continued for 5 more days, will stop remdesivir  Continue Symbicort, DuoNebs, and PRN albuterol PT/OT consulted: Pt declined consult   Chest pain CAD Recent work-up including PET perfusion in November with stable CAD Pain in setting of new COVID infection Troponin minimally elevated at 16, trended flat to 15 EKG without evidence of acute ischemia Monitor symptoms   Abnormal Urinalysis 15 WBC/hpf in ED Denies symptoms of UTI   Hypertension BPs in the ED up to 218/86 with wide fluctuations Resume home antihypertensives  COPD Without acute exacerbation Scheduled Duonebs and PRN Albuterol Continue Symbicort   Prediabetes A1c 5.7 off medications Monitor glucose while on steroids, initiate SSI if needed   HLD Continue home pravastatin   A-fib Paroxysmal Continue metoprolol for rate control Sinus on admission Not anticoagulated   CKD Creatinine stable on admission   Chronic HFpEF Clinically approximately euvolemic Continue home Bumex EF 62% with grade 2 diastolic dysfunction on most recent echo
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Dyspnoea, Echocardiogram abnormal, Ejection fraction normal, Electrocardiogram normal, Glucose tolerance impaired
Clinical narrative: Assessment and Plan:  77 y.o. female patient of, MD with history of respiratory failure, CHF, A-fib, CAD, CKD, COPD, DM 2, HLD, PulmHTN presented to Medical Center with dyspnea and chest pain.     Acute on chronic respiratory failure with hypoxia Covid-19 Virus Infection Date of onset of symptoms: 2/17/2023 Symptoms present on admission: Dyspnea, chest pain, cough Date of covid positive test: 2/18/2023 Vaccination status: vaccinated Platelets: 115 (2/18) admitted with COVID-19 Baseline 102-115 Imaging: CT dissection without evidence of dissection or PE Oxygen requirements on admission: 4 L Current oxygen requirements: 2 L which is her baseline Medical therapy: steroids continued for 5 more days, will stop remdesivir  Continue Symbicort, DuoNebs, and PRN albuterol PT/OT consulted: Pt declined consult   Chest pain CAD Recent work-up including PET perfusion in November with stable CAD Pain in setting of new COVID infection Troponin minimally elevated at 16, trended flat to 15 EKG without evidence of acute ischemia Monitor symptoms   Abnormal Urinalysis 15 WBC/hpf in ED Denies symptoms of UTI   Hypertension BPs in the ED up to 218/86 with wide fluctuations Resume home antihypertensives  COPD Without acute exacerbation Scheduled Duonebs and PRN Albuterol Continue Symbicort   Prediabetes A1c 5.7 off medications Monitor glucose while on steroids, initiate SSI if needed   HLD Continue home pravastatin   A-fib Paroxysmal Continue metoprolol for rate control Sinus on admission Not anticoagulated   CKD Creatinine stable on admission   Chronic HFpEF Clinically approximately euvolemic Continue home Bumex EF 62% with grade 2 diastolic dysfunction on most recent echo
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Glycosylated haemoglobin, Hypertension, Pain, Platelet count decreased, Positron emission tomogram normal
Clinical narrative: Assessment and Plan:  77 y.o. female patient of, MD with history of respiratory failure, CHF, A-fib, CAD, CKD, COPD, DM 2, HLD, PulmHTN presented to Medical Center with dyspnea and chest pain.     Acute on chronic respiratory failure with hypoxia Covid-19 Virus Infection Date of onset of symptoms: 2/17/2023 Symptoms present on admission: Dyspnea, chest pain, cough Date of covid positive test: 2/18/2023 Vaccination status: vaccinated Platelets: 115 (2/18) admitted with COVID-19 Baseline 102-115 Imaging: CT dissection without evidence of dissection or PE Oxygen requirements on admission: 4 L Current oxygen requirements: 2 L which is her baseline Medical therapy: steroids continued for 5 more days, will stop remdesivir  Continue Symbicort, DuoNebs, and PRN albuterol PT/OT consulted: Pt declined consult   Chest pain CAD Recent work-up including PET perfusion in November with stable CAD Pain in setting of new COVID infection Troponin minimally elevated at 16, trended flat to 15 EKG without evidence of acute ischemia Monitor symptoms   Abnormal Urinalysis 15 WBC/hpf in ED Denies symptoms of UTI   Hypertension BPs in the ED up to 218/86 with wide fluctuations Resume home antihypertensives  COPD Without acute exacerbation Scheduled Duonebs and PRN Albuterol Continue Symbicort   Prediabetes A1c 5.7 off medications Monitor glucose while on steroids, initiate SSI if needed   HLD Continue home pravastatin   A-fib Paroxysmal Continue metoprolol for rate control Sinus on admission Not anticoagulated   CKD Creatinine stable on admission   Chronic HFpEF Clinically approximately euvolemic Continue home Bumex EF 62% with grade 2 diastolic dysfunction on most recent echo
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Respiratory failure, SARS-CoV-2 test positive, Scan myocardial perfusion normal, Troponin increased, Urine analysis abnormal
Clinical narrative: Assessment and Plan:  77 y.o. female patient of, MD with history of respiratory failure, CHF, A-fib, CAD, CKD, COPD, DM 2, HLD, PulmHTN presented to Medical Center with dyspnea and chest pain.     Acute on chronic respiratory failure with hypoxia Covid-19 Virus Infection Date of onset of symptoms: 2/17/2023 Symptoms present on admission: Dyspnea, chest pain, cough Date of covid positive test: 2/18/2023 Vaccination status: vaccinated Platelets: 115 (2/18) admitted with COVID-19 Baseline 102-115 Imaging: CT dissection without evidence of dissection or PE Oxygen requirements on admission: 4 L Current oxygen requirements: 2 L which is her baseline Medical therapy: steroids continued for 5 more days, will stop remdesivir  Continue Symbicort, DuoNebs, and PRN albuterol PT/OT consulted: Pt declined consult   Chest pain CAD Recent work-up including PET perfusion in November with stable CAD Pain in setting of new COVID infection Troponin minimally elevated at 16, trended flat to 15 EKG without evidence of acute ischemia Monitor symptoms   Abnormal Urinalysis 15 WBC/hpf in ED Denies symptoms of UTI   Hypertension BPs in the ED up to 218/86 with wide fluctuations Resume home antihypertensives  COPD Without acute exacerbation Scheduled Duonebs and PRN Albuterol Continue Symbicort   Prediabetes A1c 5.7 off medications Monitor glucose while on steroids, initiate SSI if needed   HLD Continue home pravastatin   A-fib Paroxysmal Continue metoprolol for rate control Sinus on admission Not anticoagulated   CKD Creatinine stable on admission   Chronic HFpEF Clinically approximately euvolemic Continue home Bumex EF 62% with grade 2 diastolic dysfunction on most recent echo
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: White blood cells urine positive
Clinical narrative: Assessment and Plan:  77 y.o. female patient of, MD with history of respiratory failure, CHF, A-fib, CAD, CKD, COPD, DM 2, HLD, PulmHTN presented to Medical Center with dyspnea and chest pain.     Acute on chronic respiratory failure with hypoxia Covid-19 Virus Infection Date of onset of symptoms: 2/17/2023 Symptoms present on admission: Dyspnea, chest pain, cough Date of covid positive test: 2/18/2023 Vaccination status: vaccinated Platelets: 115 (2/18) admitted with COVID-19 Baseline 102-115 Imaging: CT dissection without evidence of dissection or PE Oxygen requirements on admission: 4 L Current oxygen requirements: 2 L which is her baseline Medical therapy: steroids continued for 5 more days, will stop remdesivir  Continue Symbicort, DuoNebs, and PRN albuterol PT/OT consulted: Pt declined consult   Chest pain CAD Recent work-up including PET perfusion in November with stable CAD Pain in setting of new COVID infection Troponin minimally elevated at 16, trended flat to 15 EKG without evidence of acute ischemia Monitor symptoms   Abnormal Urinalysis 15 WBC/hpf in ED Denies symptoms of UTI   Hypertension BPs in the ED up to 218/86 with wide fluctuations Resume home antihypertensives  COPD Without acute exacerbation Scheduled Duonebs and PRN Albuterol Continue Symbicort   Prediabetes A1c 5.7 off medications Monitor glucose while on steroids, initiate SSI if needed   HLD Continue home pravastatin   A-fib Paroxysmal Continue metoprolol for rate control Sinus on admission Not anticoagulated   CKD Creatinine stable on admission   Chronic HFpEF Clinically approximately euvolemic Continue home Bumex EF 62% with grade 2 diastolic dysfunction on most recent echo
Age: 69.0
Sex: F
Vaccine: COVID19-2
Symptoms: COVID-19, Cough, Headache, Nausea, Pain
Clinical narrative: I started developed a cough and my fever was 99.7 and a headache and body was hurting and felt nauseous. I did a home COVID-19 test and it was positive.
Age: 69.0
Sex: F
Vaccine: COVID19-2
Symptoms: Pyrexia, SARS-CoV-2 test positive
Clinical narrative: I started developed a cough and my fever was 99.7 and a headache and body was hurting and felt nauseous. I did a home COVID-19 test and it was positive.
Age: 65.0
Sex: M
Vaccine: COVID19
Symptoms: Fatigue, Immediate post-injection reaction
Clinical narrative: Very noticeable, unusual onset of fatigue immediately after injection. Continued fatigue has been evident most days for the last two years.
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Genitourinary symptom, Oropharyngeal discolouration, Pharyngeal disorder, Urinary tract infection
Clinical narrative: I had my vaccination on 09/23/2022. On 02/03/2023 I started to experience UTI symptoms and I took a 5 day antibiotic. I started to experience throat issues with a white spot on the back of my throat on one side on 03/17/2023. I am seeing an Ear Nose and Throat specialist on 03/29/2023 because I am still having symptoms on my throat on 03/28/2023 and would like further checkups. I have recovered from the UTI on 03/28/2023.
Age: 74.0
Sex: M
Vaccine: COVID19-2
Symptoms: Blood test normal, Diplopia, Magnetic resonance imaging normal, Scan with contrast normal
Clinical narrative: I developed double vision, that has continued, it has almost, resolved. I saw my ophthalmologist, who ran blood test, and an MRI, all tests came back negative. I had to adjust my daily life as there is nothing to be done until the vision corrects itself. My eyesight is progressively getting better, I am almost back to seeing as I was before the double vision.
Age: 84.0
Sex: M
Vaccine: COVID19
Symptoms: Acute kidney injury, Acute respiratory failure, Alanine aminotransferase increased, Anaemia, Angiogram pulmonary abnormal
Clinical narrative: The patient is a 85 y.o. male with a history of AS, HTN, hx of Granulomatous disease who presented to the Hospital 2/11/23 with worsening SOB and generalized weakness in the setting of COVID-19. Hospital course complicated by Submassive saddle PE and was transferred to another hospital 2/12/23 and admitted to the ICU.   consulted to assume medical management out of the ICU.    1. Acute Hypoxic Respiratory Failure: In setting of submassive PE and COVID-19. Not on O2 at baseline. Admit CXR with hazy left opacities. Admit CT PA with ground glass opacities consistent with COVID-19 and pulmonary embolism as below. Weaned from BiPAP to  HHFNC to now 3L nasal cannula only with exertion. Requiring 3 L with exertion at time of discharge  2. COVID-19: Presented as above. Symptom onset 1 week PTA with sinus congestion, tested positive on 2/11/23, +vaccinated. CXR 2/11/23 with hazy left opacities. CT PA 2/11/23 with groundglass opacities in bilateral lungs. Continued decadron with stop date 2/20/23. Did not get remdesivir due to AKI. Symptoms improving. Isolation ends 2/21/23.  3. Acute Submassive PE with core pulmonale:  in setting of COVID-19 infection.  Admit CT PA with large saddle embolus and groundglass opacities consistent with COVID-19 infection. Duplex ultrasounds 2/11/23: residual DVTs in left distal femoral, popliteal, and tibial veins; low chance of embolization.  S/p bilateral pulmonary artery mechanical thrombectomy 2/12/2023 (Dr., cardiology). Continued eliquis with plan for 1 year.  4. Transaminitis: asymptomatic. Alk phos elevated, AST and ALT downtrending. Tbili 2.5. Dbili 2.1, downtrending. RUQ U/S 2/14/23 with sludge, which clinically would fit with cholestasis. LFTs improving: T. Bili 1.6, D. Bili 1.1, ALP 300, AST 100, ALT 141 at time of discharge  5.  Anemia: Baseline Hgb ~13-14, Hgb 12.4 in setting above on 2/13/23, stable. No evidence of further acute blood loss. Hemoglobin stable at 12.6 at time of discharge  6. AKI: Baseline Cr. ~1.2. Cr 1.5 peak, potentially pre-renal in setting of acute illness and decreased PO intake. Acute kidney injury resolved, creatinine 1.0 at time of discharge
Age: 84.0
Sex: M
Vaccine: COVID19
Symptoms: Anticoagulant therapy, Aspartate aminotransferase increased, Asthenia, Bilirubin conjugated, Blood alkaline phosphatase increased
Clinical narrative: The patient is a 85 y.o. male with a history of AS, HTN, hx of Granulomatous disease who presented to the Hospital 2/11/23 with worsening SOB and generalized weakness in the setting of COVID-19. Hospital course complicated by Submassive saddle PE and was transferred to another hospital 2/12/23 and admitted to the ICU.   consulted to assume medical management out of the ICU.    1. Acute Hypoxic Respiratory Failure: In setting of submassive PE and COVID-19. Not on O2 at baseline. Admit CXR with hazy left opacities. Admit CT PA with ground glass opacities consistent with COVID-19 and pulmonary embolism as below. Weaned from BiPAP to  HHFNC to now 3L nasal cannula only with exertion. Requiring 3 L with exertion at time of discharge  2. COVID-19: Presented as above. Symptom onset 1 week PTA with sinus congestion, tested positive on 2/11/23, +vaccinated. CXR 2/11/23 with hazy left opacities. CT PA 2/11/23 with groundglass opacities in bilateral lungs. Continued decadron with stop date 2/20/23. Did not get remdesivir due to AKI. Symptoms improving. Isolation ends 2/21/23.  3. Acute Submassive PE with core pulmonale:  in setting of COVID-19 infection.  Admit CT PA with large saddle embolus and groundglass opacities consistent with COVID-19 infection. Duplex ultrasounds 2/11/23: residual DVTs in left distal femoral, popliteal, and tibial veins; low chance of embolization.  S/p bilateral pulmonary artery mechanical thrombectomy 2/12/2023 (Dr., cardiology). Continued eliquis with plan for 1 year.  4. Transaminitis: asymptomatic. Alk phos elevated, AST and ALT downtrending. Tbili 2.5. Dbili 2.1, downtrending. RUQ U/S 2/14/23 with sludge, which clinically would fit with cholestasis. LFTs improving: T. Bili 1.6, D. Bili 1.1, ALP 300, AST 100, ALT 141 at time of discharge  5.  Anemia: Baseline Hgb ~13-14, Hgb 12.4 in setting above on 2/13/23, stable. No evidence of further acute blood loss. Hemoglobin stable at 12.6 at time of discharge  6. AKI: Baseline Cr. ~1.2. Cr 1.5 peak, potentially pre-renal in setting of acute illness and decreased PO intake. Acute kidney injury resolved, creatinine 1.0 at time of discharge
Age: 84.0
Sex: M
Vaccine: COVID19
Symptoms: Blood bilirubin, Blood creatinine increased, Blood loss assessment, COVID-19, Chest X-ray abnormal
Clinical narrative: The patient is a 85 y.o. male with a history of AS, HTN, hx of Granulomatous disease who presented to the Hospital 2/11/23 with worsening SOB and generalized weakness in the setting of COVID-19. Hospital course complicated by Submassive saddle PE and was transferred to another hospital 2/12/23 and admitted to the ICU.   consulted to assume medical management out of the ICU.    1. Acute Hypoxic Respiratory Failure: In setting of submassive PE and COVID-19. Not on O2 at baseline. Admit CXR with hazy left opacities. Admit CT PA with ground glass opacities consistent with COVID-19 and pulmonary embolism as below. Weaned from BiPAP to  HHFNC to now 3L nasal cannula only with exertion. Requiring 3 L with exertion at time of discharge  2. COVID-19: Presented as above. Symptom onset 1 week PTA with sinus congestion, tested positive on 2/11/23, +vaccinated. CXR 2/11/23 with hazy left opacities. CT PA 2/11/23 with groundglass opacities in bilateral lungs. Continued decadron with stop date 2/20/23. Did not get remdesivir due to AKI. Symptoms improving. Isolation ends 2/21/23.  3. Acute Submassive PE with core pulmonale:  in setting of COVID-19 infection.  Admit CT PA with large saddle embolus and groundglass opacities consistent with COVID-19 infection. Duplex ultrasounds 2/11/23: residual DVTs in left distal femoral, popliteal, and tibial veins; low chance of embolization.  S/p bilateral pulmonary artery mechanical thrombectomy 2/12/2023 (Dr., cardiology). Continued eliquis with plan for 1 year.  4. Transaminitis: asymptomatic. Alk phos elevated, AST and ALT downtrending. Tbili 2.5. Dbili 2.1, downtrending. RUQ U/S 2/14/23 with sludge, which clinically would fit with cholestasis. LFTs improving: T. Bili 1.6, D. Bili 1.1, ALP 300, AST 100, ALT 141 at time of discharge  5.  Anemia: Baseline Hgb ~13-14, Hgb 12.4 in setting above on 2/13/23, stable. No evidence of further acute blood loss. Hemoglobin stable at 12.6 at time of discharge  6. AKI: Baseline Cr. ~1.2. Cr 1.5 peak, potentially pre-renal in setting of acute illness and decreased PO intake. Acute kidney injury resolved, creatinine 1.0 at time of discharge
Age: 84.0
Sex: M
Vaccine: COVID19
Symptoms: Cholelithiasis, Cholestasis, Cor pulmonale, Deep vein thrombosis, Dyspnoea
Clinical narrative: The patient is a 85 y.o. male with a history of AS, HTN, hx of Granulomatous disease who presented to the Hospital 2/11/23 with worsening SOB and generalized weakness in the setting of COVID-19. Hospital course complicated by Submassive saddle PE and was transferred to another hospital 2/12/23 and admitted to the ICU.   consulted to assume medical management out of the ICU.    1. Acute Hypoxic Respiratory Failure: In setting of submassive PE and COVID-19. Not on O2 at baseline. Admit CXR with hazy left opacities. Admit CT PA with ground glass opacities consistent with COVID-19 and pulmonary embolism as below. Weaned from BiPAP to  HHFNC to now 3L nasal cannula only with exertion. Requiring 3 L with exertion at time of discharge  2. COVID-19: Presented as above. Symptom onset 1 week PTA with sinus congestion, tested positive on 2/11/23, +vaccinated. CXR 2/11/23 with hazy left opacities. CT PA 2/11/23 with groundglass opacities in bilateral lungs. Continued decadron with stop date 2/20/23. Did not get remdesivir due to AKI. Symptoms improving. Isolation ends 2/21/23.  3. Acute Submassive PE with core pulmonale:  in setting of COVID-19 infection.  Admit CT PA with large saddle embolus and groundglass opacities consistent with COVID-19 infection. Duplex ultrasounds 2/11/23: residual DVTs in left distal femoral, popliteal, and tibial veins; low chance of embolization.  S/p bilateral pulmonary artery mechanical thrombectomy 2/12/2023 (Dr., cardiology). Continued eliquis with plan for 1 year.  4. Transaminitis: asymptomatic. Alk phos elevated, AST and ALT downtrending. Tbili 2.5. Dbili 2.1, downtrending. RUQ U/S 2/14/23 with sludge, which clinically would fit with cholestasis. LFTs improving: T. Bili 1.6, D. Bili 1.1, ALP 300, AST 100, ALT 141 at time of discharge  5.  Anemia: Baseline Hgb ~13-14, Hgb 12.4 in setting above on 2/13/23, stable. No evidence of further acute blood loss. Hemoglobin stable at 12.6 at time of discharge  6. AKI: Baseline Cr. ~1.2. Cr 1.5 peak, potentially pre-renal in setting of acute illness and decreased PO intake. Acute kidney injury resolved, creatinine 1.0 at time of discharge
Age: 84.0
Sex: M
Vaccine: COVID19
Symptoms: Haemoglobin decreased, Hypertransaminasaemia, Hypophagia, Illness, Intensive care
Clinical narrative: The patient is a 85 y.o. male with a history of AS, HTN, hx of Granulomatous disease who presented to the Hospital 2/11/23 with worsening SOB and generalized weakness in the setting of COVID-19. Hospital course complicated by Submassive saddle PE and was transferred to another hospital 2/12/23 and admitted to the ICU.   consulted to assume medical management out of the ICU.    1. Acute Hypoxic Respiratory Failure: In setting of submassive PE and COVID-19. Not on O2 at baseline. Admit CXR with hazy left opacities. Admit CT PA with ground glass opacities consistent with COVID-19 and pulmonary embolism as below. Weaned from BiPAP to  HHFNC to now 3L nasal cannula only with exertion. Requiring 3 L with exertion at time of discharge  2. COVID-19: Presented as above. Symptom onset 1 week PTA with sinus congestion, tested positive on 2/11/23, +vaccinated. CXR 2/11/23 with hazy left opacities. CT PA 2/11/23 with groundglass opacities in bilateral lungs. Continued decadron with stop date 2/20/23. Did not get remdesivir due to AKI. Symptoms improving. Isolation ends 2/21/23.  3. Acute Submassive PE with core pulmonale:  in setting of COVID-19 infection.  Admit CT PA with large saddle embolus and groundglass opacities consistent with COVID-19 infection. Duplex ultrasounds 2/11/23: residual DVTs in left distal femoral, popliteal, and tibial veins; low chance of embolization.  S/p bilateral pulmonary artery mechanical thrombectomy 2/12/2023 (Dr., cardiology). Continued eliquis with plan for 1 year.  4. Transaminitis: asymptomatic. Alk phos elevated, AST and ALT downtrending. Tbili 2.5. Dbili 2.1, downtrending. RUQ U/S 2/14/23 with sludge, which clinically would fit with cholestasis. LFTs improving: T. Bili 1.6, D. Bili 1.1, ALP 300, AST 100, ALT 141 at time of discharge  5.  Anemia: Baseline Hgb ~13-14, Hgb 12.4 in setting above on 2/13/23, stable. No evidence of further acute blood loss. Hemoglobin stable at 12.6 at time of discharge  6. AKI: Baseline Cr. ~1.2. Cr 1.5 peak, potentially pre-renal in setting of acute illness and decreased PO intake. Acute kidney injury resolved, creatinine 1.0 at time of discharge
Age: 84.0
Sex: M
Vaccine: COVID19
Symptoms: Liver function test abnormal, Lung opacity, Positive airway pressure therapy, Pulmonary embolism, SARS-CoV-2 test positive
Clinical narrative: The patient is a 85 y.o. male with a history of AS, HTN, hx of Granulomatous disease who presented to the Hospital 2/11/23 with worsening SOB and generalized weakness in the setting of COVID-19. Hospital course complicated by Submassive saddle PE and was transferred to another hospital 2/12/23 and admitted to the ICU.   consulted to assume medical management out of the ICU.    1. Acute Hypoxic Respiratory Failure: In setting of submassive PE and COVID-19. Not on O2 at baseline. Admit CXR with hazy left opacities. Admit CT PA with ground glass opacities consistent with COVID-19 and pulmonary embolism as below. Weaned from BiPAP to  HHFNC to now 3L nasal cannula only with exertion. Requiring 3 L with exertion at time of discharge  2. COVID-19: Presented as above. Symptom onset 1 week PTA with sinus congestion, tested positive on 2/11/23, +vaccinated. CXR 2/11/23 with hazy left opacities. CT PA 2/11/23 with groundglass opacities in bilateral lungs. Continued decadron with stop date 2/20/23. Did not get remdesivir due to AKI. Symptoms improving. Isolation ends 2/21/23.  3. Acute Submassive PE with core pulmonale:  in setting of COVID-19 infection.  Admit CT PA with large saddle embolus and groundglass opacities consistent with COVID-19 infection. Duplex ultrasounds 2/11/23: residual DVTs in left distal femoral, popliteal, and tibial veins; low chance of embolization.  S/p bilateral pulmonary artery mechanical thrombectomy 2/12/2023 (Dr., cardiology). Continued eliquis with plan for 1 year.  4. Transaminitis: asymptomatic. Alk phos elevated, AST and ALT downtrending. Tbili 2.5. Dbili 2.1, downtrending. RUQ U/S 2/14/23 with sludge, which clinically would fit with cholestasis. LFTs improving: T. Bili 1.6, D. Bili 1.1, ALP 300, AST 100, ALT 141 at time of discharge  5.  Anemia: Baseline Hgb ~13-14, Hgb 12.4 in setting above on 2/13/23, stable. No evidence of further acute blood loss. Hemoglobin stable at 12.6 at time of discharge  6. AKI: Baseline Cr. ~1.2. Cr 1.5 peak, potentially pre-renal in setting of acute illness and decreased PO intake. Acute kidney injury resolved, creatinine 1.0 at time of discharge
Age: 84.0
Sex: M
Vaccine: COVID19
Symptoms: Sinus congestion, Thrombectomy, Ultrasound Doppler abnormal, Ultrasound abdomen abnormal
Clinical narrative: The patient is a 85 y.o. male with a history of AS, HTN, hx of Granulomatous disease who presented to the Hospital 2/11/23 with worsening SOB and generalized weakness in the setting of COVID-19. Hospital course complicated by Submassive saddle PE and was transferred to another hospital 2/12/23 and admitted to the ICU.   consulted to assume medical management out of the ICU.    1. Acute Hypoxic Respiratory Failure: In setting of submassive PE and COVID-19. Not on O2 at baseline. Admit CXR with hazy left opacities. Admit CT PA with ground glass opacities consistent with COVID-19 and pulmonary embolism as below. Weaned from BiPAP to  HHFNC to now 3L nasal cannula only with exertion. Requiring 3 L with exertion at time of discharge  2. COVID-19: Presented as above. Symptom onset 1 week PTA with sinus congestion, tested positive on 2/11/23, +vaccinated. CXR 2/11/23 with hazy left opacities. CT PA 2/11/23 with groundglass opacities in bilateral lungs. Continued decadron with stop date 2/20/23. Did not get remdesivir due to AKI. Symptoms improving. Isolation ends 2/21/23.  3. Acute Submassive PE with core pulmonale:  in setting of COVID-19 infection.  Admit CT PA with large saddle embolus and groundglass opacities consistent with COVID-19 infection. Duplex ultrasounds 2/11/23: residual DVTs in left distal femoral, popliteal, and tibial veins; low chance of embolization.  S/p bilateral pulmonary artery mechanical thrombectomy 2/12/2023 (Dr., cardiology). Continued eliquis with plan for 1 year.  4. Transaminitis: asymptomatic. Alk phos elevated, AST and ALT downtrending. Tbili 2.5. Dbili 2.1, downtrending. RUQ U/S 2/14/23 with sludge, which clinically would fit with cholestasis. LFTs improving: T. Bili 1.6, D. Bili 1.1, ALP 300, AST 100, ALT 141 at time of discharge  5.  Anemia: Baseline Hgb ~13-14, Hgb 12.4 in setting above on 2/13/23, stable. No evidence of further acute blood loss. Hemoglobin stable at 12.6 at time of discharge  6. AKI: Baseline Cr. ~1.2. Cr 1.5 peak, potentially pre-renal in setting of acute illness and decreased PO intake. Acute kidney injury resolved, creatinine 1.0 at time of discharge
Age: 65.0
Sex: F
Vaccine: COVID19-2
Symptoms: COVID-19, Feeling abnormal, Malaise, Nasal congestion, Pain
Clinical narrative: On Saturday prior our children started feeling not well. I then felt off and stuffy. By that day I was able to start PAXLOVID. I had a little fever, congestion, and little achy. I just didn't feel well.
Age: 65.0
Sex: F
Vaccine: COVID19-2
Symptoms: Pyrexia, Respiratory tract congestion, SARS-CoV-2 test positive
Clinical narrative: On Saturday prior our children started feeling not well. I then felt off and stuffy. By that day I was able to start PAXLOVID. I had a little fever, congestion, and little achy. I just didn't feel well.
Age: 14.0
Sex: M
Vaccine: HEPA, IPV, MNQ
Symptoms: Nausea, Pallor
Clinical narrative: Pt. 14 year old male. Came to receive his shots.  Mother was aware child would be receiving 6 shots plus TB.  Pt. was laughing and complaining why he was receiving so many shots.  I explained to him and his mother the reason to all the shots.  I began placing MCV4, HPV, and Polio, TB on rt arm.   09:18am Pt. stated "My B/P dropped".  I stopped and held pt. by his shoulders.  He's stated he wanted to throw up.  I told pt. to deep breath thru nose and out thru mouth. Pt. began to look pale.  I called PHN for help.  We transferred pt. onto the ottomon.  Laid him down and raised his feet.  O2 NC started @ 6L.  Began initial B/P 118/64 HR56.  Began to ask pt. his name, age and where he was at  AOx3.  Pt. stated he was feeling better.   09:23am reassessed patient.  O2 Sats @100%, tapered O2 to 4L. B/P 118/74 HR 80.  Pt. stated he wanted to sit up.   09:27am Sat pt. up on ottomon.  Reassessed patient B/P 110/78 HR 76 O2 Sats @ 98%.  Tapered O2 to 2L.  I asked pt. and mother if they wanted to continue with remaining shots.  HAV, Tdap, VZV on left arm.  Mother and pt. agreed.   09:33am  Asked patient if he's like to stand up.  Reassessed patient.  B/P 100/72 HR76 AOx3 , O2 Sats@ 100% discontinued O2.   09:45am  Pt. stated he could walk out with no assistance.  Mother walked along side him.
Age: 40.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure, Bronchitis chronic, COVID-19, COVID-19 pneumonia, Chest X-ray normal
Clinical narrative: Ogie Stoops is a 42 y.o. male patient of Physician No with no significant PMH who presented to the Hospital with sob and HA. Diagnosed with COVID-19 pneumonia   Covid-19 Pneumonia Acute hypoxic respiratory failure - resolved Date of onset of symptoms: 2/13 Symptoms present on admission: sob and cough Date of covid positive test: 2/16/23 Vaccination status: vaccinated Imaging: CXR (2/16) no acute findings Oxygen requirements on admission: 2 liters with ambulation, increased to 6L overnight Current oxygen requirements: back to room air Medical therapy: Received Decadron and remdesivir Consultants following: N/A Anticipated special isolation end date: 2/23 Discharge home with Decadron   COPD suspected CT chest shows extensive bronchitis, likely chronic In setting of smoking Will discharge with Spiriva, Symbicort, rescue inhaler Needs PFTs outpatient   OSA suspected Continue pulse ox when sleeping UM c/s for PCP referral and will need OP sleep study   Lung nodule Seen on CT - 2 right middle lobe nodules <1cm Follow up CT in 12 months   Tobacco use d/o Advised cessation ~5 min spent Ordered NRT
Age: 40.0
Sex: M
Vaccine: COVID19
Symptoms: Chronic obstructive pulmonary disease, Computerised tomogram thorax abnormal, Cough, Dyspnoea, Headache
Clinical narrative: Ogie Stoops is a 42 y.o. male patient of Physician No with no significant PMH who presented to the Hospital with sob and HA. Diagnosed with COVID-19 pneumonia   Covid-19 Pneumonia Acute hypoxic respiratory failure - resolved Date of onset of symptoms: 2/13 Symptoms present on admission: sob and cough Date of covid positive test: 2/16/23 Vaccination status: vaccinated Imaging: CXR (2/16) no acute findings Oxygen requirements on admission: 2 liters with ambulation, increased to 6L overnight Current oxygen requirements: back to room air Medical therapy: Received Decadron and remdesivir Consultants following: N/A Anticipated special isolation end date: 2/23 Discharge home with Decadron   COPD suspected CT chest shows extensive bronchitis, likely chronic In setting of smoking Will discharge with Spiriva, Symbicort, rescue inhaler Needs PFTs outpatient   OSA suspected Continue pulse ox when sleeping UM c/s for PCP referral and will need OP sleep study   Lung nodule Seen on CT - 2 right middle lobe nodules <1cm Follow up CT in 12 months   Tobacco use d/o Advised cessation ~5 min spent Ordered NRT
Age: 40.0
Sex: M
Vaccine: COVID19
Symptoms: Obstructive sleep apnoea syndrome, Pulmonary mass, SARS-CoV-2 test positive, Tobacco user
Clinical narrative: Ogie Stoops is a 42 y.o. male patient of Physician No with no significant PMH who presented to the Hospital with sob and HA. Diagnosed with COVID-19 pneumonia   Covid-19 Pneumonia Acute hypoxic respiratory failure - resolved Date of onset of symptoms: 2/13 Symptoms present on admission: sob and cough Date of covid positive test: 2/16/23 Vaccination status: vaccinated Imaging: CXR (2/16) no acute findings Oxygen requirements on admission: 2 liters with ambulation, increased to 6L overnight Current oxygen requirements: back to room air Medical therapy: Received Decadron and remdesivir Consultants following: N/A Anticipated special isolation end date: 2/23 Discharge home with Decadron   COPD suspected CT chest shows extensive bronchitis, likely chronic In setting of smoking Will discharge with Spiriva, Symbicort, rescue inhaler Needs PFTs outpatient   OSA suspected Continue pulse ox when sleeping UM c/s for PCP referral and will need OP sleep study   Lung nodule Seen on CT - 2 right middle lobe nodules <1cm Follow up CT in 12 months   Tobacco use d/o Advised cessation ~5 min spent Ordered NRT
Age: 68.0
Sex: M
Vaccine: PNC20, VARZOS
Symptoms: Immediate post-injection reaction, Immunisation reaction
Clinical narrative: Immediately after shots on both arms of Pneumonia and Shingrix I had a reaction very bad of possible Shingles on Right and left lower leg.