chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 76.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 RNA, SARS-CoV-2 test positive
Clinical narrative: HOSPITALIZATION RELATED TO COVID-19 FOLLOWING COMPLETION OF PRIMARY COVID VACCINE SERIES
Age: 85.0
Sex: M
Vaccine: PNC20
Symptoms: Pain in extremity
Clinical narrative: Patient states that he had a mildly sore arm within 24 hours of receiving the vaccine. The pain only worsened as days went by. He went to see his doctor who prescribed a round of steroids orally, which did not help. Has an MRI scheduled to see if they can find out more.
Age: 30.0
Sex: M
Vaccine: COVID19
Symptoms: Anxiety, Condition aggravated, Hallucination, auditory, Paranoia
Clinical narrative: I HAVE BEEN HEARING COWARDICE VOICES THREATENING MY LIFE, TELLING ME TO GO AWAY AND I AM DEAD. ALL IN ORDER. AS YOU ARE AWARE, I WILL NEVER GIVE-IN FOR THIS COWARDICE ACTS, I AM NOT WELCOME IN YOU MIST AND LEAVE ME ALONE. LEAVE MY FAMILY ALONE, YOU ALL KNOW WHAT IS HAPPENING.
Age: 44.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain upper, Chest discomfort, Chills, Electrocardiogram normal, Hyperhidrosis
Clinical narrative: 10/30/23 received COVID vaccine at approx 10.30am at -COVID received Moderna COVID vaccine 10/30/2023 at pharmacy , started chills same evening 10/31/23Body aches, sweats, nausea  11/1/23 new onset of pain under right shoulder blade pain, constant, also tight ribs and stomach cramps. No SOB musculature of ribs, tingling in tips of fingers and toes 11/2/23 dinner time: no change in symptoms 11/2/23 evening, went to UC, did EGK (reports it was normal)  11/3/23 woke up, felt totally fine and at baseline. All sx resolved.
Age: 44.0
Sex: F
Vaccine: COVID19
Symptoms: Musculoskeletal pain, Nausea, Pain
Clinical narrative: 10/30/23 received COVID vaccine at approx 10.30am at -COVID received Moderna COVID vaccine 10/30/2023 at pharmacy , started chills same evening 10/31/23Body aches, sweats, nausea  11/1/23 new onset of pain under right shoulder blade pain, constant, also tight ribs and stomach cramps. No SOB musculature of ribs, tingling in tips of fingers and toes 11/2/23 dinner time: no change in symptoms 11/2/23 evening, went to UC, did EGK (reports it was normal)  11/3/23 woke up, felt totally fine and at baseline. All sx resolved.
Age: 34.0
Sex: M
Vaccine: COVID19
Symptoms: Chest X-ray, Generalised tonic-clonic seizure, Intervertebral disc protrusion, Joint dislocation, Magnetic resonance imaging joint
Clinical narrative: Grand maul seizure. Dislocation of right shoulder which resulted in a full rotator cuff surgery in April 2023. Thoracic spine issues to which I have a herniated disc at T11-T12 and recently found out I have a compression fracture in T4 or T5. I have had no other incidents of trauma since the seizure 10 or 11 days after the vaccine.
Age: 34.0
Sex: M
Vaccine: COVID19
Symptoms: Magnetic resonance imaging spinal abnormal, Rotator cuff repair, Spinal X-ray abnormal, Spinal compression fracture, X-ray limb abnormal
Clinical narrative: Grand maul seizure. Dislocation of right shoulder which resulted in a full rotator cuff surgery in April 2023. Thoracic spine issues to which I have a herniated disc at T11-T12 and recently found out I have a compression fracture in T4 or T5. I have had no other incidents of trauma since the seizure 10 or 11 days after the vaccine.
Age: 31.0
Sex: F
Vaccine: COVID19
Symptoms: Blood test normal, CSF pressure increased, CSF volume increased, Headache, Injury
Clinical narrative: Headaches, nauseous - kind of like my sugar is low, or like I am missing vitamins. I have had MRI, BLOOD WORK. Nothing is irregular, not until I had to have the surgery. They had tried me on anxiety medications. I had to have a VP Shunt due to extra fluid and pressure build up. They said it's due to trauma and an accident I didn't have.  May 2023 I was hospitalized for a week. That's when they found out about the pressure. I had my surgery on October 9th, 2023 at facility.
Age: 31.0
Sex: F
Vaccine: COVID19
Symptoms: Magnetic resonance imaging normal, Nausea, Surgery, Ventriculo-peritoneal shunt
Clinical narrative: Headaches, nauseous - kind of like my sugar is low, or like I am missing vitamins. I have had MRI, BLOOD WORK. Nothing is irregular, not until I had to have the surgery. They had tried me on anxiety medications. I had to have a VP Shunt due to extra fluid and pressure build up. They said it's due to trauma and an accident I didn't have.  May 2023 I was hospitalized for a week. That's when they found out about the pressure. I had my surgery on October 9th, 2023 at facility.
Age: 1.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect dose administered
Clinical narrative: Patient was administered .5ml doses instead of .25 dose, bottle says .25ml, actual vial contained .5ml
Age: 78.0
Sex: F
Vaccine: VARZOS
Symptoms: Varicella zoster virus infection
Clinical narrative: Varicella vaccine-strain viral reactivation
Age: 67.0
Sex: F
Vaccine: RSV
Symptoms: Injection site bruising
Clinical narrative: bruise at injection site
Age: 0.5
Sex: M
Vaccine: COVID19
Symptoms: Underdose
Clinical narrative: Patient was given .25ml instead of .5ml
Age: 6.0
Sex: F
Vaccine: TDAP
Symptoms: Wrong product administered
Clinical narrative: Client was 6 years old and received TDaP instead of Dtap. Client was with mother. Waited 15 minutes after injection and then left. Error discovered after departure
Age: 71.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Acute kidney injury, Alanine aminotransferase increased, Angiogram pulmonary abnormal, Aspartate aminotransferase increased, Asthenia
Clinical narrative: BRIEF OVERVIEW: Admission Date: 6/9/2023 Discharge Date: Jun 12, 2023 Discharge Disposition:  home health care  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Hypokalemia [E87.6] Generalized weakness [R53.1] AKI (acute kidney injury) [N17.9] Fall, initial encounter [W19.XXXA] Left upper lobe consolidation [J18.1] COVID [U07.1] Compression fracture of thoracic vertebra, unspecified thoracic vertebral level, initial encounter [S22.000A] COVID-19 [U07.1]   HOSPITAL COURSE: 72 y.o. female  COPD requiring 2.5 L O2 at baseline presents to emergency department with complaint of cough and shortness of breath x 3 weeks. Seen by PCP prescribed a 9 day taper of prednisone, completed 7 days. Patient's husband had COVID about a month ago, but patient never tested positive. She unfortunately had her sandal caught and she sustained a fall  . She presented with SOB and back pain .    Patient presents to emergency department tachycardic with heart rate to 110. She was initially placed on 4 L via nasal cannula but was weaned down to baseline 2.5 L. labs remarkable for potassium 2.8, creatinine 1.55, AST 44, ALT 43. Patient has a leukocytosis of 14.7. COVID-19 positive. Procalcitonin was at 12.9.  CTA thorax shows left upper lobe consilidation, mod-severe COPD, hiatal hernia and distal esophageal wall thickening, sclerosis and compression of T9. No evidence of PE. Patient was given 40 mEq of potassium and a 1 L normal saline bolus. CT lumbar and thoracic spine showed  age-indeterminate moderate burst fracture T9.   Seen and examined, husband and wife appreciative explained diagnosis, plans and need for ff up . Discharged hemodynamically stable.
Age: 71.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Back pain, Blood creatinine increased, Blood potassium decreased, COVID-19, Chronic obstructive pulmonary disease
Clinical narrative: BRIEF OVERVIEW: Admission Date: 6/9/2023 Discharge Date: Jun 12, 2023 Discharge Disposition:  home health care  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Hypokalemia [E87.6] Generalized weakness [R53.1] AKI (acute kidney injury) [N17.9] Fall, initial encounter [W19.XXXA] Left upper lobe consolidation [J18.1] COVID [U07.1] Compression fracture of thoracic vertebra, unspecified thoracic vertebral level, initial encounter [S22.000A] COVID-19 [U07.1]   HOSPITAL COURSE: 72 y.o. female  COPD requiring 2.5 L O2 at baseline presents to emergency department with complaint of cough and shortness of breath x 3 weeks. Seen by PCP prescribed a 9 day taper of prednisone, completed 7 days. Patient's husband had COVID about a month ago, but patient never tested positive. She unfortunately had her sandal caught and she sustained a fall  . She presented with SOB and back pain .    Patient presents to emergency department tachycardic with heart rate to 110. She was initially placed on 4 L via nasal cannula but was weaned down to baseline 2.5 L. labs remarkable for potassium 2.8, creatinine 1.55, AST 44, ALT 43. Patient has a leukocytosis of 14.7. COVID-19 positive. Procalcitonin was at 12.9.  CTA thorax shows left upper lobe consilidation, mod-severe COPD, hiatal hernia and distal esophageal wall thickening, sclerosis and compression of T9. No evidence of PE. Patient was given 40 mEq of potassium and a 1 L normal saline bolus. CT lumbar and thoracic spine showed  age-indeterminate moderate burst fracture T9.   Seen and examined, husband and wife appreciative explained diagnosis, plans and need for ff up . Discharged hemodynamically stable.
Age: 71.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Computerised tomogram spine abnormal, Condition aggravated, Cough, Dyspnoea, Fall
Clinical narrative: BRIEF OVERVIEW: Admission Date: 6/9/2023 Discharge Date: Jun 12, 2023 Discharge Disposition:  home health care  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Hypokalemia [E87.6] Generalized weakness [R53.1] AKI (acute kidney injury) [N17.9] Fall, initial encounter [W19.XXXA] Left upper lobe consolidation [J18.1] COVID [U07.1] Compression fracture of thoracic vertebra, unspecified thoracic vertebral level, initial encounter [S22.000A] COVID-19 [U07.1]   HOSPITAL COURSE: 72 y.o. female  COPD requiring 2.5 L O2 at baseline presents to emergency department with complaint of cough and shortness of breath x 3 weeks. Seen by PCP prescribed a 9 day taper of prednisone, completed 7 days. Patient's husband had COVID about a month ago, but patient never tested positive. She unfortunately had her sandal caught and she sustained a fall  . She presented with SOB and back pain .    Patient presents to emergency department tachycardic with heart rate to 110. She was initially placed on 4 L via nasal cannula but was weaned down to baseline 2.5 L. labs remarkable for potassium 2.8, creatinine 1.55, AST 44, ALT 43. Patient has a leukocytosis of 14.7. COVID-19 positive. Procalcitonin was at 12.9.  CTA thorax shows left upper lobe consilidation, mod-severe COPD, hiatal hernia and distal esophageal wall thickening, sclerosis and compression of T9. No evidence of PE. Patient was given 40 mEq of potassium and a 1 L normal saline bolus. CT lumbar and thoracic spine showed  age-indeterminate moderate burst fracture T9.   Seen and examined, husband and wife appreciative explained diagnosis, plans and need for ff up . Discharged hemodynamically stable.
Age: 71.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Hiatus hernia, Hypokalaemia, Leukocytosis, Lung consolidation, Oesophageal wall hypertrophy
Clinical narrative: BRIEF OVERVIEW: Admission Date: 6/9/2023 Discharge Date: Jun 12, 2023 Discharge Disposition:  home health care  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Hypokalemia [E87.6] Generalized weakness [R53.1] AKI (acute kidney injury) [N17.9] Fall, initial encounter [W19.XXXA] Left upper lobe consolidation [J18.1] COVID [U07.1] Compression fracture of thoracic vertebra, unspecified thoracic vertebral level, initial encounter [S22.000A] COVID-19 [U07.1]   HOSPITAL COURSE: 72 y.o. female  COPD requiring 2.5 L O2 at baseline presents to emergency department with complaint of cough and shortness of breath x 3 weeks. Seen by PCP prescribed a 9 day taper of prednisone, completed 7 days. Patient's husband had COVID about a month ago, but patient never tested positive. She unfortunately had her sandal caught and she sustained a fall  . She presented with SOB and back pain .    Patient presents to emergency department tachycardic with heart rate to 110. She was initially placed on 4 L via nasal cannula but was weaned down to baseline 2.5 L. labs remarkable for potassium 2.8, creatinine 1.55, AST 44, ALT 43. Patient has a leukocytosis of 14.7. COVID-19 positive. Procalcitonin was at 12.9.  CTA thorax shows left upper lobe consilidation, mod-severe COPD, hiatal hernia and distal esophageal wall thickening, sclerosis and compression of T9. No evidence of PE. Patient was given 40 mEq of potassium and a 1 L normal saline bolus. CT lumbar and thoracic spine showed  age-indeterminate moderate burst fracture T9.   Seen and examined, husband and wife appreciative explained diagnosis, plans and need for ff up . Discharged hemodynamically stable.
Age: 71.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Osteosclerosis, Procalcitonin, SARS-CoV-2 test positive, Spinal compression fracture, Spinal cord compression
Clinical narrative: BRIEF OVERVIEW: Admission Date: 6/9/2023 Discharge Date: Jun 12, 2023 Discharge Disposition:  home health care  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Hypokalemia [E87.6] Generalized weakness [R53.1] AKI (acute kidney injury) [N17.9] Fall, initial encounter [W19.XXXA] Left upper lobe consolidation [J18.1] COVID [U07.1] Compression fracture of thoracic vertebra, unspecified thoracic vertebral level, initial encounter [S22.000A] COVID-19 [U07.1]   HOSPITAL COURSE: 72 y.o. female  COPD requiring 2.5 L O2 at baseline presents to emergency department with complaint of cough and shortness of breath x 3 weeks. Seen by PCP prescribed a 9 day taper of prednisone, completed 7 days. Patient's husband had COVID about a month ago, but patient never tested positive. She unfortunately had her sandal caught and she sustained a fall  . She presented with SOB and back pain .    Patient presents to emergency department tachycardic with heart rate to 110. She was initially placed on 4 L via nasal cannula but was weaned down to baseline 2.5 L. labs remarkable for potassium 2.8, creatinine 1.55, AST 44, ALT 43. Patient has a leukocytosis of 14.7. COVID-19 positive. Procalcitonin was at 12.9.  CTA thorax shows left upper lobe consilidation, mod-severe COPD, hiatal hernia and distal esophageal wall thickening, sclerosis and compression of T9. No evidence of PE. Patient was given 40 mEq of potassium and a 1 L normal saline bolus. CT lumbar and thoracic spine showed  age-indeterminate moderate burst fracture T9.   Seen and examined, husband and wife appreciative explained diagnosis, plans and need for ff up . Discharged hemodynamically stable.
Age: 71.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Tachycardia
Clinical narrative: BRIEF OVERVIEW: Admission Date: 6/9/2023 Discharge Date: Jun 12, 2023 Discharge Disposition:  home health care  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Hypokalemia [E87.6] Generalized weakness [R53.1] AKI (acute kidney injury) [N17.9] Fall, initial encounter [W19.XXXA] Left upper lobe consolidation [J18.1] COVID [U07.1] Compression fracture of thoracic vertebra, unspecified thoracic vertebral level, initial encounter [S22.000A] COVID-19 [U07.1]   HOSPITAL COURSE: 72 y.o. female  COPD requiring 2.5 L O2 at baseline presents to emergency department with complaint of cough and shortness of breath x 3 weeks. Seen by PCP prescribed a 9 day taper of prednisone, completed 7 days. Patient's husband had COVID about a month ago, but patient never tested positive. She unfortunately had her sandal caught and she sustained a fall  . She presented with SOB and back pain .    Patient presents to emergency department tachycardic with heart rate to 110. She was initially placed on 4 L via nasal cannula but was weaned down to baseline 2.5 L. labs remarkable for potassium 2.8, creatinine 1.55, AST 44, ALT 43. Patient has a leukocytosis of 14.7. COVID-19 positive. Procalcitonin was at 12.9.  CTA thorax shows left upper lobe consilidation, mod-severe COPD, hiatal hernia and distal esophageal wall thickening, sclerosis and compression of T9. No evidence of PE. Patient was given 40 mEq of potassium and a 1 L normal saline bolus. CT lumbar and thoracic spine showed  age-indeterminate moderate burst fracture T9.   Seen and examined, husband and wife appreciative explained diagnosis, plans and need for ff up . Discharged hemodynamically stable.
Age: 63.0
Sex: M
Vaccine: VARZOS
Symptoms: Blood test normal, Electrocardiogram ambulatory normal, Electrocardiogram normal, Syncope
Clinical narrative: On 6/12/21 I fainted while seated.  After waking from faint I was transported to Hospital.  I was examined and released with no apparent cause for fainting.  I followed up the next week with a cardiologist at hospital Dr recommendation.  Cardiologist also found no apparent cause.  I have not fainted since.  I had the second dose on 11/23/2021 and had no adverse impacts.
Age: 91.0
Sex: M
Vaccine: COVID19
Symptoms: Atelectasis, Blood culture, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: DO  Admission Date: 6/9/2023 Discharge Date: 6/10/2023  PRESENTING PROBLEM: Pneumonia due to COVID-19 virus [U07.1, J12.82] COVID-19 [U07.1]   Patient is a wonderful 92yo M w/ PMH of COPD admitted briefly to obs for covid19 PNA with possible COPD exacerbation complicated.     Patient presented with worsening dyspnea and tested positive for COVID19 and he was started on decadron for this and COPD.  CXR showed atelectasis vs possible lingular PNA so patient was started on CAP coverage.  He also was noted to have a small non-occlusive RLE DVT on US.  Given lack of fever, no leukocytosis, and imaging not convincing for lobar PNA images were re-reviewed and procal was obtained; antibiotics were held as bacterial infection was felt to be very unlikely.  Patient improved significantly by AM.  He was discharged on paxlovid, decadron, and eliquis with plan for a 3 month total course.  Given interaction with paxlovid and eliquis he will need to take 1 pill BID for 5 days, 2 pills BID for 2 days once off paxlovid, then 1 pill BID which was reviewed with patient and son.  They will f/u closely with PCP.   Addendum - of note, patient's BC grew 2 different coag negative staph species highly suggestive of contamination/poor sampling.  Case reviewed with ID who recommended no further workup given very low suspicion for bacteremia.
Age: 91.0
Sex: M
Vaccine: COVID19
Symptoms: Deep vein thrombosis, Dyspnoea, Procalcitonin, SARS-CoV-2 test positive, Ultrasound Doppler abnormal
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: DO  Admission Date: 6/9/2023 Discharge Date: 6/10/2023  PRESENTING PROBLEM: Pneumonia due to COVID-19 virus [U07.1, J12.82] COVID-19 [U07.1]   Patient is a wonderful 92yo M w/ PMH of COPD admitted briefly to obs for covid19 PNA with possible COPD exacerbation complicated.     Patient presented with worsening dyspnea and tested positive for COVID19 and he was started on decadron for this and COPD.  CXR showed atelectasis vs possible lingular PNA so patient was started on CAP coverage.  He also was noted to have a small non-occlusive RLE DVT on US.  Given lack of fever, no leukocytosis, and imaging not convincing for lobar PNA images were re-reviewed and procal was obtained; antibiotics were held as bacterial infection was felt to be very unlikely.  Patient improved significantly by AM.  He was discharged on paxlovid, decadron, and eliquis with plan for a 3 month total course.  Given interaction with paxlovid and eliquis he will need to take 1 pill BID for 5 days, 2 pills BID for 2 days once off paxlovid, then 1 pill BID which was reviewed with patient and son.  They will f/u closely with PCP.   Addendum - of note, patient's BC grew 2 different coag negative staph species highly suggestive of contamination/poor sampling.  Case reviewed with ID who recommended no further workup given very low suspicion for bacteremia.
Age: 91.0
Sex: M
Vaccine: COVID19
Symptoms: Unevaluable specimen
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: DO  Admission Date: 6/9/2023 Discharge Date: 6/10/2023  PRESENTING PROBLEM: Pneumonia due to COVID-19 virus [U07.1, J12.82] COVID-19 [U07.1]   Patient is a wonderful 92yo M w/ PMH of COPD admitted briefly to obs for covid19 PNA with possible COPD exacerbation complicated.     Patient presented with worsening dyspnea and tested positive for COVID19 and he was started on decadron for this and COPD.  CXR showed atelectasis vs possible lingular PNA so patient was started on CAP coverage.  He also was noted to have a small non-occlusive RLE DVT on US.  Given lack of fever, no leukocytosis, and imaging not convincing for lobar PNA images were re-reviewed and procal was obtained; antibiotics were held as bacterial infection was felt to be very unlikely.  Patient improved significantly by AM.  He was discharged on paxlovid, decadron, and eliquis with plan for a 3 month total course.  Given interaction with paxlovid and eliquis he will need to take 1 pill BID for 5 days, 2 pills BID for 2 days once off paxlovid, then 1 pill BID which was reviewed with patient and son.  They will f/u closely with PCP.   Addendum - of note, patient's BC grew 2 different coag negative staph species highly suggestive of contamination/poor sampling.  Case reviewed with ID who recommended no further workup given very low suspicion for bacteremia.
Age: 71.0
Sex: F
Vaccine: FLU4
Symptoms: Extra dose administered, No adverse event
Clinical narrative: Patient asked for flu and pneumonia, but she has already received the vaccine on 9/28/23. The flu shot was processed and administered. She has currently not reported any adverse events from the second dose of flu vaccine.
Age: 83.0
Sex: M
Vaccine: COVID19-2
Symptoms: Blood creatinine, Blood lactic acid, Blood phosphorus, COVID-19, Chest X-ray normal
Clinical narrative: BRIEF OVERVIEW: Admission Date: 6/9/2023 Discharge Date: Jun 12, 2023 Discharge Disposition:  skilled nursing facility   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Sepsis [A41.9] Severe sepsis [A41.9, R65.20]   HOSPITAL COURSE: Patient is a 84 y.o. male with a past medical history of Alzheimer's dementia A&Ox1 at baseline, CKD three, BPH, hypertension, anxiety, AAA who presents with confusion and fever found to have COVID-19 infection and potential urinary tract infection.  Patient lives in a facility, he is typically oriented to self and recognizes family and his caregivers, but is not oriented to situation or place.  Today, he became confused and speaking gibberish, which is not usual for him, and has had a cough for the past couple days.  He also had episode of rigors.  Multiple residents at his facility are COVID positive, including one he has close contact with.  EMS was called when patient became progressively less responsive.   In the emergency department, he was noted to be febrile to 39.3, tachycardic to 138, hypotensive to 91/48, and satting in the low to mid 90s on room air.  Chest x-ray reveals no acute process.  Labs reveal positive for COVID-19, creatinine 1.48 which is near his baseline, phosphorus 2.3, lactic acid 0.9, WBC 6.7, hemoglobin 13.6, UA reveals 27 wbc's and 54 RBCs.  In the emergency department, he received IV Tylenol, Zosyn, and 3 L of IV fluid.  When patient first arrived in the emergency department, he was obtunded, and throughout his stay he progressive became more alert.  He intermittently will spontaneously open his eyes and look around and attempts to answer questions, though his speech is unintelligible.  He was admitted to Internal Medicine for further evaluation and management.                Even though, patient was covid positive he was asymptomatic and remdesivir was discontinued.  Patient return to baseline. His urine culture grew Enterococcus Faecalis and he received 4 doses of ceftriaxone and one dose of Fosfomycin was given prior to discharge. The patient went back to SNF in a stable condition.
Age: 83.0
Sex: M
Vaccine: COVID19-2
Symptoms: Chills, Confusional state, Cough, Culture urine positive, Depressed level of consciousness
Clinical narrative: BRIEF OVERVIEW: Admission Date: 6/9/2023 Discharge Date: Jun 12, 2023 Discharge Disposition:  skilled nursing facility   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Sepsis [A41.9] Severe sepsis [A41.9, R65.20]   HOSPITAL COURSE: Patient is a 84 y.o. male with a past medical history of Alzheimer's dementia A&Ox1 at baseline, CKD three, BPH, hypertension, anxiety, AAA who presents with confusion and fever found to have COVID-19 infection and potential urinary tract infection.  Patient lives in a facility, he is typically oriented to self and recognizes family and his caregivers, but is not oriented to situation or place.  Today, he became confused and speaking gibberish, which is not usual for him, and has had a cough for the past couple days.  He also had episode of rigors.  Multiple residents at his facility are COVID positive, including one he has close contact with.  EMS was called when patient became progressively less responsive.   In the emergency department, he was noted to be febrile to 39.3, tachycardic to 138, hypotensive to 91/48, and satting in the low to mid 90s on room air.  Chest x-ray reveals no acute process.  Labs reveal positive for COVID-19, creatinine 1.48 which is near his baseline, phosphorus 2.3, lactic acid 0.9, WBC 6.7, hemoglobin 13.6, UA reveals 27 wbc's and 54 RBCs.  In the emergency department, he received IV Tylenol, Zosyn, and 3 L of IV fluid.  When patient first arrived in the emergency department, he was obtunded, and throughout his stay he progressive became more alert.  He intermittently will spontaneously open his eyes and look around and attempts to answer questions, though his speech is unintelligible.  He was admitted to Internal Medicine for further evaluation and management.                Even though, patient was covid positive he was asymptomatic and remdesivir was discontinued.  Patient return to baseline. His urine culture grew Enterococcus Faecalis and he received 4 doses of ceftriaxone and one dose of Fosfomycin was given prior to discharge. The patient went back to SNF in a stable condition.
Age: 83.0
Sex: M
Vaccine: COVID19-2
Symptoms: Enterococcus test positive, Exposure to SARS-CoV-2, Haemoglobin, Hyporesponsive to stimuli, Hypotension
Clinical narrative: BRIEF OVERVIEW: Admission Date: 6/9/2023 Discharge Date: Jun 12, 2023 Discharge Disposition:  skilled nursing facility   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Sepsis [A41.9] Severe sepsis [A41.9, R65.20]   HOSPITAL COURSE: Patient is a 84 y.o. male with a past medical history of Alzheimer's dementia A&Ox1 at baseline, CKD three, BPH, hypertension, anxiety, AAA who presents with confusion and fever found to have COVID-19 infection and potential urinary tract infection.  Patient lives in a facility, he is typically oriented to self and recognizes family and his caregivers, but is not oriented to situation or place.  Today, he became confused and speaking gibberish, which is not usual for him, and has had a cough for the past couple days.  He also had episode of rigors.  Multiple residents at his facility are COVID positive, including one he has close contact with.  EMS was called when patient became progressively less responsive.   In the emergency department, he was noted to be febrile to 39.3, tachycardic to 138, hypotensive to 91/48, and satting in the low to mid 90s on room air.  Chest x-ray reveals no acute process.  Labs reveal positive for COVID-19, creatinine 1.48 which is near his baseline, phosphorus 2.3, lactic acid 0.9, WBC 6.7, hemoglobin 13.6, UA reveals 27 wbc's and 54 RBCs.  In the emergency department, he received IV Tylenol, Zosyn, and 3 L of IV fluid.  When patient first arrived in the emergency department, he was obtunded, and throughout his stay he progressive became more alert.  He intermittently will spontaneously open his eyes and look around and attempts to answer questions, though his speech is unintelligible.  He was admitted to Internal Medicine for further evaluation and management.                Even though, patient was covid positive he was asymptomatic and remdesivir was discontinued.  Patient return to baseline. His urine culture grew Enterococcus Faecalis and he received 4 doses of ceftriaxone and one dose of Fosfomycin was given prior to discharge. The patient went back to SNF in a stable condition.
Age: 83.0
Sex: M
Vaccine: COVID19-2
Symptoms: Pyrexia, Red blood cells urine positive, SARS-CoV-2 test positive, Sepsis, Speech disorder
Clinical narrative: BRIEF OVERVIEW: Admission Date: 6/9/2023 Discharge Date: Jun 12, 2023 Discharge Disposition:  skilled nursing facility   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Sepsis [A41.9] Severe sepsis [A41.9, R65.20]   HOSPITAL COURSE: Patient is a 84 y.o. male with a past medical history of Alzheimer's dementia A&Ox1 at baseline, CKD three, BPH, hypertension, anxiety, AAA who presents with confusion and fever found to have COVID-19 infection and potential urinary tract infection.  Patient lives in a facility, he is typically oriented to self and recognizes family and his caregivers, but is not oriented to situation or place.  Today, he became confused and speaking gibberish, which is not usual for him, and has had a cough for the past couple days.  He also had episode of rigors.  Multiple residents at his facility are COVID positive, including one he has close contact with.  EMS was called when patient became progressively less responsive.   In the emergency department, he was noted to be febrile to 39.3, tachycardic to 138, hypotensive to 91/48, and satting in the low to mid 90s on room air.  Chest x-ray reveals no acute process.  Labs reveal positive for COVID-19, creatinine 1.48 which is near his baseline, phosphorus 2.3, lactic acid 0.9, WBC 6.7, hemoglobin 13.6, UA reveals 27 wbc's and 54 RBCs.  In the emergency department, he received IV Tylenol, Zosyn, and 3 L of IV fluid.  When patient first arrived in the emergency department, he was obtunded, and throughout his stay he progressive became more alert.  He intermittently will spontaneously open his eyes and look around and attempts to answer questions, though his speech is unintelligible.  He was admitted to Internal Medicine for further evaluation and management.                Even though, patient was covid positive he was asymptomatic and remdesivir was discontinued.  Patient return to baseline. His urine culture grew Enterococcus Faecalis and he received 4 doses of ceftriaxone and one dose of Fosfomycin was given prior to discharge. The patient went back to SNF in a stable condition.
Age: 83.0
Sex: M
Vaccine: COVID19-2
Symptoms: Tachycardia, White blood cell count normal, White blood cells urine positive
Clinical narrative: BRIEF OVERVIEW: Admission Date: 6/9/2023 Discharge Date: Jun 12, 2023 Discharge Disposition:  skilled nursing facility   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Sepsis [A41.9] Severe sepsis [A41.9, R65.20]   HOSPITAL COURSE: Patient is a 84 y.o. male with a past medical history of Alzheimer's dementia A&Ox1 at baseline, CKD three, BPH, hypertension, anxiety, AAA who presents with confusion and fever found to have COVID-19 infection and potential urinary tract infection.  Patient lives in a facility, he is typically oriented to self and recognizes family and his caregivers, but is not oriented to situation or place.  Today, he became confused and speaking gibberish, which is not usual for him, and has had a cough for the past couple days.  He also had episode of rigors.  Multiple residents at his facility are COVID positive, including one he has close contact with.  EMS was called when patient became progressively less responsive.   In the emergency department, he was noted to be febrile to 39.3, tachycardic to 138, hypotensive to 91/48, and satting in the low to mid 90s on room air.  Chest x-ray reveals no acute process.  Labs reveal positive for COVID-19, creatinine 1.48 which is near his baseline, phosphorus 2.3, lactic acid 0.9, WBC 6.7, hemoglobin 13.6, UA reveals 27 wbc's and 54 RBCs.  In the emergency department, he received IV Tylenol, Zosyn, and 3 L of IV fluid.  When patient first arrived in the emergency department, he was obtunded, and throughout his stay he progressive became more alert.  He intermittently will spontaneously open his eyes and look around and attempts to answer questions, though his speech is unintelligible.  He was admitted to Internal Medicine for further evaluation and management.                Even though, patient was covid positive he was asymptomatic and remdesivir was discontinued.  Patient return to baseline. His urine culture grew Enterococcus Faecalis and he received 4 doses of ceftriaxone and one dose of Fosfomycin was given prior to discharge. The patient went back to SNF in a stable condition.
Age: 36.0
Sex: F
Vaccine: UNK
Symptoms: Arthralgia, Injected limb mobility decreased
Clinical narrative: right shoulder pain and having lots of difficulty moving arm and even pushing door open that continues even until 11.8.23
Age: 89.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site inflammation
Clinical narrative: Right deltoid red area and inflamed.
Age: 61.0
Sex: M
Vaccine: COVID19
Symptoms: Anaemia, Angiogram pulmonary abnormal, Asthenia, Biopsy lung, Biopsy lung normal
Clinical narrative: BRIEF OVERVIEW: Admission Date: 6/7/2023 Discharge Date: Jun 13, 2023 Discharge Disposition:  home or self care   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Cavitary pneumonia [J18.9, J98.4] Multifocal pneumonia [J18.9]   HOSPITAL COURSE: 63 y.o. male with past medical history of COPD, HTN, Crohn's disease, and right lung mass s/p EBUS with biopsy negative for malignancy who presented to the ED with chief complaint of SOB, productive cough, and weakness.    Patient was recently evaluated last month for hemoptysis and found to have right sided lung lesion highly suspicious for malignancy. He has been following with the clinic and has a chest port placed on 5/17 for anticipation of starting chemotherapy. Patient underwent bronchoscopy on 5/25 for lung biopsy with fine needle aspiration negative for malignancy. Tissue pathology showed pulmonary parenchyma with reactive pneumocyte hyperplasia.  Tissue culture grew Streptococcus agalactiae and streptococcus intermedius. Patient was scheduled to follow up with office this month and have repeat chest imaging. In the interim patient reports he had worsening cough and dyspnea with malaise and loss of appetite. He presented to ED for further care.    In the emergency department, patient was afebrile, tachycardic with heart rate 108bpm, otherwise hemodynamically stable on room air.  Labs significant for leukocytosis with WBC 24.76, anemia with hemoglobin 10.1, and thrombocytosis with platelets 449.  EKG revealed sinus tachycardia without signs of ischemia.  CTA thorax was negative for PE but did show rapidly progressive RUL, RML, and RLL dense consolidative changes concerning for multifocal PNA. In addition COVID-19 PCR was positive. Patient was started on broad spectrum abx and admitted to hospitalist.    The patient slowly improved. COVID-19 was thought to be incidental and not contributing to PNA. ID was consulted. Sputum cx grew MSSA. ID recommended 4-6 weeks total of abx with IV unasyn while inpatient and discharge on cefadroxil 1000 mg bid x 4-6 weeks to treat GBS and strep intermedius seen on cultures from 5/25 bronch as well as MSSA in sputum cx.    Pulmonology was also consulted and recommended outpatient follow up in clinic with repeat imaging to document improvement.    SLP was consulted and evaluation negative for dysphagia.    PT/OT evaluated patient and recommended SAR, the patient declined and the was discharged home with assistance from his brother, with whom he will be staying.
Age: 61.0
Sex: M
Vaccine: COVID19
Symptoms: Biopsy soft tissue, Bronchoscopy normal, COVID-19, Central venous catheterisation, Culture positive
Clinical narrative: BRIEF OVERVIEW: Admission Date: 6/7/2023 Discharge Date: Jun 13, 2023 Discharge Disposition:  home or self care   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Cavitary pneumonia [J18.9, J98.4] Multifocal pneumonia [J18.9]   HOSPITAL COURSE: 63 y.o. male with past medical history of COPD, HTN, Crohn's disease, and right lung mass s/p EBUS with biopsy negative for malignancy who presented to the ED with chief complaint of SOB, productive cough, and weakness.    Patient was recently evaluated last month for hemoptysis and found to have right sided lung lesion highly suspicious for malignancy. He has been following with the clinic and has a chest port placed on 5/17 for anticipation of starting chemotherapy. Patient underwent bronchoscopy on 5/25 for lung biopsy with fine needle aspiration negative for malignancy. Tissue pathology showed pulmonary parenchyma with reactive pneumocyte hyperplasia.  Tissue culture grew Streptococcus agalactiae and streptococcus intermedius. Patient was scheduled to follow up with office this month and have repeat chest imaging. In the interim patient reports he had worsening cough and dyspnea with malaise and loss of appetite. He presented to ED for further care.    In the emergency department, patient was afebrile, tachycardic with heart rate 108bpm, otherwise hemodynamically stable on room air.  Labs significant for leukocytosis with WBC 24.76, anemia with hemoglobin 10.1, and thrombocytosis with platelets 449.  EKG revealed sinus tachycardia without signs of ischemia.  CTA thorax was negative for PE but did show rapidly progressive RUL, RML, and RLL dense consolidative changes concerning for multifocal PNA. In addition COVID-19 PCR was positive. Patient was started on broad spectrum abx and admitted to hospitalist.    The patient slowly improved. COVID-19 was thought to be incidental and not contributing to PNA. ID was consulted. Sputum cx grew MSSA. ID recommended 4-6 weeks total of abx with IV unasyn while inpatient and discharge on cefadroxil 1000 mg bid x 4-6 weeks to treat GBS and strep intermedius seen on cultures from 5/25 bronch as well as MSSA in sputum cx.    Pulmonology was also consulted and recommended outpatient follow up in clinic with repeat imaging to document improvement.    SLP was consulted and evaluation negative for dysphagia.    PT/OT evaluated patient and recommended SAR, the patient declined and the was discharged home with assistance from his brother, with whom he will be staying.
Age: 61.0
Sex: M
Vaccine: COVID19
Symptoms: Culture tissue specimen positive, Decreased appetite, Dyspnoea, Electrocardiogram abnormal, Haemoglobin
Clinical narrative: BRIEF OVERVIEW: Admission Date: 6/7/2023 Discharge Date: Jun 13, 2023 Discharge Disposition:  home or self care   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Cavitary pneumonia [J18.9, J98.4] Multifocal pneumonia [J18.9]   HOSPITAL COURSE: 63 y.o. male with past medical history of COPD, HTN, Crohn's disease, and right lung mass s/p EBUS with biopsy negative for malignancy who presented to the ED with chief complaint of SOB, productive cough, and weakness.    Patient was recently evaluated last month for hemoptysis and found to have right sided lung lesion highly suspicious for malignancy. He has been following with the clinic and has a chest port placed on 5/17 for anticipation of starting chemotherapy. Patient underwent bronchoscopy on 5/25 for lung biopsy with fine needle aspiration negative for malignancy. Tissue pathology showed pulmonary parenchyma with reactive pneumocyte hyperplasia.  Tissue culture grew Streptococcus agalactiae and streptococcus intermedius. Patient was scheduled to follow up with office this month and have repeat chest imaging. In the interim patient reports he had worsening cough and dyspnea with malaise and loss of appetite. He presented to ED for further care.    In the emergency department, patient was afebrile, tachycardic with heart rate 108bpm, otherwise hemodynamically stable on room air.  Labs significant for leukocytosis with WBC 24.76, anemia with hemoglobin 10.1, and thrombocytosis with platelets 449.  EKG revealed sinus tachycardia without signs of ischemia.  CTA thorax was negative for PE but did show rapidly progressive RUL, RML, and RLL dense consolidative changes concerning for multifocal PNA. In addition COVID-19 PCR was positive. Patient was started on broad spectrum abx and admitted to hospitalist.    The patient slowly improved. COVID-19 was thought to be incidental and not contributing to PNA. ID was consulted. Sputum cx grew MSSA. ID recommended 4-6 weeks total of abx with IV unasyn while inpatient and discharge on cefadroxil 1000 mg bid x 4-6 weeks to treat GBS and strep intermedius seen on cultures from 5/25 bronch as well as MSSA in sputum cx.    Pulmonology was also consulted and recommended outpatient follow up in clinic with repeat imaging to document improvement.    SLP was consulted and evaluation negative for dysphagia.    PT/OT evaluated patient and recommended SAR, the patient declined and the was discharged home with assistance from his brother, with whom he will be staying.
Age: 61.0
Sex: M
Vaccine: COVID19
Symptoms: Leukocytosis, Lung consolidation, Malaise, Pathology test, Platelet count increased
Clinical narrative: BRIEF OVERVIEW: Admission Date: 6/7/2023 Discharge Date: Jun 13, 2023 Discharge Disposition:  home or self care   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Cavitary pneumonia [J18.9, J98.4] Multifocal pneumonia [J18.9]   HOSPITAL COURSE: 63 y.o. male with past medical history of COPD, HTN, Crohn's disease, and right lung mass s/p EBUS with biopsy negative for malignancy who presented to the ED with chief complaint of SOB, productive cough, and weakness.    Patient was recently evaluated last month for hemoptysis and found to have right sided lung lesion highly suspicious for malignancy. He has been following with the clinic and has a chest port placed on 5/17 for anticipation of starting chemotherapy. Patient underwent bronchoscopy on 5/25 for lung biopsy with fine needle aspiration negative for malignancy. Tissue pathology showed pulmonary parenchyma with reactive pneumocyte hyperplasia.  Tissue culture grew Streptococcus agalactiae and streptococcus intermedius. Patient was scheduled to follow up with office this month and have repeat chest imaging. In the interim patient reports he had worsening cough and dyspnea with malaise and loss of appetite. He presented to ED for further care.    In the emergency department, patient was afebrile, tachycardic with heart rate 108bpm, otherwise hemodynamically stable on room air.  Labs significant for leukocytosis with WBC 24.76, anemia with hemoglobin 10.1, and thrombocytosis with platelets 449.  EKG revealed sinus tachycardia without signs of ischemia.  CTA thorax was negative for PE but did show rapidly progressive RUL, RML, and RLL dense consolidative changes concerning for multifocal PNA. In addition COVID-19 PCR was positive. Patient was started on broad spectrum abx and admitted to hospitalist.    The patient slowly improved. COVID-19 was thought to be incidental and not contributing to PNA. ID was consulted. Sputum cx grew MSSA. ID recommended 4-6 weeks total of abx with IV unasyn while inpatient and discharge on cefadroxil 1000 mg bid x 4-6 weeks to treat GBS and strep intermedius seen on cultures from 5/25 bronch as well as MSSA in sputum cx.    Pulmonology was also consulted and recommended outpatient follow up in clinic with repeat imaging to document improvement.    SLP was consulted and evaluation negative for dysphagia.    PT/OT evaluated patient and recommended SAR, the patient declined and the was discharged home with assistance from his brother, with whom he will be staying.
Age: 61.0
Sex: M
Vaccine: COVID19
Symptoms: Pneumonia, Pneumonia necrotising, Productive cough, Pulmonary mass, Pulmonary nodular lymphoid hyperplasia
Clinical narrative: BRIEF OVERVIEW: Admission Date: 6/7/2023 Discharge Date: Jun 13, 2023 Discharge Disposition:  home or self care   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Cavitary pneumonia [J18.9, J98.4] Multifocal pneumonia [J18.9]   HOSPITAL COURSE: 63 y.o. male with past medical history of COPD, HTN, Crohn's disease, and right lung mass s/p EBUS with biopsy negative for malignancy who presented to the ED with chief complaint of SOB, productive cough, and weakness.    Patient was recently evaluated last month for hemoptysis and found to have right sided lung lesion highly suspicious for malignancy. He has been following with the clinic and has a chest port placed on 5/17 for anticipation of starting chemotherapy. Patient underwent bronchoscopy on 5/25 for lung biopsy with fine needle aspiration negative for malignancy. Tissue pathology showed pulmonary parenchyma with reactive pneumocyte hyperplasia.  Tissue culture grew Streptococcus agalactiae and streptococcus intermedius. Patient was scheduled to follow up with office this month and have repeat chest imaging. In the interim patient reports he had worsening cough and dyspnea with malaise and loss of appetite. He presented to ED for further care.    In the emergency department, patient was afebrile, tachycardic with heart rate 108bpm, otherwise hemodynamically stable on room air.  Labs significant for leukocytosis with WBC 24.76, anemia with hemoglobin 10.1, and thrombocytosis with platelets 449.  EKG revealed sinus tachycardia without signs of ischemia.  CTA thorax was negative for PE but did show rapidly progressive RUL, RML, and RLL dense consolidative changes concerning for multifocal PNA. In addition COVID-19 PCR was positive. Patient was started on broad spectrum abx and admitted to hospitalist.    The patient slowly improved. COVID-19 was thought to be incidental and not contributing to PNA. ID was consulted. Sputum cx grew MSSA. ID recommended 4-6 weeks total of abx with IV unasyn while inpatient and discharge on cefadroxil 1000 mg bid x 4-6 weeks to treat GBS and strep intermedius seen on cultures from 5/25 bronch as well as MSSA in sputum cx.    Pulmonology was also consulted and recommended outpatient follow up in clinic with repeat imaging to document improvement.    SLP was consulted and evaluation negative for dysphagia.    PT/OT evaluated patient and recommended SAR, the patient declined and the was discharged home with assistance from his brother, with whom he will be staying.