Age: 18.0
Sex: F
Vaccine: COVID19
Symptoms: Scan with contrast, Systemic inflammatory response syndrome, Tachycardia, Thyroid mass, Troponin I normal
Clinical narrative: From Emergency Room Doctor:  PERSISTENT TACHYCARDIA HYPOMAGNESEMIA FEVER Encounter Diagnosis: NONTOXIC SINGLE THYROID NODULE , LOCALIZED ENLARGED LYMPH NODES , HYPOMAGNESEMIA , OTHER CHEST PAIN , SHORTNESS OF BREATH , OTHER MALAISE , FEVER, UNSPECIFIED , ELEVATED WHITE BLOOD CELL COUNT, SYSTEMIC INFLAMMATORY REACTION SYNDROME OF NON-INFECTIOUS ORIGIN W/O ACUTE ORGAN DYSFUNCTION  Mother's notes are as follows and can be printed and sent to you via portal we set up.  Heart rate was 148bpm; sustained around 122bpm x 12 hours.  Fever 103 F; decreased after Toradol IV and (2) Tylenol and IV fluids x 3 or 4 L     Major headache as well and overall weakness.  ***** Hospital records report she signed out against medical advice which is a lie.  As her mother I initially wanted badly for hospital to perform an echo to R/O pericarditis or myocarditis.  Admission to hospital was the only way they would do that.  Upon calling an internist or attending doc, they then tell us she will be admitted to a COVID + floor even though they had already tested her TWICE for COVID and she was NEGATIVE!  I did not allow her to be admitted alone to a COVID floor.  Now records stated she signed out against medical advice which is INCORRECT.  Please see tests and results below: Please see COVID test results from hospital itself: Range: Negative Comments: NOTE: This assay has been cleared for SARS-Cov-2 (COVID19) testing under the Emergency Use Authorization (EUA). Assay Methodology: RT-PCR; Another COVID test: Range: Negative;  Comments: The ID NOW COVID-19 has been authorized by the FDA under an emergency use authorization for use by authorized laboratories and patient care settings. The test has been authorized only for the detection of nucleic acid from SARS-CoV-2. Assay Methodology:Isothermal nucleic acid amplification technology  Tests:    CT CTA CHEST W/ CONTRAST Result: Age/Sex: 18/F EXAMS: 011059252 CT CTA CHEST W/ CONTRAST STUDY: CTA CHEST REASON FOR EXAM: Female, 18 years old. Tachy, -- RADIATION DOSAGE (If Supplied By Facility): DLP = ( 622.2 ) mGycm TECHNIQUE: The examination was performed with the intravenous administration of 75 cc of ISOVUE-370. Post-processing of the angiographic images was performed, with multiplanar reformation and 3D reconstruction. Individualized dose optimization techniques were used for this CT. COMPARISON: None. ___________________________________ FINDINGS: Normal enhancement of the main pulmonary artery and right and left pulmonary arteries. Normal enhancement of the bilateral peripheral pulmonary arteries. There is no demonstrated pulmonary embolism. Normal thoracic aorta and visualized great vessels. There is no demonstrated aortic dissection. Normal heart and pericardium. Normal mediastinum. Normal hilar regions. Normal visualized trachea and bronchi. The lungs are well expanded. Normal pulmonary parenchyma. Normal pleura. No pleural effusion or pneumothorax Multiple nonenlarged as well as few enlarged lymph nodes are seen within the left axilla with the largest measuring 2.5 x 1.5 cm is best seen on series 4 image 51. The right axilla contains few nonenlarged lymph nodes as well. No enlarged mediastinal nodes. Normal osseous structures. Normal visualized upper abdomen. PAGE 1 Signed Report (CONTINUED) Status: REG ER Dis Date Admit Diagnosis: TACHY,FEVER Radiology #: EXAM DATE: 08/14/2021 CT CTA CHEST W/ CONTRAST 7 mm nodule within the left thyroid lobe.___________________________ IMPRESSION: Normal CTA chest examination, without a demonstrated pulmonary embolism or arterial dissection. Multiple nonenlarged as well as few enlarged lymph nodes are seen within the left axilla with the largest measuring 2.5 x 1.5 cm. 7 mm hypodense nodule within the left thyroid lobe. ** Transcribed Date/Time: 08/14/2021 (1221) Printed Date/Time: 08/14/2021 (1222) BATCH NO: N/A PAGE 2 Signed Report Date: 14-Aug-2021 12:21 CXR: - CHEST PORTABLE Result: Status: REG ER Dis Date Admit Diagnosis: TACHY,FEVER Radiology #: EXAM DATE: 08/14/2021 CHEST PORTABLE INDICATION: Chest Pain -- EXAMINATION/TECHNIQUE: X-RAY - XR Chest 1 View COMPARISON: None. ____________________________________________ FINDINGS: LINES/DEVICES: None. LUNGS: No consolidation, edema or effusion. No pneumothorax. MEDIASTINUM AND CARDIOVASCULAR STRUCTURES: Cardiac silhouette not enlarged. Central airways and mediastinal contour are unremarkable. BONES AND SOFT TISSUES: Unremarkable. IMPRESSION: No radiographic evidence of acute cardiopulmonary disease. Transcribed Date/Time: 08/14/2021 (0605) Printed Date/Time: 08/14/2021 (0606) BATCH NO: N/A PAGE 1 Signed Report  Labs showed elevated WBC count,  low Potassium count of 3.5 Low Magnesium count of 1.4