I'm really an intern

Chapter 75

Zhang Tianyang thought for a while, and ran to the ward to take some pictures of the little girl.

Broken skin, pustules on legs, bloody throat, and add photos to the dossier.

Refreshed the results of the girl's urgent blood test, and many items have already produced results.

As always, it was red.

Zhang Tianyang copied and pasted the abnormal data one by one into the document, and then read it again and again.

"Why are the symptoms so severe, but the infection indicators are not high?"

Infection indicators mainly look at the following items, one is white blood cells and N% in blood routine, one is CRP (C-reactive protein), the other is PCT (procalcitonin), and erythrocyte sedimentation rate.

Generally speaking, these items will increase significantly in the case of bacterial infection, and the higher the increase, the more serious the bacterial infection.

"Her white blood cells are not high, even low normal, neutrophils are high, but not many, CRP and PCT are within the normal range"

"It's not like a normal bacterial infection"

Zhang Tianyang reviewed the previous diagnosis and treatment process, "Sure enough, after using antibiotics, it didn't ease."

But if it's not bacteria, is it a virus?Or fungus?

Over the past five years, so many inspections have been done, but the exact source of the disease has not been detected.

After thinking for a long time, Zhang Tianyang always felt that there was something missing, so Zhang Tianyang shook his head violently.

"What are you thinking, so many big cows haven't found out the cause of the disease, it's really floating!"

Re-examined the patient's case report document, printed a dozen copies after confirming that they were correct, and distributed them to the vacant seats in the conference room first.

At 02:30 in the afternoon, Senior Sister Chen appeared next to Zhang Tianyang.

Zhang Tianyang was sorting out a box of patients' medical records and various examination results, "Why did you come so early?"

Senior Sister Chen blinked, "I was called back to help you!"

As a salted fish senior sister, it is rare for Chen Shishi not to complain about being called back to do such "extraordinary" things.

"I can't help it. I feel that the patient is really pitiful. I'm too good at diagnosis, so I can only help you with some chores~"

Chen Shishi saw that Zhang Tianyang was about to sort out the past medical records and examination results, so she looked around and ran to the corner of the conference room to pour water for the coming big bosses with disposable paper cups.

At [-]:[-], the chief physicians from the Department of Infectious Diseases arrived one after another, and Professor Zhu was also there, nodding to Zhang Tianyang and Chen Shishi.

Brother He also sat at the back of the conference room.Before coming here, he deliberately read the new inspection results of the 8-bed girl, and took notes for the first time.

After all, it was the situation where all the bosses were present, and the patient's condition was very complicated. Although Zhang Tianyang's ability was trustworthy, this was Zhang Tianyang's first time after all.

He'll have to help see if he's missing something or saying something wrong.

At three o'clock, Professor Zhu signaled Zhang Tianyang to start.

The biggest leader in infectious internal medicine is on a business trip abroad. I heard that it is a very important meeting, but he even prepared to understand the situation through mobile phone video.

Zhang Tianyang walked to the front computer, clicked on the document he had prepared earlier, and began to introduce the illness to the big guys.

From the girl's first onset five years ago, to the key changes in the disease and diagnosis and treatment nodes in the past five years, as well as the results of various examinations and the progress compared to the previous, Zhang Tianyang introduced in detail.

A past medical history said a full 10 minutes.

The bigwigs in the audience didn't show any impatience at all.

It was because Zhang Tianyang focused on what they wanted to know, such as the characteristics of the initial onset, such as the comparison of the progress of the disease, such as the changes in chest X-rays taken at different times.

Professor Zhu and Senior Brother He had seen the patients and past medical records in the morning, so they couldn't help nodding at this moment, Zhang Tianyang didn't miss any of the points they were concerned about.

Senior Sister Chen was sitting further back than Senior Brother He. At this time, she looked left and then again, feeling a little surprised.

She also worked as an intern and reported medical records during consultations. She was scolded and watched others be scolded.

Many times, you big brothers just want you to introduce your condition in the simplest and clearest language, and don't want to listen to your opinions and nonsense at all.

But Zhang Tianyang also mixed a lot of his own judgments in the process of introduction. Chen Shishi carefully observed the expressions of the big guys, and found that there was no trace of impatience.

This shows that the bosses agree with Zhang Tianyang's judgment.

Chen Shishi blinked, a glimmer of hope suddenly rose in her heart.

The bosses are all here, and the junior brother is so powerful, maybe the cause of this patient can be found, or even cured?

After introducing the past medical records, Zhang Tianyang posted the results of the various examinations that have been admitted to the hospital this time, and then looked at the big guys.

"The above is what we know so far. This time I invite all the teachers to consult for a consultation, just to see if we can find her cause."

The voice fell, and the big brothers who had been silent below finally made a movement.

Professor Zhu is the professor in charge of this patient, but she has checked the literature at noon, but she still has no clue, so she took the initiative to speak at this time.

"What do you guys think?"

"This chest CT should be typical, right? Is there any idea from the imaging department?"

Zhang Tianyang spread his hands regretfully, "No, not only is there no imaging department in our hospital, I called Chongshan Medical and Provincial Medical imaging departments at noon, and they all said that it is rare to see this kind of film, and I didn't give any advice. .”

"I think there must still be pathogenic bacteria, maybe it's too cunning."

Academician, the biggest boss in the Department of Infectious Diseases, expressed his opinion through the screen, which aroused the approval of a group of big bosses.

"But the patient's infection indicators are not high, and the previous empirical antibiotic treatment is also ineffective. Maybe it's not bacteria?"

This is Zhang Tianyang's doubt, and everyone's doubt. A group of big bosses from the infection department started a discussion on this issue.

"If it's not bacteria, but fungus or virus, why can't it be found in various previous specimens?"

"Maybe it's because the laboratory departments of other hospitals are not strong enough?"

"Who is that, hasn't the doctor in charge of the bed listed all the hospitals she has been to before, and our laboratory department is not as powerful as them?"

"Where are you going to send Jinyu?"

"There must be a direction for them to investigate, right?"

"Is it a virus? Or a fungus? Haven't used these medicines before, why don't you try them?"

"The side effects are so serious, how can we use the medicine without evidence? We are all directors, and we still need to use trial and error to treat diseases?"

"Then what kind of disease do you think this is? I have used such powerful antibiotics as Meiping Wangu, but it is useless, and the infection index is not high."

"Maybe it's a special bacterium? Isn't Mycobacterium tuberculosis also insensitive to conventional antibiotics? And anti-tuberculosis treatment is useful at the beginning."

"Then how do you explain that the disease developed faster later?"

A group of bigwigs were discussing with red faces, and their voices became louder and louder, as if they were arguing directly, and they almost rolled up their sleeves and started working.

Chen Shishi looked surprised from behind, "Why do you start arguing while you're talking? I thought big brothers wouldn't quarrel with big brothers."

Senior Brother He was calm, "Normally, of course not. Everyone agrees and the illness is clear, so naturally there will be no quarrel, but this patient's illness"

As he said that, Senior Brother He frowned slightly, "What is Xiao Zhang doing on stage? Are you in a daze?"

Chen Shishi followed Senior Brother He's gaze and became anxious.

"A group of big bosses are here. Although he can't participate in the discussion of the disease, he can't be in a daze! No, I have to remind him!"

Chen Shishi lowered her head and took out her mobile phone, and called Zhang Tianyang directly, telling him to recover quickly.

But is Zhang Tianyang really in a daze?

(End of this chapter)