I can see the status bar

Chapter 621 HIV Positive
Compared with penicillin, the biggest advantage of cephalosporins is that no skin test is required.According to the consensus and guidelines of domestic experts, the incidence of allergy to cephalosporins is one-fifth of that of penicillin, and anaphylactic shock is extremely rare, with an incidence between one in a million and one in a thousand.Compared with the 10% allergy rate of penicillin and the anaphylactic shock of [-]/[-], cephalosporins do not need to be specifically tested by skin tests, at least under the current expert consensus-not to mention that the skin test results of cephalosporins are not It must be accurate, and its false positive rate is much higher than other antibiotics.

Moreover, compared with the first-generation and second-generation cephalosporins, since the C7 side chain of the third-generation and fourth-generation cephalosporins is different from that of penicillin, the probability of cross-allergic reactions with penicillin is extremely low.Therefore, it must not be generalized that patients with penicillin allergies cannot use cephalosporins.

The fourth-generation cephalosporins are now restricted-use antibiotics, and some third-generation cephalosporins are also restricted-use antibiotics.The ceftriaxone recommended by Sun Lien is the only cephalosporin among the third-generation cephalosporins that is not restricted for use.It also fulfills the requirements of being hypoallergenic, sensitive to Streptococcus pyogenes, and broad-spectrum antimicrobial against necrotizing fasciitis.

"Is ceftriaxone enough?" Chen Tianyang said to Sun Li'en while clipping and cleaning the Nigerian soldier's perineal fascia, "This infection is quite serious. If you are not sure, use a limiter Use-grade antibiotics are also acceptable—just ask Dr. Wang to make up for it later in the procedure.”

Chen Tianyang was a little worried about Sun Lien's medication plan.In his opinion, this level of perianal necrotizing fasciitis is likely to develop into more severe retroperitoneal necrotizing fasciitis.No matter how clean the surgery is now, it is impossible for the surgery to remove all the pathogenic bacteria.If the anti-infective treatment plan is not strong enough for the reason of "restricted use", then the situation will only be more troublesome.When necrotizing fasciitis develops systemic sepsis, it will be really difficult to save.

"Ceftriaxone should be enough. His symptoms do not support MRSA (methicillin-resistant Staphylococcus aureus) and other drug-resistant bacterial infections." Sun Lien was silent for a while before giving his own answer.He decided to trust the status column and save some drug reserves for the peacekeeping secondary hospital. "However, I am a little worried about the speed of his disease progression-have you done the five infectious diseases?"

After this question was asked, there was a moment of silence in the operating room.Dr. Wang raised his head and said to Sun Lien, "Five items of infectious diseases?"

"His condition is progressing a little faster." Sun Lien frowned and said, "This...five items of infectious diseases, at least we can rest assured." He blinked, and asked in disbelief, "You won't Haven't done it?"

"According to regulations, members of the peacekeeping force need to undergo a medical examination before they are stationed..." Dr. Wang said in a low voice. He wanted to say something more, but was interrupted by Chen Tianyang. Five tests for infectious diseases before the operation? You don’t know if he is HIV positive?” Chen Tianyang carefully put down the scalpel in his hand while talking, and said to the nurse beside him, “Bring the normal saline, Take two more pairs of gloves."

HIV is as closely bound to Africa as lions, giraffes and savannas are to Africa.As the most likely origin of HIV and the most severe HIV epidemic area in the world, African people have suffered from HIV for decades.In Southeastern Africa, where Politanvia is located, the average HIV prevalence rate is about 9%, much higher than the 5.4/[-] level in my country.The HIV prevalence rate in Nigeria is slightly lower than that in Southeast Africa, about [-]%.But it still belongs to a group of countries that must be careful.

"Everyone check it out and take protective measures." Dr. Wang shook his head and said to the other doctors and nurses, "Xiaotian, send the blood sample to the laboratory for investigation. Also, ask the Neiliya camp to transfer this soldier The previous medical report is here."

Sun Lien himself was a little uncertain, after all, the status bar did not clearly state whether the Nigerian soldier was HIV positive.But three hours of necrotizing fasciitis resulted in the necrosis of all the superficial fascia of the gluteus maximus on both sides-at least as far as Sun Lien's knowledge level is concerned, this matter does not make sense.

Chen Tianyang washed his hands again with physiological saline, and after making sure that the gloves on his hands were not broken, he put on two new gloves again.Then pick up the scalpel and instruments again and start the following operation.The patient's perineal fascia still needs to be further removed and rinsed. Even if the patient is HIV positive, the operation that needs to be done must be performed further down.Anyway, Chen Tianyang had never encountered HIV-positive patients before but concealed his medical history.The big deal is to take good protection during the operation, and take blocking medicine while scolding your mother after the operation.

The operation came to an end two hours later.Chen Tianyang and Dr. Wang successively made twelve openings on both sides of the patient's buttocks and around the anus.A total of more than 1400ml of necrotic tissue fluid and pus were discharged.Fortunately, through the efforts of doctors, the Nigerian soldier temporarily saved his life, excretory organs and excretory function.Unfortunately, the HIV quick test confirmed Sun Lien's concerns.

HIV positive.

"Ban Ma Ri Li, what the fuck!" Chen Tianyang carefully took off his gloves in the operating locker room, and then furiously cursed at the street, "This is killing me, I don't know why!"

Chen Tianyang was furious, and Liu Tangchun's expression was extremely ugly.After learning that the peacekeeping hospital did not conduct five inspections for infectious diseases in advance, he kept a gloomy face.It wasn't until he looked at Chen Tianyang's hands, confirmed that there were no wounds on them, and that Sun Li'en hadn't used his hands, that he slowly said to Dr. Wang, "Are you okay?"

Dr. Wang also checked his hands, and then replied with an ugly face, "I'm fine..."

"The main responsibility for this matter is not yours." Liu Tangchun directly determined the nature of the accident—he didn't care whether he had the qualifications or not. "This soldier was not HIV-positive in the medical examination a year ago. That means, either the examination at that time was faulty, and the Nigerian military forged the soldier's HIV test report. Or... the management discipline of the military camp was flawed. The problem is that this soldier got sick during his mission in Politanvia."

Both speculations are dire.Either way, there would be very serious diplomatic consequences.Liu Tangchun turned around and said to Sun Lien and Chen Tianyang, "Don't tell anyone about today's matter. No matter how close the relationship is, you can't reveal a word."

Sun Li'en nodded, he didn't think it was necessary to report today's matter to others.Chen Tianyang expressed his concern, "It's like seeing cockroaches. One HIV positive means that more people in the military camp may be positive. Peacekeeping hospitals have disease prevention responsibilities, and they can't suppress this matter." Bar?"

"Report according to the procedures and regulations, and put down other matters first." Liu Tangchun thought for a while, and said to Dr. Wang, "You first report to the superiors of our China camp, and then operate according to their opinions."

　Due to some personal reasons, the second one was more than an hour later, sorry.

　　
　
(End of this chapter)