When doctors have a simulated operating room

Why is it suspected to be a fungal infection?

Because Zhang Yi just looked at the medical record again carefully.

First of all, common bacterial infections can be overcome by antibiotics, that is, seven types of antibiotics such as β-lactam, macrolide, aminoglycoside, etc.

This includes drugs such as penicillin, cephalosporin, erythromycin, gentamicin, etc.

But the doctor's instructions for this patient also wrote that after oral and intravenous infusion of penicillin and cephalosporin, the two most common antibiotics, the treatment effect was still poor.

From this, it can be inferred that the cause of this patient must be more serious than bacterial infection.

Then we can consider viral infection.

Viral infection is not ruled out by Zhang Yi, but the proportion is very small.

Why?

Although the patient is indeed a carrier of the hepatitis C virus.

But most of the clinical symptoms of hepatitis C are very mild, only fatigue, loss of appetite, nausea and other symptoms of chronic hepatitis.

The most serious is that it develops into cirrhosis and liver cancer in the later stage.

These symptoms are far from the situation of Li Xiaojun's skin ulcers and corrosion inside the body.

So Zhang Yi felt that viral infection is not ruled out, but the proportion is small.

Then there is parasitic infection.

In fact, in a broad sense, bacteria, fungi and even viruses can be called "parasitic" infections.

But the difference is that real parasites need to attach to the host to grow and reproduce, and even change their biological form.

And most parasites are transmitted through feces and mouth.

That is, eating food with parasites will infect parasites.

(For example, if you eat raw shrimp, which contains parasites, you will become the new host of the parasite after eating it.)

But fungi, bacteria, and viruses are different. They are microorganisms that exist in nature and can live well and reproduce stably without relying on hosts.

Their transmission routes are also more extensive than those of parasites.

Fecal-oral transmission, respiratory transmission, contact transmission (skin damage), and even aerosol transmission are all ways to infect such microorganisms.

Therefore, clinically, parasitic infections and microbial infections are distinguished.

The medical optical microscopes currently used can find parasites in the human body.

Immunological detection methods, pathogen detection methods, etc. can all be checked.

The sampling sources are mainly feces, secretions, blood, etc.

But Li Xiaojun also did this examination and did not find any parasites.

You can't say that parasites are so small that they can't be seen with an optical microscope, right?

Finally, there is fungal infection.

Fungal infection is different from ordinary bacterial infection.

The most obvious difference between the two is the cause of the disease.

Fungal infections are mostly caused by superficial, subcutaneous or internal tissues being infected, and then slowly spreading outward from the lesion.

Bacterial infections are mostly spread in the blood, and then slowly spread to the whole body.

The symptoms of the former infection are mostly tinea versicolor, tinea manuum or subcutaneous fungal diseases.

The latter is manifested as inflammation, skin rash, sepsis, etc.

The infection method and symptoms are different.

In Li Xiaojun's examination sheet, both white blood cells and neutrophils are very high.

The strange thing about this medical record is that penicillin and cephalosporin used for antibacterial purposes have been tried, but they are ineffective.

Then teicoplanin and terbinafine used for antifungal purposes have also been tried, but they are also ineffective.

Then pyrazinamide and isoniazid used against tuberculosis bacteria have also been tried.

Still ineffective!

Of course, Zhang Yi felt that the problem must be with the patient.

It may still be these problems, but they just didn't find them.

At present, Zhang Yi's biggest suspicion is still fungal infection, but there may not be a drug that can treat the symptoms, so the treatment effect after taking the medicine is not good.

The second is viruses and bacteria.

After listening to Zhang Yi's explanation, the doctors in the office also silently took out their mobile phones and planned to take a closer look at the medical record.

Just at this time, Kang Yanming returned to the office with a few books that he found from nowhere.

Just heard what Zhang Yi said.

Kang Yanming lowered his eyes and thought for a while, then walked in and said:

"Zhang Yi, Yuanpei, He Xiao and Yufei, you guys will go to the respiratory department with me later."

Huh?

Zhang Yi thought, isn't this just right!

He just wanted to go to the respiratory department to see the patient named Li Xiaojun!

Then he heard Kang Yanming walking in

While saying:

"Since you have all seen the medical records, let's go and see the patient again and help find the cause of the disease.

The results of the bone marrow biopsy and the re-biopsy of the lung tissue of the laboratory department have not yet come out.

Only one tuberculosis bacillus was found, but the treatment effect was not good.

This means that the tuberculosis bacillus may exist, but it is not the cause of his serious condition.

You all should treat this patient as a test for yourself.

You can also see how capable you are."

Kang Yanming's move is to compare these top talents in the department.

First, if Zhang Yi can help find the cause of the disease this time, then his position as assistant director will be more legitimate, and others will obey him from the bottom of their hearts, and will no longer say that he has too many privileges.

Second, if Cai Yuanpei and He Xiao find the cause of the disease, it can only mean that the old employees are more powerful.

Even if Kang Yanming does not change the position of assistant director, these employees will clamor for a change.

At that time, it will be difficult for Zhang Yi to convince others.

Anyway, no matter who wins in the end, it will be good for the patients and the entire emergency department.

Kang Yanming is happy to agree.

But if no one can find it, there is nothing we can do.

Once the disease develops, it can kill people in a few days.

They are all still young, and it is understandable that they cannot be cured...

Cai Yuanpei was the first to agree:

"Okay, Director! When are we going?"

He Xiao also nodded and said:

"No problem, the patient's condition is indeed strange, and I am also very interested."

Both of them understood why Kang Yanming asked them to go together.

Isn't it just to compare together?

Isn't it just to see who can find the pathogen first and cure the patient?

Cai Yuanpei looked at Zhang Yi while answering.

Assistant Director?

I don't recognize it!

You are good at surgery, but my operation is not bad either.

My education, experience, and professional title are all higher than yours. I don't believe that this Assistant Director can't be replaced? ?

Cai Yuanpei had worked in the emergency department for nearly ten years, and he should have been promoted long ago.

But a "Cheng Yaojin" suddenly appeared and cut off his promotion path.

Well, this time, let Director Kang and colleagues in the department take a good look.

Cai Yuanpei will definitely find the cause of this patient before anyone else!