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Many lymphocytes accumulate here. If there is an infection or a blood disease, lymphocytes or white blood cells will increase, and the lymph nodes will enlarge.

What exactly is the infection? Brother Hua had a headache. The patient changed antibiotics several times before and after, but the white blood cell count was still high, and the person still had fever, which shows that the current antibiotics are ineffective. The blood culture result is also negative. This is very annoying.

So much so that Brother Hua and his family proposed to do high-throughput gene sequencing of pathogenic microorganisms. This is a very expensive test. Simply put, we draw a tube of the patient's blood and send it to the laboratory for examination. The laboratory can analyze and compare all known pathogen gene fragments in the blood. For example, last time, one of our patients drew blood and found that it was liver fluke infection, and another fever patient detected that it was non-tuberculous Mycobacterium infection. If it weren't for sequencing this gene, we might really not be able to start treatment.

Brother Hua highly praised this inspection, but it was expensive. It costs about 10,000 yuan, and it was at its own expense.

Seeing the patient lying in the ICU with a ventilator, the family members were anxious, and Brother Hua also had a headache. The feeling of being unable to do so was the most helpless. Therefore, Brother Hua wanted his family members to try any helpful things.

The family hesitated for a while and finally agreed. If the person is gone, no matter how much money it is, it will be useless. This is a sentence the patient's wife talks to herself.

Brother Hua made an appointment with the inspection company staff and came to get the specimens in the afternoon.

At this moment, the nurse in charge of the bed called Brother Hua, saying that the patient had a corruption here, so whether he had come to see it.

When Brother Hua heard this, the first thing he thought of wouldn’t the patient have any STDs. How could he get erosion?

When I went over and saw that there was a small ulcer 0.5cmX0.5cm on the back of the patient. If it weren't for the nurse's careful care, Brother Hua would not have noticed it, because he hadn't looked at the patient's perineum in the past few days.

What kind of STDs have ** ulcers and syphilis? Brother Hua thought to himself that this disease is really weak in knowledge. He has to read through the book. He was about to ask for a dermatology consultation. A thought in his mind passed... Brother Hua was stunned.

Is it the eschar caused by scrub typhus?

picture

No way??

Brother Hua couldn't imagine it.

Isn’t eschars of scrub typhus often in the groin? How can they grow here? In addition, the patients had a related examination before, and they were all negative. Didn’t scrub typhus be ruled out?

Brother Hua quickly took his cell phone, took a photo at the ulcer stove of **, and sent it to the infectious doctor to see what it was. Well, it was a bit heavy, but I didn't care about it. The infectious doctor replied immediately, saying that the eschar is very similar, and I should be wary of the possibility of scrub typhus. Some patients' eschars are on the sac or even the anus, which is not surprising.

Brother Hua called back the superior doctor and everyone thought about it together.

The superior doctor said, in this way, since the patient's family agreed, we should draw blood first for this genetic test, and then we should hurry up and treat it as scrub typhus. The antibiotics need to be replaced, and use doxycycline.

You may not know that although they are all antibiotics, different pathogenic microorganisms will be sensitive to different antibiotics. Just like the guy who is worried about scrub typhus disease, the antibiotics such as doxycycline and chloramphenicol are sensitive, while the higher-level antibiotics they used before are ineffective.

If the patient uses doxycycline and the fever subsides and the condition is cured, the diagnosis of scrub typhus can still be verified. The superior doctor squinted his eyes and said with a smile.

Things are just like this, and life is like this.

Since doxycycline was used, the patient has stopped having a fever. The various indicators for the reexamination also tend to improve.

That is, the next afternoon, the results of high-throughput gene sequencing of pathogenic vitamins came out.

After seeing this result, everyone cheered more. Brother Hua couldn't help but share the result with Lao Ma. Lao Ma boasted, and I knew this guy was not simple.

The result is: There are hundreds of gene sequences for scrub typhus disease.

Now, the truth has finally come out.

The patient is indeed scrub typhus. There are two evidences: First, doxycycline treatment is effective, and the patient successfully left the ventilator on the third day of taking the medicine and removed the tracheal intubation. Second, genetic sequencing found the sequence of rickettsia in scrub typhus. This is called evidence, and it is impossible to rely on it.

Scrub typhus is a vascular disease caused by the invasion of this Scrub typhus Riksti's body. It has a series of vascular inflammations and blood vessels are all over the body, so multiple organs may have problems. The problems of each organ are not single, but are the culprit. Only by killing the culprit can other organs be cured. Most patients with scrub typhus can recover, and a few patients will develop multiple organ dysfunction, just like this patient, the heart, lungs, liver, etc. have problems.

Later, I asked about the medical history and said that the patient went to the park a few days ago. Could it be that the patient was bitten by chiggers at that time? It is possible. So I warned all neighbors that if you really want to go to these overgrown places, it is best to wear tighter and not expose your legs, otherwise something will be easy to get into.

But everyone is curious why so many Waifei tests have been done before and some antibody tests are negative. This involves a question of the positive rate. All tests are not 100%. It may be related to the course of the disease. This is the case with scrub typhus. The positive rate of the test is not high a week after the onset, but if it is two weeks later, the positive rate will soar. It is a bit strange that the doctor did not do this test repeatedly at that time. We have reason to believe that next time, they will definitely do this test on the suspects every few days.

In addition, why didn’t the deputy director of the respiratory department find the patient’s perineum or eschar at the beginning? This is also a question of time. When they looked at it, it might have been that the eschar had not yet formed. It was not until the ICU nurse was taking care of it that the eschar came out.

This is fate.

Who is the most unfair? I think he is the deputy director of the respiratory department. He thought of everything, but his luck is a little bit short of it.

No, the most unfair thing is the patient.

It's definitely not Lao Ma.

The brother told his family the result of the discussion that he would have a bone marrow apnea. The patient's wife had already calmed down a little and said she could do it. If she was helpful, she could do it. That's right, it can be seen that she was reluctant to let it go. After all, treatment in the ICU means suffering.

After signing the letter, Brother Hua began to prepare for bone marrow puncture.

The operation went smoothly.

The next day, the results came out. The bone marrow aspiration test results were consistent with the appearance of infection and did not support blood diseases such as lymphoma or leukemia. Infectious diseases were considered.
Chapter completed!