bookpower Chapter 704
Chapter 704
That day.
The patient was given a PET-CT examination.
In addition, the patient's situation was somewhat unclear, so he took the emergency department to speed up the channel.
Results come in in three hours.
During this period, the patient repeatedly developed a low-grade fever.
In the eyes of everyone, this is obviously a sign of lung cancer, obviously the fever caused by the tumor, not infectious fever, otherwise why antibiotics are not effective.
Soon.
The results of PET-CT are in.
Result: Does not support tumor lesions.
PET-CT examination is still relatively reliable, the doctor who does the examination will also inject some substances into the patient's vein, these substances will be ingested by tumor cells with strong metabolism, if the film sees a high concentration of this substance in a certain place, it is suspected that this is a tumor.
But the results did not.
After getting this report, the patient was very excited.
A happy smile also appeared on his face.
This way he doesn't need to do a lung biopsy.
But
Lin Feng wondered.
Chest CT suggests lung cancer, but PET-CT results do not support lung cancer lesions.
So is the patient or not!
According to the clinical manifestations, the patient is a middle-aged man, coughing, coughing up blood, and there is a mass in the lung, which is highly suspected of lung cancer.
But rheumatic immunity is all normal.
The most authoritative lung biopsy is the patient, and the patient is reluctant to do it.
This is a headache.
Now I can't figure out the pathology, and Lin Feng can't figure out what the patient's situation is.
Antibiotics are still in use, but the effect is obviously not good.
After communicating with the patient for a long time, he was still unwilling to undergo lung biopsy.
Although the patient's wife is also there and obviously disagrees with the patient's approach, it still cannot change the final result.
This happens.
Lin Feng is also gone.
Then he had to take out the "Informed Consent Form for Disagreement to Lung Penetration Biopsy" and ask the patient to sign it.
When he saw this consent form, the patient showed hesitation.
Just for a moment.
So he signed his name very cheerfully.
Lin Feng immediately said: "Your current situation is a little unclear, I suggest you stay in the hospital for observation for a period of time first!" "
"No problem!" The patient answered immediately.
He was not at all resistant to hospitalization.
Hearing that the patient was going to stay in the hospital for a while, the patient's wife said: "Since you are going to be hospitalized here, let's stay!" Just let those pigeons at home starve, I can't take care of those little things anyway! "
"I'm like this, I can manage them, let them fend for themselves!" The patient smiled wryly.
Lin Feng, who was about to leave, heard the conversation between the two.
Suddenly stopped.
Turning around, he asked, "You just said to feed the pigeons?" "
"That's right! This guy has a couple of pigeons, saying they are for inspiration! What's wrong? The patient's wife said immediately.
"So it is!" Lin Feng instantly understood what was going on with this patient.
He thought of another disease!
Cryptococcal pneumonia.
Cryptococcus is a fungus that often lives in dirt and pigeon droppings.
If it is inhaled into the respiratory tract, it may cause cryptococcal infection, such as the current patient's cryptococcal pneumonia, and cryptococcal encephalitis may also occur.
The respiratory department of the hospital had previously accepted a patient with pneumonia, which was later confirmed to be cryptococcal pneumonia, and the family kept pigeons.
If the patient is cryptococcal pneumonia, then it can explain all this.
Cryptococcus can cause a lump in the lung, can also cause the patient to cough up blood, and also has fever, often confused with tumors, which is why chest CT has always suggested lung cancer, and PET-CT does not support lung cancer.
The next step is simple.
Lin Feng informed the patient of these situations.
The patient regretted learning that he might have been in this situation because he had pigeons.
The patient's wife even showed that she would go home now and release the pigeons.
Then he asked Lin Feng how to treat it.
Lin Feng said: "Now the patient's condition is uncertain whether it is cryptococcal pneumonia, so it is still necessary to do targeted examinations. I'll arrange for someone to check you later! "
"Good, good, you're in trouble, doctor!" The patient answered immediately.
Another news confirmed that he was not pneumonia, and the patient was happy.
Although I was a little disappointed because I couldn't keep pigeons in the future, it quickly dissipated.
Get out of the ward.
Lin Feng said to Dr. Guipei: "Arrange HIV testing for patients, as well as cryptococcal tests. "
Hearing Lin Feng's arrangement, Doctor Guipei was just about to respond, and suddenly reacted and asked: "Check for HIV!" Dr. Lam? "
"That's right! Hurry up! Lin Feng waved his hand and said.
"Okay!" Doctor Guipei nodded doubtfully.
Why test for HIV!
Lin Feng thinks in this way, in general, cryptococcal pneumonia appears in immunodeficient patients, the most common is AIDS patients.
People who are generally healthy and have no deficient immunity are unlikely to be infected with cryptococcus, otherwise there would be people who dare to raise pigeons.
According to the probability, the probability of infection with cryptococcus in a person with normal immunity is almost 1 in 100,000.
The Doctor Guipei moves quickly.
The patient's blood sample was sent to the laboratory department.
Soon.
Lin Feng got the news.
The results of HIV are out,
Negative!
This made Lin Feng a little stunned!
Negative, definitely good for the patient!
But for him, it was a complete rejection of his previous speculation.
Such a small probability is impossible!
Lin Feng was also in no hurry.
After all, there are tests for whether cryptococcus infection is later.
After a long wait.
The results came out,
Negative!
That's right.
Still negative!
Normally, if a patient is infected with cryptococcus, then there should be antigens of this fungus in his blood.
Now that the test result is negative, it means that the patient is basically unlikely to have cryptococcal pneumonia.
Lin Feng informed the patient of this result.
After learning this result, the patient's emotions immediately began to fail.
If it is not cryptococcus, then there is still the possibility of lung cancer!
Then he may also need a lung biopsy, which of course he is lost.
For the current situation.
The best thing to do is a biopsy.
Lin Feng said again: "We still highly suspect that you are lung cancer!" My advice is not to delay time, or to get the pathology this morning, figure out the diagnosis, and receive treatment early! "
Seeing that the patient still looked resistant, Lin Feng continued: "If it is really lung cancer, in the time you delayed, if it is transferred to other places, it will be very tricky!" "
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