bookpower Chapter 367
Chapter 367
【367】
"The situation of this patient, specifically..."
Director Chen told Lin Feng about the pediatric patient's illness.
After listening to it, Lin Feng pondered: "Did you start all the examinations for the patient again?" "
Director Chen: "Yes, but the results of those tests in the next province are exactly the same." "
Lin Feng: "I want to see those checklists..."
soon
The nurse put all the checklists in front of Lin Feng.
Lin Feng spread out onto the table.
One by one, they looked up.
The examination of Harmony Hospital is very detailed, and basically all the diseases that cause fever have been examined.
Lymph, cardiopulmonary disease, liver, gallbladder, spleen and pancreas... Blood culture... Routine blood tests, various blood draws...
Results: In addition to CRP and high white blood cells,
Nothing out of the ordinary!
Just like before!
However, the little girl is already in her 32nd day of fever, which can be said to be a very difficult time.
Lin Feng frowned,
I looked at the medical record data again, including detailed course information, tens of thousands of words of description, all of which were accumulated by doctors from municipal hospitals, provincial hospitals, and harmony hospitals in the past 32 days.
Read......
Still didn't find it...
"I want to meet the patient's parents and see what I haven't found..."
"Well..."
soon
Lin Feng met the parents of the family.
"Doctor Lin, I know that you are very good at medicine, please save my daughter!"
The young mother took Lin Feng's hand, knelt down, and burst into tears.
My father didn't know what to do at this time, this is Harmony Hospital, which is already the best hospital in the country.
Do you want to go to the beautiful country?
But the consumption of the beautiful country, they cannot afford it.
Lin Feng comforted the young mother: "I will do my best, I want to know some of the patient's experience now, you try to explain in detail..."
Mom: "Okay, okay... It started a month ago, my daughter came back from nursery and started having a fever%..."
Mom said it carefully, messy, and trivial, but Lin Feng preferred this more detailed thing.
Spoke for a few minutes...
Suddenly, a description of the patient's mother caught Lin Feng's attention.
"Little red dot on the body"!
"Wait... Isn't there a little red dot written in the medical record report? "
Lin Feng hurriedly asked.
Mom: "It was the first two days of illness, there were not many small red spots on my body, I thought it was bitten by mosquitoes at first, so I didn't tell the doctor... The little red dot only appeared 3 times, all of them disappeared after a few hours, I didn't think there was any need to mention it, so I didn't tell the doctor..."
"You can't do this!" When Lin Feng heard this, he couldn't help but seriously criticize: "Although I'm not sure if the red dot has anything to do with this disease now, you should still try to tell the doctor everything to avoid misdiagnosis..."
"You continue, be sure to be as detailed as possible!"
"Okay, okay."
The young mother was happy for Lin Feng's responsibility, and then described in more detail the experience, symptoms, changes in these 30 days...
Until the end,
Lin Feng didn't find anything special.
The only thing is that it has a rash.
But
Lin Feng also thought of a disease from the red rash here:
"Systemic JIA"!
Listen,
This is similar to the "juvenile idiopathic arthritis" previously checked!
But actually,
The names are similar, but the difference is great!
"Juvenile idiopathic arthritis": Antibodies of the immune system attack inflammation produced by its own tissues.
"Systemic JIA": Self-cells fight inflammation produced by their own tissues.
The mechanism of both is different.
Therefore, although the antibody test results negate "juvenile idiopathic arthritis", they cannot negate "systemic juvenile idiopathic arthritis"
And "systemic type" has several special clinical symptoms:
Unexplained long-term fever (manifested as fever time is often greater than 2 weeks, high fever, body temperature greater than 38.5 degrees Celsius, ineffective for antibiotic therapy);
• A rash that appears randomly throughout the body and disappears after a few short stays, usually small red dots on a flat surface.
Hepatospleen, lymphoma, joint redness and swelling, systemic organ involvement.
And the little girl,
It just fits the first two items, and it is also consistent that it is not a bacterium, nor is it a viral infection.
Although it does not meet the third article 'liver and spleen, lymphoma' these...
However, if no other cause can be found, this "systemic type" can be considered.
Lin Feng told his conjecture to Director Chen, the director of pediatrics.
"You're talking about Still's disease? (Systemic juvenile idiopathic arthritis)"
Director Chen's eyes lit up!
Lin Feng: "Yes, just now the young mother said that the child had a red rash..."
Lin Feng explained the derivation process.
Director Chen nodded repeatedly: "I also read the paper on this disease last month... Or the first time I encountered this disease... Your analysis is quite similar. "
Then wave your hand!
"Take a blood and go for a 'central nervous system-specific protein (S100)' test..."
Soon, the nurse drew blood ...
It is then sent for testing.
......
And then there's waiting.
An hour later,
The test results are in.
The results have excited all pediatricians!
· S100 indicator, 8 times higher!
Didn't run!
It is definitely "systemic juvenile idiopathic arthritis"!
The whole pediatrics suddenly became active.
"I really haven't heard of this disease..."
"I only found out last month..."
"Dr. Lin is really powerful!"
One doctor after another, at this moment, he was finally full of identification with Lin Feng's strength.
Lin Feng told the patient's parents the good news,
The young parents were naturally excited, and they had been suffering for 32 days, and now they had finally found the cause.
Next is treatment.
This "systemic **" cannot be cured, but can only be controlled by drugs.
The treatment is to control the inflammatory response by suppressing the immune system, such as injecting methotrexate, leflunomide, etc...
soon
After injecting the drug,
The effect is immediate,
In less than 30 minutes, the fever stopped immediately!!
For the next day, there was no more fever!
This further proves that Lin Feng's diagnosis is correct, and it is indeed "whole body **"!
But
For this little girl, the disease means that she will need to be constantly injected in the future.
However, for parents, finding the cause of the disease, and it will not affect future life, is already considered 'the rest of the life'.
And Lin Feng,
It is also because of this case that the pediatricians were completely conquered.
And the remarks of Harmony Hospital, 'Look, the hot man (Lin Feng) has extended his claws to the XX department again', began to prevail.
......
......
The next day,
Lin Feng continued to come to work in the pediatrics,
Today, Lin Feng was arranged to go to a specialist outpatient clinic to receive many pediatric patients.
The first patient,
It is a young mother who enters the clinic with a baby who has just turned one.
"Doctor Lin?"
"It's me... Sit down..."
The young mother had surprise in her eyes.
"Doctor Lin, help me see my baby, suddenly I have a fever..."
Lin Feng had already begun to observe the baby.
・ Not very conscious, not elf...
The corners of the mouth seem to have swollen herpes...
The patient's mother complains of fever...
.