This Doctor is Great - Chapter 142
Could it be “Hantavirus”?
Then caused “hemorrhagic fever with renal syndrome”?
Zhou Mo looked at the documents about Hantavirus in front of him.
Hantavirus can cause two diseases: pulmonary syndrome (HPS) and hemorrhagic fever with renal syndrome (HFRS).
Among them, “hemorrhagic fever with renal syndrome” is divided into five stages: fever stage, hypotensive shock stage, oliguria stage, polyuria stage and recovery stage.
“Patient Xie Mingtao, very similar to the first fever period!”
In the literature, the description of the ‘fever period’ is like this.
The onset is acute, with fever (38℃~40℃), three pains (headache, low back pain, orbital pain), and nausea, vomiting, chest tightness, abdominal pain, diarrhea in some people…
Above, except back pain, orbital pain, chest tightness, everything else! !
correct,
There is another very crucial point:
“Hemorrhagic fever with renal syndrome”, there will be thrombocytopenia.
Isn’t this exactly the same as the patient Xie Mingtao’s strange blood routine results? !
Completely monistic!
One cause, explaining all symptoms!
Zhou Mo was extremely excited, and quickly took out a few papers on “hemorrhagic fever with renal syndrome” and began to brush them up.
After 30 minutes,
Zhou Mo called the teacher Zhang Luojia.
“Teacher, are you resting?”
“not yet.”
“I seem to have found the cause of that Xie Mingtao?”
“Found it? What’s the reason?”
“Hantavirus!”
“You mean ‘hemorrhagic fever with renal syndrome’? “
“Yes, all the current symptoms of the patient are in line with the various symptoms of the initial stage of this “hemorrhagic fever with renal syndrome”…”
“I’m in the office here, come here…”
“it is good.”
soon,
Zhou Mo quickly came to another office with several senior doctors.
are staying up all night.
“Come on, let’s be specific…”
“Teacher, based on the information I just checked…” Zhou Mo explained his judgment one by one.
Teacher Zhang Luojia pondered and nodded: “It is really possible that it is Hantavirus.”
This hantavirus, in the first stage (febrile period) alone, can cause systemic problems, such as systemic poisoning (nerve (brain), digestion, eyes), kidney damage, capillary damage (skin, mucous membrane bleeding, and even intestinal tract hematemesis, hematemesis),
“go!”
Teacher Zhang Luojia got up.
“Go to the internal medicine department?”
“right.”
The two went out of the gastroenterology department and then went to the neurology department.
…
Divine Internal Medicine.
At this time, Dr. Zhang was also having a headache for this patient.
The blood routine examination showed that the white blood cell count was 15x10E9/L, and it did not go up further, but the platelet count was only 50x10E9/L, which had further decreased compared to the previous one.
Moreover, he found that the patient’s blood pressure was falling, and now it was down to 80/45!
unknown reason!
But the rehydration is still going on.
Why does blood pressure keep dropping?
At this moment,
Zhang Luojia and Zhou Mo came to the ward.
Doctor Zhang was surprised: “Hey, you two haven’t gotten off work yet?”
Teacher Zhang Luojia: “No, Zhou Mo just found a disease, very similar to the patient, I think it is very likely, so come up and take a look.”
Dr. Zhang suddenly refreshed: “What’s the disease?”
Teacher Zhang Luojia: “It’s Hantavirus!”
“Hantavirus?” Dr. Zhang thought for a while and said, “You mean hemorrhagic fever with renal syndrome?”
Zhang Luojia nodded: “Yes, it is it.”
Dr. Zhang hesitated: “I’m really unfamiliar with this disease. Is it from the Department of Nephrology or the Department of Infectious Diseases?”
Zhang Luojia: “Yes, it’s from the infectious disease department.”
Dr. Zhang: “Then let the doctor from the infectious disease department come to consult…”
Zhou Mo took this opportunity to observe the patient Xie Mingtao.
It was found that his spirit was worse, lethargic.
Consistent with hantavirus.
At this time, the wife of the patient Xie Mingtao gratefully said to Zhou Mo: “Thank you, Dr. Zhou, my husband made you worry.”
Zhou Mo: “Your husband, have you ever used the toilet or urinated?”
The patient’s wife shook her head: “No.”
Zhou Mo nodded, this is more in line with kidney damage. After kidney damage, there will be problems with urination.
“I want to see your husband’s skin…isn’t there any problem…”
“Doctor Zhou, you are free!”
soon,
Zhou Mo lifted the patient Xie Mingtao’s shirt!
really!
There are a lot of places with red dots!
Is it a rash?
Or bleeding spots?
The judgment method is very simple. Zhou Mo pressed the red spot on the patient’s chest with his hand.
Do not fade.
Obviously, it’s a bleeding spot.
The rash will turn white!
This further confirms the symptoms of “Hantavirus Renal Syndrome Hemorrhagic Fever”: capillary damage, thrombocytopenia, and continuous bleeding…
Then open the sleeves and trouser legs, there are also many bleeding spots!
“Teacher, he has a lot of blood spots on his body!”
Zhou Mo informed Zhang Luojia and Doctor Zhang of his findings.
“Hey, it’s really…”
“I think it’s Hantavirus more and more!”
After about 20 minutes,
The doctor on duty in the infectious disease department arrived.
“What the **** is this evening? I’m so busy…” The infectious disease doctor complained.
“This patient is suspected to be Hantavirus’s renal syndrome hemorrhagic fever, please help me…”
“Hantavirus?”
Now the infectious disease doctor is interested.
Rare.
After the infectious disease doctor understood the situation, he couldn’t help nodding:
“Really similar!”
“Draw blood, be an epidemic hemorrhagic fever IgM…”
“Yes!”
Blood is drawn and sent to the laboratory for examination (expedited).
The infectious disease doctor asked the patient’s wife, “Are there any mice in your house?”
The patient’s wife nodded: “Yes, our house is on the first floor, and sometimes there are mice…”
Infectious doctor: “That’s right…Rats~www.mtlnovel.com~ are common carriers of Hantavirus. If they are infected through food or something, people may be infected with Hantavirus after eating…”
Waited another 20 minutes,
Soon, the results of the laboratory test came back.
positive! !
In other words, there is indeed a hemorrhagic fever!
Next, the patient will be transferred to the infectious disease department for treatment.
He has been transferred three times, from the emergency room to the digestive system to the Shennai to the infectious disease department… This patient Xie Mingtao is also considered a ‘blessed by nature’.
During the transfer procedure,
Dr. Shen Nei Zhang looked at Zhou Mo: “Your name is Zhou Mo, right? Gui Pei?”
Zhou Mo: “Yes, teacher.”
Dr. Zhang smiled: “When will you come to the Department of Internal Medicine for training? I will take you…”
Obviously, he was extremely satisfied with Zhou Mo.
The disease in front of me,
There is great confusion.
The patient’s meningitis and intracranial hypertension were prominent, blinding everyone, ignoring the rash and kidneys.
There is also shock. I always thought it was a common septic shock, but I didn’t think it was the haemorrhage and hypotension caused by the hantavirus.
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If it wasn’t for Zhou Mo’s suggestion of Hantavirus, it is estimated that the neurology department would continue to deal with the brain infection, delaying for many days, and finally it is estimated that multi-department consultations would be required to find the real cause.
Zhou Mo is a great hero! !
.
Chapter 142 Zhou Mo’s great hero, the appreciation of the psychiatrist! Click to download this site APP, massive novels, free to read!