Chapter 325 Say something, thank Dr. Xu quickly!

Clinically, there are many causes of fever.

For elderly people with repeated fevers and a history of severe pneumonia, there are three main directions to consider.

Infections, tumors, and rheumatic immune diseases.

Infection is easily ruled out.

Tao Changhan's infection indicators are improving. The most intuitive chest X-ray also shows that the infection focus has decreased and the inflammation has been alleviated. Repeated pneumonia attacks can basically be ruled out.

Then, the problem is likely to be between tumors and rheumatic immune diseases.

"Do you want to call for a consultation?" Director Jiang asked.

In the ICU, it is okay to die, but to find tumors and check for rheumatic immune diseases, you need specialists in oncology and rheumatology.

"Need not."

Xu Qiu shook his head.

No one in the oncology department or rheumatology department can treat me.

He alone can match the elites of several departments.

"Has the patient had tumors before?" Xu Qiu asked the question while scanning the medical records again.

"have."

The woman holding the lunch box said: "About thirteen or four years ago, he had colon cancer."

"Colon cancer..."

This is a cancer that occurs at the junction of the rectum and sigmoid colon. The incidence rate is highest among those in their forties and fifties. The male to female ratio is 2:1, or even 3:1. Its incidence rate ranks third among gastrointestinal tumors.

Cancer can be treated with endoscopic minimally invasive treatment in its early stages. After resection, most patients can survive for a long time, making it one of the few tumors that can be cured radically.

If the patient has had colon cancer before, he should be wary.

This kind of cancer easily develops in a circular pattern along the intestinal wall, metastasizes to lymphatic vessels and blood, and can also plant into the abdominal cavity.

"Do an abdominal CT and check the tumor indicators."

After Xu Qiu finished speaking, he continued to investigate rheumatic and immune system diseases.

He also has a lot of knowledge reserves in this field.

In the provincial competition of the Famous Swordsman Competition, the person who had repeated fevers and inflammation in many parts of his body was finally diagnosed with relapsing polychondritis, which was rheumatic immune disease.

Now that Xu Qiu has richer experience in the diagnosis and treatment of rare diseases, as well as the comprehensive bonus brought by multi-day check-in, she is very comfortable handling such patients.

"Rheumatic fever... doesn't look like it."

"Lupus, neither."

“Dermatomyositis, which generally involves the skin and muscles, can also be ruled out.”

Xu Qiu shook his head and ruled out all the related rheumatic and immune diseases that he could think of.

But nothing was gained.

"Check the antinuclear antibodies, rheumatoid factor, and total complement C3 and C4..." Xu Qiu said solemnly.

These examinations are collectively called rheumatism immune indicators, but he needs to look at more detailed items.

"Got it, I'll call you as soon as the results come out." Director Jiang said.

With Xu Qiu here, he felt a lot more at ease.

The doctor in charge of the bed said: "There are no other major problems. We just use antipyretics. Otherwise, the patient will have a fever day by day. I'm afraid he won't be able to survive."

"Can."

There are no taboos, and there is no problem taking medicine.

"Oh, Dad, please say something. Thank you Doctor Xu!" the woman muttered.

On the hospital bed, Tao Changhan was already in a state after taking medicine, his mind was very clear, and he was looking around with big eyes.

The corner of the doctor's mouth twitched: "What are you talking about? Your father has a trachea in his mouth and is connected to a ventilator, so he can't speak."

"Yes, this old man talks less recently. At that time, I used a magnifying glass to look at the newborn baby and found that she also had a mole on the sole of her foot. He, a grandfather, had no reaction at all... Really, he used to go around dancing square dances to seduce old ladies. Well, now I don’t even dare to come up and say a few words at Full Moon Wine!”

Director Jiang: "Hurry up and throw away your magnifying glass."

Xu Qiu looked at the patient again, confirmed that the old man had no other symptoms except repeated fevers, and returned to the emergency department for outpatient care.

…

Today's outpatient clinic was controlled at around 80.

Nowadays, Linhai No. 1 Hospital is becoming more and more fond of Xu Qiu, and is afraid that giving him too many outpatient visits will affect his rest.

Therefore, many patients were diverted to people like Wang Fan, He Hai, and Wang Ping.

After all, these people behind are not tired to death, and they are not afraid of exhaustion.

After attending the outpatient clinic at noon, Xu Qiu had just two bites of food when she heard the ding-ding-ding-ding of her cell phone.

When he opened it, the department exploded.

The head nurse posted several 60-second voices in the group, which sounded like curses.

The reason was that one of the attending physicians admitted a patient whose arm almost turned into matcha.

Judging from the pictures taken, the patient's entire left upper limb is covered with gray-green scabs, as if he was wearing a layer of matcha-colored gloves. At first glance, he looks like a green giant.

There are a large number of dark red papules and papules on the trunk and limbs.

The epidermis is partially exfoliated and scabbed, and there are purulent secretions on the surface of some skin lesions. There are also thick accumulations of keratinized scaly spots on the palms, and small blisters can be seen between the fingers.

As a result, I was referred to the dermatology department, but the dermatology doctor didn't pay much attention to it and went through the routine admission procedures.

It wasn’t until today that I found out that this was no ordinary eczema at all.

But Norwegian scabies!

This disease has not been recorded in many versions of dermatology and venereology, and it is a type of disease that is not clinically known and is basically unknown.

However, even clinically, it is difficult to encounter.

Even scabies are scarce in large hospitals today, and scabies, pubic lice, etc. are often seen only in the grassroots level.

Not to mention the Norwegian scabies known as crusty scabies?

Its severity is simply not comparable to that of ordinary scabies.

It is also the most malignant type of scabies.

More importantly...

It is highly contagious!

Once infected, in addition to dry skin scabs, excessive keratinization and ulceration, there will also be pustules, foul odor, hair loss, twisted nails and other manifestations. Although it is generally not life-threatening, this feeling is worse than death.

And a certain attending physician actually received it according to the routine process, which means that the department has to burn a lot of sheets, curtains, and various daily necessities. Rounding up, it means that 100 million yuan has been burned.

Furthermore, no one dares to guarantee whether this process has caused the spread of Norwegian scabies.

The only thing to be thankful for is.

After the last gas gangrene hospital infection accident, the prevention and control level of the entire Linhai First Hospital has been greatly improved.

The original deputy dean in charge of hospital infection was replaced by a more vigorous one. He started prevention and control measures as soon as Norwegian scabies was suspected, minimizing the risk brought by this patient.

Despite this, the attending physician in charge was still inevitably scolded by the head nurse for a few days.

However, making mistakes and being scolded are commonplace for frontline doctors.

Even the founder of a certain discipline in China is no exception. He is still in clinical practice at the age of over 80. His spirit is commendable, but due to his dim eyesight, he often misdiagnoses diseases. Once, he sent a thrombocytopenic purpura that should have been sent to the hematology department to the dermatology department as allergic purpura.

The problem was not big. After checking, it was found that the platelet count was wrong, and it was corrected quickly.

Later, the fearless head nurse scolded the founder a few words, and he was named the annual outstanding nurse the following year.

In general, it is not necessarily a bad thing for clinical practitioners to be scolded. It is more comfortable than the family members holding the urn and looking at you with tears on their faces.

Thinking of this, Xu Qiu sent an emoticon.

Xu Qiu: thumbs up.jpg.

The head nurse immediately sent a five-second voice message.

The voice was gentle and considerate: "Thank you for your recognition, Dr. Xu. Come to the dermatology department when you have time. It's a big place with many patients."

After hearing the last sentence, Xu Qiu admitted that his heart was moved for a moment.

…

At about 3 pm, Director Jiang of the ICU called and said that all the examination reports of Tao Changhan had been made in an expedited manner.

Xu Qiu quickly opened the medical record system to check.

At just one glance, he frowned deeply.