Chapter 364 Contradictions! Strange disease!
The diagnostic criteria for Creutzfeldt-Jakob disease have become clearer.
The problem is... the several positive indicators he finally found on Fan Fuguo suddenly lost their diagnostic value.
A direction that I have found after so much hard work has once again fallen into a dead end!
"It's not Creutzfeldt-Jakob disease. Could it be that this is an unrecorded disease?" After thinking about it, this crazy conjecture came to Joseph's mind.
"It doesn't look like that."
The trouble actually lies here.
Fan Fuguo's various symptoms are common pathological manifestations of the central system. They are not specific at all and can be associated with anyone. They are not closely related to any disease.
Looks like everything, but is nothing.
"Are there any positive cases for the virus?" Joseph stretched his neck.
Xu Qiu shook his head again.
Five common types of viral encephalitis, such as the popular Japanese encephalitis virus, herpes simplex virus, and even the rare JC virus, human herpes virus, Epstein-Barr virus, etc., have been extensively screened. However, the PCR of all viruses was negative.
This is a huge headache.
In the conference room, Fan Fuguo suddenly had typical symptoms of viral encephalitis, but no pathogen could be found at this time.
"That basically rules out viral encephalitis." Joseph rubbed his temples and made a decision.
The dragnet has been set up, but the virus cannot be found, so viral encephalitis can basically be ruled out.
"Since it is not a new disease, I recommend continuing to expand the scope of inspections."
Joseph sighed.
Although he is not a neurologist, he often sees various difficult and rare neurological diseases in multidisciplinary consultations.
However, this is the first time that someone like Fan Fuguo has no clue.
Notwithstanding the twists and turns in the course of the disease, the pathological manifestations are also different. The most terrible thing is that the full coverage examination that has always been ineffective has failed...
From this moment on, the diagnosis hit a dead end.
At least that's how it seemed to Joseph.
"No need for now, let's do a brain biopsy."
Xu Qiu stuffed the red pen into his breast pocket and walked out.
His guess is still more towards viral encephalitis!
Joseph was silent for a while.
He naturally saw Xu Qiu's thoughts.
At this time, I’m still worried about viral encephalitis, but it’s all negative!
He couldn't understand Xu Qiu's thoughts and thought it was a meaningless struggle.
"There is no pathogen, can it be viral encephalitis?"
Joseph smiled bitterly, subconsciously touched his pocket, and was suddenly stunned.
Xu Qiushun's gesture of holding a pen suddenly flashed in his mind, and his expression froze for a moment.
That's my pen!
…
Brain biopsy, to be precise, can be divided into craniotomy to remove part of the diseased tissue and stereotactic brain biopsy.
This is an expensive and expensive examination, but it can also obtain the most precise evidence of the condition.
To be more precise, it should be called surgery.
The examination process is actually a minimally invasive craniotomy under local anesthesia or general anesthesia, and the diseased brain tissue, blood vessels and dura mater are removed for pathological examination.
Even the less invasive stereotactic brain biopsy requires a guided biopsy needle to penetrate deep into the brain to obtain samples.
What Xu Qiu wants to do is naturally stereotaxic.
This is already the last resort for brain surgery and neurology.
After all, when given the choice, no one is willing to undergo an operation just for a diagnostic test.
What's more, for Fan Fuguo, the direction of diagnosis has not yet been figured out, and it is still too early to talk about a diagnosis.
The family members immediately started arguing when they heard that the examination was so damaging and the price was over 10,000 yuan.
In the end, the old lady said, "I'll pay for it with my coffin book."
This examination operation finally fell into the hands of Xu Qiu.
The examination must be conducted under a stereotaxic navigation system and must avoid blood vessels and important parts, which is relatively difficult, but it is not a problem for Xu Qiu.
Soon, the patient was pushed onto the operating table.
Looking at Fan Fuguo, who was staring blankly on the stage and remained silent as the needle penetrated his skin, everyone in the operating room felt a sad mood.
From the time he was admitted to the hospital, no family member has explained to him what he is doing now.
Unable to hear or see, and mentally tortured, no one could imagine the despair the old man had experienced these days.
"I hope this biopsy can reveal something..." Yang Yuen clasped his hands.
After anesthesia is completed, the surgery begins.
LeKsell head frame secures the head.
Scalp disinfection and incision...
Skull drilling…
Open the dura mater in turn...
Then, with the assistance of the neuronavigation system, Xu Qiu guided the biopsy needle deep into the brain and removed the sample...
To be on the safe side, he took samples from multiple locations to prevent anything from being missed.
"Send them all to pathology."
This kind of surgery is not difficult for Xu Qiu. If it weren't for Fan Fuguo's condition being too complicated, this examination could have been left to other brain surgeons.
Subsequently, the wounds were sutured one by one and the operation was completed!
Case reports are also expedited and sent for testing.
At noon the next day, the results came out.
The biopsy results showed: T cell infiltration, microglial nodules, reactive astrogliosis and neurophagocytosis around blood vessels.
And this all points to one disease:
Viral encephalitis!
This strange report once again alarmed the whole hospital, and a large consultation was soon organized.
Director Shen of Neurosurgery, Director Lin of Neurosurgery, Director Huo and Xiao Liu who came specially, all looked surprised.
Joseph and a group of foreign famous doctors were also surprised.
"Viral encephalitis?"
Joseph's eyes were wide open.
This pathological result was simply challenging everyone's knowledge.
All the tests that could be done were negative, so where did the pathogen come from?
However, this biopsy report was ironclad evidence.
It was definitely viral encephalitis!
"What's going on..."
"Sick brain without virus?"
"I've never seen such a strange patient!"
In the conference room, many neurosurgeons were also full of doubts, and were confused by this contradictory result.
Pathology suggests viral encephalitis, which is definitely correct.
However, cerebrospinal fluid biochemistry and viral PCR did not find any trace of the virus, which is definitely correct.
Which one should I believe?
In the main seat of the conference room, Xu Qiu was flipping through many examination reports in his hand, and he was also having a headache.
In the past few days, he has searched through various documents and summarized all the diseases that can cause sick brain symptoms.
He checked them one by one, but still had no answer.
Or to put it more bluntly - there is no clue at all!
"If it doesn't work, consider sending it to Berry Country?" At this time, Joseph spoke.
He felt more and more that this was a disease that had never been recorded.
It's not sick brain, but it suggests sick brain. Is there any disease more bizarre than this?
Sure enough, Professor Yan's suspected Creutzfeldt-Jakob disease is too simple.
This Fan Fuguo is the real difficult and complicated disease!
——
I had a day of surgery today and my head hurts. I can only update once tomorrow. Ask for leave from my brothers!
