stjorthotic Chapter 369
Chapter 369
Chapter 369
【367】
“The situation of this patient is like this…”
Director Chen told Lin Feng about the pediatric patient’s illness.
After Lin Feng listened, he meditated: “Did you start all the examinations on the patient?”
Director Chen: “Yes, but the results are exactly the same as those in the next province.”
Lin Feng: “I want to see those checklists…”
soon,
The nurse put all the checklists in front of Lin Feng.
Lin Feng spread out on the table.
Looked at them one by one.
The examination at Harmony Hospital is very detailed. Basically all diseases that cause fever have been examined.
Lymph, heart, lung, liver, gallbladder, spleen and pancreas… blood culture… blood routine, various blood draws…
Results: In addition to high CRP and white blood cells,
Nothing unusual!
Same as before!
However, the little girl is already on the 32nd day of fever, which can be said to be a very difficult time.
Lin Feng frowned.
I took a look at the medical records again, including detailed information about the course of the disease, and tens of thousands of words of descriptions, all of which were accumulated by doctors from the municipal hospital, provincial hospital, and Harmony Hospital, over the past 32 days.
After reading…
Still haven’t found…
“I want to meet the patient’s 08 parents to see if there is anything that I haven’t found…”
“good……”
soon,
Lin Feng met his family’s parents.
“Doctor Lin, I know your medical skills are very good, please save my daughter!”
The young mother took Lin Feng’s hand and knelt down, crying.
My father didn’t know what to do at this time. This is Harmony Hospital, which is already the best hospital in the country.
Is it going to a beautiful country?
But they cannot afford the consumption of the beautiful country.
Lin Feng comforted the young mother: “I will try my best. I now want to know something about the patient’s experience. You guys will try to elaborate as much as possible…”
Mother: “Okay, okay… things have to start a month ago. My daughter came back from the nursery and started to have a fever%…”
My mother was very careful, messy, and trivial, but Lin Feng preferred this kind of more detailed things.
Talked for a few minutes…
Suddenly, a description of the patient’s mother caught Lin Feng’s attention.
“Little red dot on body”!
“Wait…Isn’t there a little red dot in the medical report?”
Lin Feng asked quickly.
Mom: “It was the first two days of being ill, and there were not many small red spots on my body. I thought it was bitten by a mosquito, so I didn’t tell the doctor… the small red spots only appeared 3 times, all It disappeared within a few hours. I didn’t think it was necessary to mention it, so I didn’t tell the doctor…”
“You can’t do this!” Lin Feng heard this and couldn’t help but seriously criticize: “Although I am not sure whether the red dot is related to this disease, you should still tell the doctor everything as much as possible to avoid misdiagnosis… ”
“Go on, you must be as detailed as possible!”
“Okay.”
The young mother was happy for Lin Feng’s responsibility, and then described the 30-day experience, symptoms, changes in more detail…
Until the end,
Lin Feng has nothing special to discover.
The only thing is the rash.
but,
Lin Feng also thought of a disease from the rash:
“Systemic Juvenile Idiopathic Arthritis”!
One listen,
This is similar to the “Juvenile Idiopathic Arthritis” checked earlier!
But in fact,
Similar names, but very different!
“Juvenile idiopathic arthritis”: The inflammation caused by the immune system’s antibodies attacking its own tissues.
“Systemic Juvenile Idiopathic Arthritis”: One’s own cells fight the inflammation produced by one’s own tissues.
The mechanism of the two is different.
Therefore, although the antibody test result denies “juvenile idiopathic arthritis”, it cannot deny “systemic juvenile idiopathic arthritis”.
And the “systemic type” has several special clinical symptoms:
· Unexplained prolonged fever (manifested as fever often longer than 2 weeks, high fever, body temperature greater than 38.5 degrees Celsius, ineffective for antibiotic treatment);
A rash that appears randomly all over the body and disappears after a short stay for a few hours, usually a flat red spot.
· Liver and spleen, lymphatic enlargement, joint redness and swelling, and systemic organ involvement.
And the little girl,
It happens to meet the first two, and it is also not a bacterial or viral infection.
Although it doesn’t meet the third ‘Liver and Spleen, Lymphatic Enlargement’…
However, now that no other cause is found, this “systemic type” can be considered.
Lin Feng told his conjecture to Director Chen, the director of pediatrics.
“Are you talking about Still’s disease? (Systemic Juvenile Idiopathic Arthritis)”
Director Chen’s eyes lit up!
Lin Feng: “Yes, the young mother just said that the child had a rash…”
Lin Feng recounted the derivation process.
Director Chen nodded again and again: “I also only read a paper on this disease last month… This is the first time I have encountered this disease… It is quite similar to your analysis like this.”
Then he waved his hand!
“Pick a blood, go and do a “Central Nerve Specific Protein (S100)” check…”
Soon, the nurse draws blood…
Then sent to the laboratory.
…
The next step is to wait,
after an hour,
The test results are out.
All the doctors in the pediatrics department were excited about it!
·The S100 index has increased by 8 times!
Did not run away!
It is definitely “systemic juvenile idiopathic arthritis”!
The whole pediatrics department suddenly became active.
“I haven’t heard of this disease…”
“I only found out last month…”
“Doctor Lin is really amazing!”
Every doctor, at this moment, finally feels full of identification with Lin Feng’s strength.
Lin Feng told the patient’s parents the good news,
The young parents were naturally very excited and pitiful. They have been suffering for 32 days, and now they have finally found the cause.
The next step is treatment.
There is no cure for this “systemic type **, only medication can be used to control it.
The treatment is to control the inflammatory response by suppressing the immune system, such as injection of 053 methotrexate, leflunomide, etc…
soon,
After the injection of the drug,
The effect is immediate,
In less than 30 minutes, the fever stopped immediately! !
In the next day, I never had a fever again!
This further proves that Lin Feng’s diagnosis is correct and it is indeed a “whole body type**”!
but,
For this little girl, this disease means that she will need constant injections in the future.
However, for parents, finding the cause of the disease without affecting future lives is already considered a “survival after the disaster”.
And Lin Feng,
Because of this case, the pediatricians were completely conquered.
And the remarks of Harmony Hospital, “Look, a hot man (Lin Feng) has extended his claws to the XX department again”, began to prevail.
…
…
the next day,
Lin Feng continued to work in pediatrics,
Today, Lin Feng was assigned to a specialist outpatient clinic, and he has received many pediatric patients.
The first patient,
It was a young mother who brought her one-year-old baby into the clinic.
“Doctor Lin?”
“It’s me… sit down…”
The young mother had a surprise in her eyes.
“Doctor Lin, help me see my baby, suddenly he has a fever…”
Lin Feng has already started to observe the baby.
·The consciousness is not so clear, not spirit…
·The corner of the mouth seems to have herpes…
·The patient’s mother complained of fever…
..