Qi Jing's title is too low. Except for a few doctors with heavy weight and internal emergency, others don't have much impression of him. Even the doctor of ENT does not know that Director Qi has a son working in the internal medicine emergency department.

Xia Wei couldn't make a judgment easily because of Qi Jing's words. As a consultant doctor, he had to review the ct that had just been taken: "The patient can't see foreign objects in his throat, but he can see changes in insect septics around him."

Before, Qi Jing only said that Chang Wenhan's throat and sinuses were a bit strange, and he needed an otolaryngology look, but did not tell them the result of his judgment. Qin Xuefeng and Chen Xiao are not otolaryngologists. Although they still have some impression of "change of insect septics", they really cannot be associated with their throats.

"I feel like Adam's tuberculosis." Xia Wei affirmed their judgment.

"Is there really Adam's tuberculosis?"

"Adam's tuberculosis is indeed rare. You may mistakenly think that damage caused by foreign objects is normal."

Qin Xuefeng and Chen Xiao both have some. If they hadn't had rich clinical experience in ENT, nose and throat, no one would have thought about tuberculosis. And doctors who specialize in their respective disciplines would not have thought that Chen Xiao would not even know that tuberculosis could settle down in the throat.

However, at this time Qi Jing made some different voices: "Tuberburn? The first hospital conducted a comprehensive examination of the bacteria. There was a tuberculin test in the report, and the result was negative."

Xia Wei frowned at Qi Jing.

No matter who it is, the first time I see a stranger, it is even more so when I meet with the opposite sex. Three doctors are anxious, Qin Xuefeng is too old and Chen Xiao is too thick. The only thing they can see is Qi Jing, but they can do things that deceive people to come for consultation, and their personality must be very bad.

Now that he heard what he said, Xia Wei didn't have any feelings for Qi Jing: "Are you an intern?"

Qin Xuefeng and Chen Xiao couldn't help laughing. Unexpectedly, Qi Jing, who was in a hurry, would have this day. However, just saw the cause of Chang Wenhan's disease, Qi Jing was in a good mood, so he endured it and did not have an attack: "Just graduated."

"Bachelor's degree?"

"Well, what's wrong?"

"It has been written in tuberculosis that the tuberculin test must first establish an allergic reaction in the body, which has a 48-week delay." Xia Wei frying cold rice, which is quite like a university lecturer. "And the patient has undergone major surgery and his body's immunity is very poor, so it is normal for the tuberculin test to rely on his body's immunity to be negative these days."

After a dogmatic remark, her eyes were filled with a counterattack against the deception just now.

The counterattack achieved a considerable effect, making Qin Xuefeng and Chen Xiao, who were watching the fun and not having fun, couldn't help but clap for her and celebrate: "Well said it, Xiao Qi, what else do you have to say?"

"Teacher Qin, are you asking him to make the final struggle?" Chen Xiao asked, holding back his smile.

"At this point, we still have to give the parties a chance to argue."

After hearing this, Chen Xiao felt thoughtful and couldn't help but nodded: "It's reasonable."

Qi Jing shrugged her shoulders and said with a smile: "If Adam's tuberculosis reaches the point of shock, it will probably have spread to other parts of the body long ago."

"Yes, there are also in the sinuses." Qin Xuefeng said.

"This is different." Qi Jing said again, "Adam's tuberculosis will produce a large number of inflammatory nodules in the throat, and the swollen nodules that proliferate inwardly will even block the throat. The throat in the image should be a curved stream. It will not be as wide as Chang Wenhan's throat, so wide that it will almost catch up with the Yangtze River."

"Oh, this is not accurate." Chen Xiao shook his head, "and the patient's body temperature has always been neither high nor low, which is very similar to tuberculosis."

"This reason is not sufficient, I vote for Xiao Xia."

Qin Xuefeng and Chen Xiao stood beside Xia Wei and continued to look at Qi Jing's "joke". But Xia Wei herself cannot be seen as a joke. She is a consulting doctor, and it is very troublesome to write a wrong consultation and diagnosis.

According to common sense, what Qi Jing said is indeed true.

Tuberculosis with insect-like phage-changed all belong to casey-like tuberculosis. The inflammatory nodules produced by tuberculosis bacteria will quickly produce central casey necrosis, and the necrotic tissue will further liquefy and leave the inflammatory nodules, creating holes.

The change of insect-swallowing is the overall feeling generated by the gathering of these large and small holes.

If these necrotic substances leave the body without passing through the mouth and nose, they will definitely enter the blood or digest the respiratory tract, and the lungs and bones and intestines will definitely spread and metastasize. However, the patient's whole body is as clean as normal people, and there is not even a little bit of inflammation that should be caused by long-term bed rest after major surgery.

The patient has not received anti-tuberculosis treatment, which is unreasonable.

Moreover, the course of tuberculosis is very long. It is impossible to complete the onset and shock process in just half a month, and it is even more impossible to cause the patient to fall into a coma again. Her diagnosis sounds very reasonable at first glance, but if you really need to investigate, there will be many loopholes. Instead, what Qi Jing said is more convincing.

This is not the diagnostic thinking that a newly graduated undergraduate should have, and his meticulousness even caught up with her teacher.

But even so, the diagnosis of foreign body in the throat is too outrageous, as if it was made up randomly. Xia Wei asked Qi Jing at this time: "What is your diagnosis?"

"Foreign object." Qi Jing still insisted on his statement.

"Stop kidding, where can I tell there is a foreign object in this ct film?"

"No matter what it is, you still have to be diagnosed first." Qi Jing looked at Xia Wei, "Even if it is Adam's tuberculosis, if you cannot undergo a tuberculin test, it should be possible to diagnose it directly with a laryngoscopy, right?"

Xia Wei thought about it and nodded.

"Then do an emergency laryngoscopy and see what's going on inside."

Xia Wei was scared with a thick stack of surgery and postoperative course records. There were many complications after the brain surgery, which were very dangerous, and problems would arise if she was not careful. If she received an irregular time bomb on the night shift, she would definitely be scolded by the director for one day tomorrow: "The ears, nose and throat can be full, and she can't accept new patients."

"You don't need to take it away, just stay in the emergency room. We can use medicine even if we confirm the diagnosis." Qi Jing explained, "You can get a laryngoscopy and come over to check it out."

"The laryngoscope is quite heavy..."

Qi Jing pulled an intern behind him over, "Go and help Sister Xia carry the laryngeal glasses together, so don't let Sister Xia be tired. By the way, bring the endoscopy together."

......

Electronic laryngoscopes are much smaller than gastroscopy and have a short length, just to see the tissues around the throat. It was not easy to do anything under the laryngoscope in 2004, and the development of endoscopy has just begun.

Xia Wei prepared a laryngoscopy, put the patient on the shoulders and back of his neck, and sat next to the head of the hospital bed.

The electronic laryngoscopy lens enters from Chang Wenhan's nose, slides into the nasopharyngeal cavity along the base of the nose, and then changes the distal angle to enter the oropharynx. Along the way, Xia Wei can already see some white spots, looking like nodules, but it is a little different when entering the pharynx.

Looking at the screen, she frowned: "How could this happen?"

The lesions scatter around the nasopharynx, with irregularly shaped yellow-black bands and white things inside. Xia Wei didn't know what these were. The Adam's tuberculosis she met was not like this.

Qin Xuefeng and Chen Xiao have never seen such things before, and Gao Jian, who was just called by Qi Jing, had even lost his mind.

"This is definitely not tuberculosis!"

"Is it a sporadic ulcer band?"

"It looks a bit similar, but is it a bit large..." Chen Xiao looked at the screen and suddenly said, "Did this white thing move just now?"

"Have you moved?" Qin Xuefeng became interested and came over.

"Don't scare me." Xia Wei was operating the laryngoscope, and she was afraid of touching after he said this.

As soon as he finished speaking, a point in the white clump suddenly twisted and rubbed around and penetrated into the tissue around his throat. This action was magnified several times by the electronic laryngoscope, which made Xia Wei, who was looking at the screen, frightened her hair all over her body: "Ah! What is this?"

"Sister Sister, don't be excited, the camera is firmly held." Qi Jing comforted, "It's not a scary thing, it's just a few maggots."

"maggot?!"

"You said maggots?"

"Just kidding!"

"That kind of maggot?"

Qi Jing pointed to the white clumps that kept wriggling and said with a smile: "Everyone is more confident, it's the one you think."

After a few people looked carefully, they found that these white clumps were all composed of several small insects. I didn’t notice it just now, but now I’ll look at the answers again.

Xia Wei suffered the biggest visual injury so far. At that time, she chose ENT just to stay away from the messy diseases of major departments. She stayed in ENT and throat and had no serious patients with easy work. The most common ones were suffocation caused by nasopharyngeal cancer or throat obstruction, which was much better than that of major departments.

Now when I came up and saw this little thing directly, for her, a princess who was used to living a generous life was suddenly thrown into the slum. Only she herself knew the horror and helplessness.

In fact, it cannot be blamed for her. Even the two big men Qin Xuefeng and Chen Xiao couldn't help but feel cold on their backs when they saw this. Chen Xiao didn't even look at them, and then found an excuse to leave.

“Ahhhhhhh…”

Xia Wei could only suppress her voice due to her duties, and she kept making strange noises in her mouth. She looked behind her and wanted to find Qin Xuefeng, an urgent doctor, for help: "Deputy Director Qin, why don't you come..."

"Stop watching, run away too." Qi Jing smiled.

"Ah??" Xia Wei looked back at Qi Jing and Gao Jian who was sitting in front of the screen and studying hard, "You guys have laryngoscopes and replace me..."

"That's not OK. You are the main treatment of ENT, nose and throat, and you can only do laryngoscopy." Qi Jing spread his hands helplessly, "And you can't leave the patient behind half of it now."

"Ahh?" Xia Wei realized why Qi Jing insisted on having a laryngoscope just now. "You must have known it a long time ago, right?"

"almost."

"You...you actually..."

"I'm right, these little guys are considered foreign objects." Qi Jing's face was full of innocentness, "Besides, you didn't ask if the foreign object would move."

Xia Wei was crying without tears. If she had known it was a maggot before, she would never have come down to have a laryngoscope. Now she has already had a laryngoscope, and the family of the patient outside the door is still waiting for the result, so it is impossible to think about it.

"What should I do with this?" she asked in a crying voice.

"Take it."

"How to get it......"

"The patient is already unconscious anyway, so it's convenient to make trouble. Just wash it directly." Qi Jing patted Gao Jian's shoulder, "I need two bottles of hydrogen peroxide to go to the debridement room, and then go to the surgery department to borrow a negative pressure suction device."

"Is hydrogen peroxide OK?"

"Don't worry, hydrogen peroxide can disinfect surrounding tissues, remove some of the carrion, and stimulate the insect body and force them out." Qi Jing was very confident.

The white maggots are not big, about 1cm in length, but they will be different when they are larger.

Although Qi Jing is simple, she just needs to wash and attract cleanly. But the little bugs are like mushrooms springing after the rain, constantly coming out. Every time she pours hydrogen peroxide, she can always bring out one or two new bugs, making her unable to see the end of her work. Especially when she mixes in hydrogen peroxide and enters the negative pressure bucket through the attraction tube in her hand, Xia Wei's mind is blank.

"Why did you think it was a maggot?" Qin Xuefeng was a little surprised. The few people watched the same ct movie. Why could this kid think of this situation?

"What does it mean to change the insect septic?" Qi Jing said with a smile, "Does tuberculosis?"

"What about that?"

"The first reaction when you see the change of insect pharyngeal is naturally that you are really bitten by the insect. This change of insect pharyngeal in the sinus and throat is a typical manifestation of nasopharyngeal myiasis."
To be continued...