The First People's Hospital does not have an infectious department specially established like Danyang Hospital, and there will be no infectious department building. The only things that are related to infectiousness are the dermatology and respiratory department. Generally, when encountering refractory infectious diseases, they will be called to these two departments for consultation, and finally decide whether to stay in the hospital for further treatment or to send it to the Center for Disease Control and Prevention.

When they are asked to consult, the most people who go to seniors are hospitalized or treated. The time is also very casual. As long as it is not critical, it will be no big problem to delay for an hour or two. After all, there are many things to do in our own department.

But this time it was very urgent, very urgent, and the director was asked for as soon as he opened his name.

The respiratory department was fine. At noon, the three directors were all resting in the department. I heard that it was an urgent consultation called by the orthopedics, so I discussed and came to take a look.

But dermatology is not a big department, and there are not so many people. There are only two directors in the general department, and only one came today. He was a grandmother-level figure in his 60s. He just returned to Danyang from another place and caught up with the big rounds this morning. There was still an outpatient clinic that lasted for several hours in the afternoon.

Now is her only rest time.

"Are you kidding? If you ask for a consultation, you will need the chief director?" The voice on the other end of the phone was obviously a little excited. "Director Kong, you should know each other. I've been busy all morning, so let her have a good rest."

Li Xin also knows Kong Qiong from the dermatology department. Of course, she knows that she is old and her body can no longer keep up with the fast pace of clinical practice: "What about Director Yu?"

"I've gone to Beijing to hold a seminar."

"Then there is always a deputy director." Li Xin settled for the second best.

"Teacher Liu is in the outpatient clinic, and Teacher Qiu goes to Dan Medical University for class."

"None are there?"

"There are only two attendees in Corey, and no other experts are here."

"Sister, please help." Li Xin was helpless. Looking back at the heated debate scene, he could only smile, "It's really too complicated for the patient. We Director Xie appointed Director Kong to help."

With Xie Zongpei's name leading the way, the other party hesitated for a moment and still responded: "Then I'll go and ask, don't hang up first."

This is an empty telephone receiver, and the other is a lively one-on-one debate scene. The young doctors who were originally full of energy and wanted to get involved have long been speechless, and now they can only sit aside with several other deputy seniors and directors to "watch the show".

This is a case discussion that looks weird. What’s weird is not only the number of people involved, but also the huge age gap between the two.

Because of the inconsistency between the major he studied and the patient's condition, the combat effectiveness of the senior director Xie Zongpei was greatly weakened. However, with his decades of perioperative experience, he also has a certain say in infection. If he is facing an ordinary resident, even if he only has five or six successes, he should be crushing the game.

But the combat power exuded by the young man on the stage is far greater than his peers. From a professional perspective, even the main treatment of infectious diseases in internal medicine may not be able to catch up.

"...hey, hey~~Where is the person? Are you there? I'll be dead anymore!"

Li Xin was still listening to what the two were talking about. After a while, he realized that a voice came from the receiver. He immediately replied: "I am here! Is it Director Kong?"

"It's me, what's the matter?"

"We have a very troublesome patient here. The course of the disease has been more than ten years and the condition is very complicated." Li Xin said, looking at the very neat timeline coordinate axis on the recording board on the stage, "It looks like there are triple infections of the respiratory tract, skin and bones."

As soon as these words were heard, they were full of loopholes. Kong Qiong frowned and asked, "Why did you send your orthopedic surgery if you have respiratory and skin infections?"

"The patient had low back pain at the beginning. After checking the X-ray, we found a compressive fracture in the lumbar spine and we accepted it."

"Is there any bone infection?" Kong Qiong had certain attainments in infectious diseases after all, and immediately asked the core of the disease, "Is the bone damaged severely?"

"Bone..."

Yes, bone infections should have obvious bone damage, but this patient...

This question awakened Li Xin because there was no bone damage on the lumbar X-ray film taken in the emergency room, and at best there was some osteoporosis.

Osteoporosis, osteoporosis...

It’s strange. Our initial diagnosis was osteoporosis. Teacher Huo was going to discuss at the beginning, which was also a compressive fracture caused by osteoporosis. When did the discussion turn into infection?

Li Xin looked at the young man on the stage who had already taken off his mask and felt that the direction of the whole thing became more and more strange. It seemed that Xie Zongpei had to debate with this young doctor, but now looking back, the entire department gave up his judgment so easily, and orthopedics had actually lost a long time ago.

"Hey! Where is the person? Why don't you talk again??"

Li Xin quickly pulled his thoughts back: "Director Kong, the patient is too complicated, I can't explain it clearly, so you should come and have a look. If you don't come to help, things will be really troublesome!"

“Is that serious?”

Seeing that he was serious about what he said, Kong Qiong sighed and could only agree: "Okay, I'll come here now."

......

Those in the authorities are confused, while those onlookers are clear.

After the two consultation calls just now, Li Xin has now withdrawn from the fierce debate environment. After reexamining all this, he gradually discovered the blind spots of the discussion meeting.

Previously, Huo Zhiye and almost all orthopedic doctors believed that the patient was osteoporosis caused by hormones, and so was Xie Zongpei. But after Qi Jing said a few words, the wind direction of the whole scene changed, and he easily brought the key to the discussion of the problem to the infection of bacteria.

Is there any evidence to say that the patient is infected?

Body temperature? Normal!

Leukocytes? Normal!

The bone damage mentioned? I haven’t seen it!

The only doubtful thing is a chronic cough and a chest x-ray without a follow-up examination, but there are too many non-infectious causes of chronic cough. Asthma, old chronic branches, and even lung inflammation caused by Sle can cause cough.

In fact, strictly speaking, there is no conclusive evidence for this young man. He is just a positive tuberculin test. However, the treatment of tuberculosis itself is ineffective, and no lesions were found in the chest radiograph at that time. Even if the chest radiograph is now found in the lung infection, can we assert that the two coughs that have been separated for so many years are the same source?

Obviously not that simple!

Infection naturally has its possibility, but according to Wang Pingshi's condition, this bacteria not only infects the lungs, skin and bones, but also has to endure and develop slowly during long-term hormone treatment, and then it will start to slowly erode the patient's body after five years of silence.

How high is this probability?

After calm analysis, Li Xin found that there was nothing wrong with insisting that it was osteoporosis, because the conclusions of the examination supported osteoporosis. In this case, why should we give up all of them? Instead, follow the ideas of a young man of unknown origin?

However, now, his own chief director is led by the nose and has no rhythm at all.

The more Li Xin thought about it, the more he became, the more he was wrong. This kind of thought filled his mind. At this time, he especially needed to find someone to have a good chat, communicate and express his inner thoughts. Starting from childhood, the first thing he thought of was Shi Ruilin, who had been closer to him in the past few days.

However, as soon as he put down the phone and turned his eyes over, Shi Ruilin was even more excited than him, with a strange smile on his face: "Teacher Li, what is this guy from? He can actually play against Director Xie. Not only can heal almost all the key medical history of the patient, but he can also understand such rare bacteria. It is too strong, too strong..."

Looking at the intern team leader whose smile gradually distorted, Li Xin shook his head helplessly: The poisoning is too deep, there is no help...

Li Xin could only find Huo Zhiye in the end: "Teacher Huo, Teacher Huo..."

Huo Zhiye was getting rid of all distracting thoughts and focusing his spirit on the issues discussed by the two. Unexpectedly, the idea that he could barely keep up was suddenly interrupted: "Why are you calling me?"

"Teacher Huo, when did this guy take the topic aside?"

"How can I know?" Huo Zhiye is now full of tuberculosis, Noka, and non-tuberculosis. He is like taking an infectious disease course. He cares about such things. "Xiao Li, listen carefully to Director Xie's speech, don't think about those things that are there or not."

Li Xin scratched his head and was really not vomiting: "But Teacher Huo, don't you find it strange? He just said that there is another possibility of a cause, but osteoporosis is still tenable. Why should we follow his ideas?"

“…”

Huo Zhiye listened to what Qi Jing said before and thought about it carefully, and found that it seemed like this: "It's over. Director Xie is so skillful that he can't speak well. A generation of surgeons is almost fooled by this kid. He has obviously practiced it, has a first-class quibbling, and he will use several surgical examples from time to time, which looks very down-to-earth."

But looking at the current situation, the two of them faced each other and the others couldn't get in the way.

Huo Zhiye didn't have any good idea at this time: "I can only let them go first. How are you in touch with those two big directors? Are you here?"

"I finally told you."

Although Li Xin listened to his ears, it didn't matter what disease Wang Pingshi had. Instead, Qi Jing's identity was even more concerned: "Where did this kid come from?"

Huo Zhiye also shook his head repeatedly: "I don't know where it came out."

Just looking at his face, he was only in his 20s, and there were no traces left by time, and he looked young.

The first hospital is just that big, and they have known new doctors who came last year. And the young people who just joined the company this year are also several master and doctoral graduates who have worked in the first hospital for a period of time. Even if they don’t know each other, they have met each other and have never looked like this.

Could it be the student who just accepted the director?

That's not right. At this age, with such meticulous diagnostic thinking and massive clinical knowledge, it's a true monster. If it were still a student, it would have spread it long ago.

The two of them looked at Qi Jing up and down, but they still had no clue, but the debate between Qi Jing and Xie Zongpei continued.

Mycobacterium is a huge category, and the most well-known of them is Mycobacterium tuberculosis, because tuberculosis is so common. Pulmonary tuberculosis, intestinal tuberculosis, bone tuberculosis, Adam's tuberculosis, renal tuberculosis, tuberculosis meningitis... As long as you are a clinician, you will have some intersection with this bacteria in your daily work.

After removing Mycobacterium tuberculosis, Mycobacterium bovis and Mycobacterium leprosy, the rest are collectively called non-tuberculosis. This shows how big a group is this.

"Nokaci causes the pyoga, while these non-tuberculous mycobacteria cause tissue necrosis."

"The bacteria cannot be distinguished from the characteristics of the infection cavity alone," Xie Zongpei retorted, "and the patient's imaging examination does not have the lesions you mentioned."

"The subcutaneous lump is this kind of lesion."

"But it has healed, and now there is no evidence of death."

Qi Jing smiled and immediately got rid of Xie Zongpei's entanglement in this regard, but instead turned his gaze back to his lungs: "I think the most important thing is to confirm the lung infection. On the premise of taking a chest X-ray, another whole-body CT scan can be seen clearly. "

“This is OK…”

Before Xie Zongpei finished speaking, Qi Jing added another sentence: "In fact, it is necessary to scan the bones of the whole body."

"Full body ct? That costs a lot of money. Where does the patient have that much money at home?"

"Isn't the foundation allocated funds just now? A fracture surgery is at least five digits. Can't you afford this examination fee?" "Nonsense! Every expenditure of that money must be recorded in detail, and the details must be submitted one by one. Do you think you can use it at will?"

Qi Jing sighed, fortunately, there was a bad luck here, and there was no problem with money: "After saying so much, Director Xie should have agreed with me. Wang Pingshi is a non-tuberculous mycobacterium infection..."

"Don't talk nonsense, I said he was infected with actinomycetes noka!"

"But I said before that Actinomycetes nocaria can cause a pyocete. Not only on bones, but even the lung infection of Nocaria can also cause serious inflammatory reactions. According to Wang Pingshi's history of hormone medication, he probably won't live now. He died of septic shock a few years ago."

To prevent automatic collection from failing to load, click to load manually, and the reading mode does not support it. Please install the latest version of the browser!
Chapter completed!