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383. Chasing the Murderer (5): The fourth and fifth infection paths

Speaking of symptoms, Wang Gui, who has been in shock, has always had a vague symptoms. It cannot be said that there are no symptoms, but it should be said that there are a lot of symptoms, but there is no one that can really directly point to the specific symptoms of the pathogen.

When Lin Rong called, Wang Gui had a high fever and then quickly entered the shock period. If you really want to complain about being able to get on the table, it is probably the long-term poor in the nap and respiratory symptoms described by Ding Xiujuan on his behalf.

As for which are caused by parasites and which are bacteria, it is hard to explain clearly. Therefore, Qi Jing and a group of experts did not want to start with the symptoms at the beginning, but instead searched for the root of the problem from the infection chain in violation of the routine.

But now Ding Xiujuan has expressed one symptom: her stomach is uncomfortable.

Wang Gui had never said that his stomach was uncomfortable before, which was a brand new symptom. For these infectious disease experts, a brand new symptom means a precious one, and finally another new thread was picked out from the messy thread.

Belly discomfort is a very general concept. In clinical emergency, abdominal pain alone can lead to more than 50 conditions. Now the Centers for Disease Control and Prevention do not have so much energy to differentiate Ding Xiujuan's belly, so Qi Jing also wants to dig out as much information as possible from her mouth.

"Other symptoms?"

Ding Xiujuan narrowed her eyes, turned her head to avoid the lights from the bedside, picked up the tissue beside her and wiped the tears at the corners of her eyes, and said, "There is nothing else that makes her feel uncomfortable, she's a little dizzy, her body is a little cold, and her hands and feet are not strong."

None?

Qi Jing felt that he was always lost, and every time the clues were broken at the key points. He sighed, thought for a while and asked again: "Did you have any cough? Or do you have other respiratory symptoms?"

Ding Xiujuan felt her throat very seriously and shook her head: "No."

"Oh well."

Qi Jing did not ask any further, but transferred his phone to Ji Qing.

On the contrary, Huang Xinghua was helping his old friend to treat a severely infectious disease patient, but behind it was the taste of him playing the stage for Qi Jing. However, for Qi Jing, it is necessary to make himself famous, but it is not enough to be famous by himself. He also has to leave some soup for Ji Qingsheng to upgrade.

Ji Qing immediately followed Ding Xiujuan's symptoms just now and asked: "Is it because of my stomach ache? Or is it because of my stomach bloating? Is there any vomiting? Dizziness?"

"Ah, doctor, don't worry, ask one by one..." The four questions made Ding Xiujuan's mind a little confused, "What were you asking just now?"

"Does your stomach hurt?"

"The stomach doesn't hurt, it's just uncomfortable."

"Is my stomach bloated?"

“Not swelling.”

“Is there vomiting and diarrhea?”

"No."

Ding Xiujuan shook her head. Perhaps because she used too much force, her brain suddenly felt like dirty water that had been precipitated for a long time. A bunch of turbid objects were raised under the shaking: "My stomach is a little uncomfortable, but it is not serious. I am now in my head and it is swelling very much."

"What's your body temperature now?"

The nurse just now stood beside her and listened, and immediately replied: "It's 38.4 degrees."

"It should be because my body temperature is getting higher. I will pay attention to what else I feel uncomfortable. If there is any problem, I will tell the doctor and nurse as soon as possible."

Ji Qing explained, then looked back at Qi Jing helplessly and returned the phone. For him, it was already very good to ask this level. In fact, the others here had never thought about what to ask from Ding Xiujuan. They wanted to follow the symptom of "stupid stomach" and sifting out a large number of clues in their hands.

The mobile phone changed with Qi Jing and returned to Huang Xinghua. On the other hand, Lin Rong's mobile phone was also handed over by Ding Xiujuan to the nurse just now.

After Ding Xiujuan finished asking questions here, Huang Xinghua wanted the nurse to go to the ward of two distant relatives and have a good exchange with them on the southern itinerary. But at this time, the young nurse spoke: "That, Director Huang..."

"Well, I'm here, what's wrong?"

"Although the patient said he had no other symptoms, I think there was something wrong with her eyes." The nurse looked at Ding Xiujuan under the light, slowly approached, and then looked carefully and said, "Her eyes were filled with tears."

"Tears?"

Huang Xinghua frowned, looked at the people around him, and continued to ask, "Can you look at her eye conjunctiva?"

Without knowing whether there are human-to-human transmissions in infectious diseases, not every nurse is willing to come forward to observe the patient close. However, as the responsibilities of the CDC nurse, she did not hesitate. As soon as Huang Xinghua finished speaking, she replied: "The patient's conjunctiva is a little red and there are obvious signs of congestion."

Is it congestion of tearing conjunctivitis?

But it is difficult to determine whether there is conjunctivitis if it is only in language descriptions. Generally speaking, it is judged by ophthalmology, and you have to see it with your own eyes.

After all, a nurse has very limited clinical experience.

However, before everyone could think about it, Ding Xiujuan's voice came from the other end of the phone: "I have been crying these two days, and I have been crying red-eyed."

However, the nurse didn't see this. Combined with her actions just now, she continued: "Director Huang, the patient is photophobic and will cry if he is a little stimulating. He has been wiped with a tissue from the corner of his eyes since he answered the phone, and several pictures on the edge of the bed were wet."

"Ah, I told you, but my eyes were red when I cried too much." Ding Xiujuan explained again, then raised her tone and said, "Besides, the lights here are so bright, whose eyes can stand it?"

The nurse emphasized it twice, and Ding Xiujuan also refuted it twice, and the more she said it, the more she felt a little bit pointed at the wheat.

The nurse understood that it was at the limit, and it became a dispute if she continued, which easily intensified the emotions of both parties. Many medical disputes started with such trivial matters, so she was very restrained and continued.

Anyway, the words have reached the ears of the experts present. Patients can ignore them, but they cannot. Wang Gui's symptoms are so messy, and now people are in a coma again. Who knows what went wrong with him? If Ding Xiujuan and Wang Gui are infected with the same pathogen, then Ding Xiujuan's symptoms are the real template, and no details can be missed.

"You'd better go back first." Huang Xinghua said.

"Yes, OK." The nurse responded and then withdrew from the ward under Ding Xiujuan's imprisonment.

"The next thing we want to find Wang Gui's two distant relatives, we also want to ask them a few questions."

"Distant relative?" the nurse walked out of the door and closed the door and said, "It's the two brothers Zhang Qi and Zhang Bo?"

"But the symptoms are a little mild." Lin Rong returned to the door of the ward and looked in through the glass window, "I think she is sleeping well now."

"No matter how serious it is, at least there are specific symptoms." Huang Xinghua sighed. The consultation has only made some progress now. "By the way, you fax Wang Gui's blood test report. We have experts in shock here, and we can check you in terms of treatment."

"Okay, I'll do it now."

Lin Rong wanted to hang up the phone, but unexpectedly a young voice called him back: "Director Lin, don't worry, I still have a problem."

"What's the problem?" Lin Rong knew this voice.

When Huang Xinghua and Lin Rong were talking about the patient's condition, Qi Jing and Ji Qing were not idle either. After both of them exchanged their own ideas, they suddenly realized that they had forgotten something very important.

"I want to ask Wang Gui's rash." Qi Jing said.

"Rash? Oh, by the way, rash! I really forgot if I didn't say it!" Lin Rong immediately realized the purpose of this problem and said quickly, "In terms of rash, there was only a very light pigmentation before, so I didn't explain it clearly when reporting it. But now it's different. The patient's rash has developed, and there are obvious ecchymns and petechiae."

The rash has always been a very vague concept. Is itching or ulceration on the surface of the skin? Is itching or ulceration? I didn’t know these before, so I can only guess by imagination.

Ji Qing first guessed that it was a small nodule caused by gonorrhea, which was spread throughout the body, but now Lin Rongyi explained that the condition seemed to be developing in another direction.

High fever, general weakness and pain, accompanied by ecchymnia on the surface of the skin...

This is the old acquaintance between Qi Jing and Ji Qing. Last summer, Danyang's bleeding fever alarmed many people. However, bleeding fever is a viral infection, and the patient is now a bacterial infection, but bacterial infection does not cause subcutaneous bleeding.

"It is probably because bacteria invaded the inner wall of the skin and caused a small-scale embolization, necrosis, bleeding, and thus pectoris." Yan Hong said, "But when it really reaches this level, the degree of shock may be even more serious than we imagined."

Several experts took a breath. How long has the shock lasted? The patient is already in vain?

But Qi Jing was thinking a little further. Wang Gui's condition developed so quickly, and Ding Xiujuan had the same infection in her body, so the development speed would never be slow. Although it was not over 39 degrees, her body temperature might rise in the blink of an eye.

When it really comes to that time, it will be not far from shock.

"Director Huang, I think I'll give Ding Xiujuan medicine directly." Qi Jing suggested at this time, "Maybe it's still time now, otherwise according to Wang Gui's course of illness, her body temperature will exceed 39 during the day today, and she may not have to wait until the next day, and she will be in shock."

"Do you mean the previous third generation of cephalosporin or the direct Wangu Taineng?"

Lin Rong inserted his mouth and sighed: "I found that she had already used levox when her body temperature rose."

"Levox seems useless, just to reach Wangu Tai Neng." Qi Jing said, "Her condition is not serious now, but if she drags down further and becomes shocked and coma, it will be too late."

Huang Xinghua looked at the experts around him, some of whom had already started nodding, while others were silent.

He thought for a while and finally made up his mind: "Okay, let's do it as you want. Lao Lin is still the same as before, and the situation is reported every hour, don't forget."

"Okay! The blood test report will be heard soon." Lin Rong hung up the phone after hearing this.

Yan Hong, who heard this, quickly got up, called Ji Qing and several critically ill doctors, and went to the conference room with a fax machine together, hoping to find a way to fight shock as soon as possible.

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