Chapter 846

"When he was diagnosed with pneumonia, he refused to be hospitalized. He said he would prescribe medicine to take home. The doctor refused and said he had to be hospitalized. Later, he was hospitalized. I asked him for leave." The man's wife went on and complained, "what if you don't go home in hospital? If something happens, I won't deal with it, and I don't know what he thinks. "

The man's face was slightly red, but he didn't refute it. Ren's wife said he was angry.

"Later, he was hospitalized. He still had a fever, was afraid of the cold and coughed. He also said that his whole body was weak and his hands and feet were sore. The doctor said that he still had pneumonia and had to live for a few more days. As a result, he still didn't live well for a week. Look, he was still burning..." the man's wife pointed to the man.

Guo Xiang took a look at the man's face. He took the thermometer on the table and shook it. "Measure it again."

The man sat down and put the thermometer under his arm. After a few minutes, he took it out. It's 39 degrees. It's not low.

Guo Xiang frowned and looked at the medical records. Antibiotics were used for pneumonia. Most pneumonia was caused by bacteria, mainly Streptococcus pneumoniae, Mycoplasma pneumoniae, Haemophilus influenzae and so on. Clinicians generally treated it with antibiotics.

The medical record does use relevant drugs, but how can it be ineffective?

If it is pneumonia, such treatment will certainly be effective. How is it possible that a hospital can not even cure an ordinary pneumonia?

"After so many crimes, it still hasn't been cured. What broken hospital is not as good as the small outpatient service in our community." Men complain to their wives.

"Aunt, we don't know the reason just by looking at it like this. We may have to be hospitalized and check it slowly. We can't take drugs casually, can't we?" Guo Xiang said, "on the other hand, we are not a public hospital. Seeing a doctor is more expensive. I don't want to lie to you..."

The middle-aged man and his wife looked at each other, "it's expensive. As long as it can be cured, human life is always more important than money." Said the man's wife.

Guo Xiang nodded, but the woman could still carry it clearly.

"Then go to the hospital first. We may have to do a lot of tests to find out the cause. The disease may be a little complicated." Guo Xiang said.

"OK, I'll go through the hospitalization formalities." Women are decisive.

Xing Ming gave the patient a bill, and then did some tests first. Filming is indispensable. Although it was done in other hospitals, it still needs to be confirmed.

Then do a blood routine and an ECG.

When the results came out, everyone looked together. Sure enough, there was still pneumonia. The blood phase was high, that is, the blood leukocyte was high, indicating inflammation.

From the ECG, there is no performance of arrhythmia, that is, the heart rate is a little faster.

However, the patient has a fever. Generally speaking, the fever increases the body temperature. Each rise will increase the heart rate by about 15 times per minute. Therefore, the heart rate of the patient with fever is too fast and normal.

"But transaminase, myocardial enzyme and troponin are also a little high. Will there be a problem with the heart?" Xing Ming said that he is a cardiothoracic surgeon and has some experience in this field.

"Is there possible myocarditis? There may also be inflammation in the liver. " Xing Ming said.

Guo Xiang frowned. "Normally, pneumonia will be effective after such treatment. There are only two reasons why it is ineffective. First, the antibiotics he uses are ineffective and do not cover the bacteria. He may have to try another one. Second, the patient may have other diseases that have not been found, so the treatment is ineffective. "

Xing Ming and Xu Wei both nodded. Although Xu Wei is an obstetrician and gynecologist, their medical theories are interlinked. Therefore, although it is a man to see a doctor this time, they still discuss it together.

"Give him another antibiotic first." Guo Xiang said that Xing Ming nodded and gave the doctor's advice. Because he was the first to receive the doctor, the middle-aged man was his patient. He was the attending doctor. Naturally, he came to bill.

"Give him another B-ultrasound to see if there is a problem with his heart function." Xing Ming said.

Guo Xiang nodded. Now the cause is unknown. Really, we can only take the exclusion method.

"The patient said that he had chest tightness and shortness of breath. Coupled with fever and sore limbs, it also looked like myocarditis." Xing Ming said, "but myocarditis is usually caused by viruses..."

Pneumonia is bacterial, myocarditis is viral, er, a little complicated.

"First use antibiotics and check the heart." Guo Xiang said, after all, now is just speculation.

The man was hospitalized for new antibiotics. During this period, he also did cardiac B-ultrasound. It seems that there is no problem. Another ECG was done, and there was no abnormality.

Everyone is a little worried. What's the reason?

Some people may say that doctors don't know. Don't they all have a fever?

However, there are hundreds of causes of fever. One book may not be recorded, and it is impossible to try one by one. I don't know how much the light examination fee is.

Although it's a private hospital, you can't be so stupid. You'll be scolded at that time.

Tumors also have a fever, but generally they don't burn so high, fast 40 degrees, so they can be ruled out.

"Can it be any infectious disease?" Xu Wei said, "can't it be AIDS?"

"Unlikely. There are few people in China now. That person doesn't seem to have been abroad..." Guo Xiang shook his head.

Think about the common infectious diseases in future generations, such as dengue fever, tsutsugamushi disease, leptospirosis and so on.

Guo Xiang said what he thought. Xing Ming shook his head, "we're not in the south. It's not so hot..."

"It's hard to say. Now it's cooler sooner or later. It's still very hot during the day. It was very hot last month. He got this disease last month..." Xu Wei said.

"It's usually humid and muggy weather in the south. It's caused by mosquitoes." Guo Xiang said, "ask him if he went to the South last month."

"I'll ask." Xing Ming said.

Yes, I did. I went on a business trip last month.

"Check the blood again." Guo Xiang said. She remembers that tsutsugamushi disease was very serious in later generations, because it was only bitten by a small insect, which did not attract people's attention and caused death. It is possible for the patient to have been to the south.

And tsutsugamushi disease can also cause fever, chills, headaches, and pneumonia, which is very likely.

Blood was drawn again, Rickettsia antigen was checked, and the result was actually negative.

no Guo Xiang frowned. Why not? Didn't find out or something?

"Go and see if he has eschar." Guo Xiang said.

Tsutsugamushi disease has an obvious feature, that is, after being bitten by tsutsugamushi, the wound will fester, and then produce a black eschar. It is obvious, but it is not painful, so some people may not pay attention at all.

Moreover, tsutsutsugamushi generally bites places with fine skin and tender meat, such as perineum, groin, armpit and so on.

The two nodded. If there was eschar, it must be tsutsugamushi disease. There was no need to do other tests.

He called the patient, took off his clothes and checked it carefully. He made the patient blush, but he didn't see anything.

"No?" Guo Xiang frowned, "have you looked carefully?"

"I saw it. I took it off. I saw it before and after. The patient puckered his ass on the bed and showed it to us..." Xu Wei said a little embarrassed. Women see too much. It's the first time to look at a man so carefully.

Guo Xiang chuckled. Will Dr. Xu be embarrassed?