v3 Chapter 2340： Small wound, big trouble

"Are you going to CT?" The patient was a little upset, but his opinion was not important at this time. The family members of the patients seemed to be aware of it, and promised.

Zhou Litao did not try to squeeze out the pus inside the skin of the wrist of the patient this time, but sterilized the surface gently, covered with sterile gauze.

I went and opened a CT bill, and the patient and family members went for an examination.

他们 As soon as they left, Zhou Litao immediately pulled Zheng Ren into the duty room, while turning on the computer, he called the CT room. He said the patient's name, and told him to upload it as soon as it was done.

"Boss Zheng, what do you suspect the patient is?"

"Mycobacterium maritime?" Su Yun could not eat, watching Zheng Ren said in a questioning tone.

嗯 "Well, it's an infection caused by Mycobacterium."

Zhou Litao worked hard to recall Mycobacterium maritime.

He is very familiar with Mycobacterium. Non-tuberculous mycobacteria refer to all mycobacteria except Mycobacterium tuberculosis and Mycobacterium leprae, also known as environmental mycobacteria. Non-tuberculous mycobacterium disease refers to the pathological changes of related tissues or organs caused by human infection with related bacteria.

"Boss Zheng, how do you judge it is Mycobacterium haikai?" Zhou Litao asked.

"General non-tuberculous mycobacteria grow at a wider temperature, and patients only have problems with their wrists. The biggest possibility to consider is the growth of Mycobacterium spp. Between 28-30 degrees Celsius." Zheng Rendao.

Although Zhou Litao understands the logical relationship among them, he can rule out other problems at a glance. This is unacceptable to Zhou Litao.

"That's it. First of all, the patient's family reports that they need to change gauze six or seven times a day." Zheng Rendao said, "This means that the patient's wound location has a lot of pus. The position of the wrist must draw out about 20ml of pus every day. It must be inside. There will be more, and it is estimated that there are already sinus tracts. "

Zhou Litao listened quietly, the first point did not completely solve his own questions.

第二 "Second, such a serious 'injury', but the patient has no history of trauma, and the purulent pus cavity is confined to the left wrist. At that time, I thought that the position was injured, but the patient did not pay attention."

"If that were the case, our scope of consideration would be much narrower."

"But it is not excluded that it is a fine needle ..." Zhou Litao was still a little puzzled.

"Stupid!" Su Yun has been trying to understand, he looked at Zhou Litao disdainfully: "What did the patient say before coming? Rheumatism, rheumatoid arthritis!"

"Ah?" Zhou Litao stared at Su Yun blankly.

"What does this mean? Staphylococcus aureus infections will be misdiagnosed as rheumatism, rheumatoid?" Su Yun's mouth full of salamanders overflowed.

"Oh oh." Zhou Litao just wanted to understand.

"Well, so it is estimated that when the patient was playing in the sea, his left wrist was stabbed by some marine life, but the wound was so subtle that he didn't notice it at all. Mycobacterium spp. Remained under the skin to breed and ended up causing this. Happening."

Zhou Litao was silent. He still didn't understand, but didn't ask questions.

"General Zhou, do you have to memorize diagnostics?" Su Yun clapped his shoulder and said, "Mycobacterium intracellular complex can cause non-tuberculous mycobacterial pneumonia. Mycobacteria and Mycobacterium dysentery cause nontuberculous mycobacterial lymphadenitis. "

"Too much, it's troublesome to talk about. Temperature is the main basis for the final determination of Bifidobacterium aeruginosa. It only appears under the skin without affecting the internal organs. It is most likely that Bifidobacterium aeruginosa."

Zhou Litao sighed slightly, he glanced at the computer. Before the thesis is finished, is it necessary to look at diagnostics on your own?

分支 The branch of modern medicine is huge and complicated. It really wants to become a former general practitioner? I'm afraid I can't do this because my hair is all white.

How rough a general practitioner used to see a doctor before, how can I now be professional.

不用 "No." Zheng Ren smiled. "Emergency department, the main energy must be focused on rescue. Others just need to do triage, like this patient, sent to hand surgery, they should be able to diagnose correctly."

"You just talk nonsense." Su Yun said scornfully.

"It's not nonsense, and there are still few people who can remember it after reading it. If Zhou always endorses as you said, it will delay emergency rescue." Zheng Ren said seriously.

Zhou Litao burst into tears.

It turned out that boss Zheng scolded people for not using dirty words, which is a disgrace to himself.

However, he quickly got rid of some frustrating emotions and asked, "Boss Zheng, what do you think of the patient's condition?"

"Not optimistic. A CT can't explain anything, I guess I need to do MRI. Tendons and the like should soon be corroded, and the hand department has encountered big trouble this time."

Zheng Zhengren sighed and said.

So heavy? !! Zhou Litao froze.

However, when the video did not return, they said everything was guessing. Several people talked casually for a while, until Zhou Litao's cell phone rang, and the doctor in the CT room said that the film had been uploaded.

Zheng Ren sat in front of the computer, searched the patient's name, and opened the CT image.

The patient had an abscess of about 3 × 4cm under the skin of the left wrist. The tendon had been eroded and even the ulnar and radial bones had been violated.

Xu really was a big trouble, Zhou Litao was once again convinced by Boss Zheng's diagnosis.

"Let's go back first, and explain to the patients when they come back." Zheng Rendao, "Send to the Department of Hand, first consult the Department of Infectious Diseases to control inflammation ..."

"The normal diagnosis and treatment process, I still use you to say? You really should be the director of hand surgery." Su Yun interrupted Zheng Ren's words, said scornfully.

I also ~ www.novelhall.com ~ Zheng Ren smiled.

"Boss Zheng, do you think the patient will be fine?" Zhou Litao asked.

"Let's talk about it after four or five operations. Chronic ulcer repair, tendon anastomosis, median nerve release, local flap repair, and negative pressure closed drainage can only be effective."

Alas ... the invisible wounds can cause such a serious illness! Zhou Litao was frightened.

"This is nothing, do you know what is the most common infection route of Bifidobacterium aeruginosa?" Su Yun asked.

Zhou Litao shook his head.

"Cut vegetables in the kitchen, and then change the water in your own fish tank. The boss first asked whether the family kept fish, and then asked if they had traveled." Su Yundao.

"Why not cut vegetables?" Zhou Litao was still immersed in the piles of techniques that boss Zheng said, and he asked.

Then he saw Su Yun's gaze behind his black hair and scolded himself in his heart. It was said that there was no wound, so this infection route was directly ruled out.

What happened to myself? Absent-minded, Zhou Litao first made self-examination.

让 "Let him rush to the operation. There are two things that are most serious in this disease-amputation and skin cancer." Zheng Ren stood up and left, leaving a sentence at the end.

Zhou Litao nodded again and again, both of which are extremely serious, but can't be delayed.