Chapter 879: 【879】Don’t miss the diagnosis Chapter 879: 【879】Don’t miss the diagnosis Chang Jiawei initially judged that it might be cellulitis.
Cellulitis is not uncommon in clinical practice. Once an exposed wound starts to go untreated, bacteria can easily continue to invade beneath the skin, causing massive infection and even necrosis of the subcutaneous adipose tissue. The appearance of subcutaneous adipose tissue resembles a honeycomb, hence the na cellulitis. Simply put, it can be thought of as an adjective describing inflammation of the subcutaneous fat tissue.
Through sterile gloves, Nie Jiamin’s fingers gently pressed on the boy’s wound to confirm it was an indentative edema, with pus-filled blisters under the skin, necessitating surgical incision, cleaning with saline, and drainage.
Turning his head, Nie Jiamin said to the nurse preparing materials, “We need to perform an abscess incision, please prepare the saline.”
When the ti ca, Xie Wanying pulled the thermoter from the child’s armpit and squinted at the scale in the sunlight, then reported to Teacher Nie with a frown, “Teacher Nie, the patient’s temperature is now thirty-nine point one degrees, and I expect it will continue to rise.”
“Mhmm,” Nie Jiamin remained unrushed.
Doctors with an abundance of dical experience, having seen a variety of patients and major events, are rarely in a hurry. Additionally, Xie Wanying noticed, Teacher Nie seed to harbor dissatisfaction with the patient’s family mbers.
The child shouldn’t have been brought to the free clinic in such a state, which indicated that the family didn’t really take his condition seriously. If the doctors here almost finished the treatnt and then the free clinic doctors left, would the family mbers just carelessly toss the child back at ho again? Therefore, it would be best to conduct initial treatnt and then make the family take responsibility to continue treatnt at the hospital.
Look at the child’s grandfather, continuing to shirk responsibility: “Ah, he runs around every day, often falls and scrapes himself. This ti he didn’t fall as badly as before, neither his grandmother nor I can comprehend how it got to this state.”
In any case, the family mbers should reflect, not just ignore the child’s wound as if it were no different from his usual tumbles.
Xie Wanying didn’t disagree with Teacher Nie’s thoughts, saying, “Teacher Nie, I think you might need to first inspect his oral cavity, the condition is equally severe there.”
“Oral cavity?” Nie Jiamin beca alert to her new suggestion.
Chang Jiawei was also taken aback. What about the oral cavity?
“I see so swelling on the left side of his jaw, I suspect this rapid bacterial infection is due to an existing oral infection, compounded with infections in other parts,” said Xie Wanying.
Chang Jiawei approached the bedside, joining Nie Jiamin in prying the child’s mouth open to take a look inside, clearly seeing that the lower teeth on the left side were especially swollen. What was worse was that there was pus formation, and as Xie Wanying said, it had caused facial swelling, which could potentially spread to intracranial infection.
The child must have experienced toothaches, but the family paid no attention at all.
After hearing the doctor’s explanation, the child’s grandfather was shocked: “Could a toothache be more serious than the inflammation in my grandson’s leg?”
“Yes,” the doctor affird confidently.
“I get toothaches too,” the child’s grandfather remarked as he opened his own mouth to show the doctor his cavities.
In cases like this, doctors could only be speechless at the family’s attitude.
“Just give him so dicine to take,” said the boy’s grandfather, much like Lulu’s Mom had earlier, rely urging the doctor to prescribe dication.
The problem is that in such cases, it is generally best for the patient to go to the hospital for IV treatnt to prevent it from turning into intracranial and systemic infection, with a pressing need for antibiotics to control it. An oral cavity incision for drainage should be handled by an oral surgeon, and if necessary, a neurosurgeon should be consulted to check for intracranial infection.
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