"Try giving so fever-reducing dicine and keep the patient in the ward," Liu Banxia said after deliberating for a mont.
Upon hearing Liu Banxia’s orders, Xu Yino quickly ran back. Liu Banxia also shared this information with the small group that had just had a consultation. Was this a new discovery?
Although the patient’s condition had worsened slightly, for these doctors, this developnt was actually helpful for diagnosis. Most of what they had just discussed could now be ruled out. Regardless of what had caused the patient’s condition, it was still developing. From the current situation, infection seed more probable. So kind of infection had likely caused vasculitis, and since the infection was still ongoing, the patient’s condition was worsening.
He now focused on the sinuses. This issue had been considered earlier, but it hadn’t been given top priority. Based on the current situation, it seed that inflammation in the lungs and sinuses could be keeping the patient’s temperature elevated. This roughly ant that levofloxacin wasn’t working for the patient, so they had to try other drugs. But they couldn’t just try things randomly, as that could harm the patient.
For sinus inspections, the ENT doctors from the inpatient departnt didn’t need to be called. It was a routine check; they could be called for a consultation if needed.
"Take it slowly. It might be caused by an infection from so particular bacteria. Have you auscultated the patient’s lungs again?" Xu Hui asked as he walked out.
"Yes, we perford it again, but there’s no further progress. The damage to the lungs wasn’t severe yet. Let’s wait to see the results of the liver and kidney function tests," Liu Banxia responded. "The key is the next dication. Levofloxacin seed useless. We have to wait until this bag is finished and then see the results. Perhaps the drug concentration wasn’t high enough to be effective."
Xu Hui patted his shoulder. The patient’s condition could now be classified as a difficult case. It would be challenging to diagnose it in a short ti. They would have to wait and see the results of the bacterial culture. If they could successfully isolate the bacteria, they could proceed with symptomatic treatnt. He also leaned towards an infection-caused vasculitis. However, ’infection’ was a broad term; one had to determine the specific type of infection that caused it.
"Brother Hui, considering the current situation, could it be that the patient’s series of symptoms were caused by a certain bacterial infection?" Liu Banxia asked.
"It’s hard to say," Xu Hui responded. "However, I personally lean towards the patient’s cold being a separate issue. Perhaps the cold compromised their immunity, leading to the outbreak of so other infection."
Liu Banxia thought for a mont and nodded. This was also very likely. A cold is a minor illness. Often, it can be overco without dication, just by drinking so hot water, as the saying goes. Even though the patient currently showed so signs of pneumonia, it wasn’t too severe. The right side, in particular, was very mild, and the breath sounds during auscultation were normal.
After a while, the results of the nasal endoscopy ca out. The sinuses did indeed show signs of infection, and part of the nasal mucosa was damaged.
Liu Banxia and the others gathered again; they had to continue the consultation.
"Everyone, share your thoughts. What do you think is going on?" Liu Banxia said with a wry smile.
"I’m out of ideas. We have to wait for the culture results," Chen Xuehai said. "The sinus infection was consistent with symptoms of an upper respiratory tract infection. Otherwise, we might need to consider a bronchoscopy, or even a more advanced fiberoptic bronchoscopy."
"What’s the patient’s current temperature?" Peng Bo asked.
"After administering the antipyretic, it has decreased, but the cough hasn’t improved," Xu Yino quickly responded.
"What about the results of the physical examination?" Xu Guosheng asked.
"Nothing unusual had been found," Miao Rui responded. "There was only a wound on one finger showing so signs of infection, but no suppuration was observed. We also debrided the wound. The patient said they had scratched it so ti ago. Currently, after thrombolysis, the patient’s condition has shown so improvent. Oxygen saturation has increased, and oxygen support is no longer needed. The numbness in his face and limbs has also lessened."
"If there were no other leads, and if he didn’t have diabetes, we might have considered the wound on his finger more closely," Xu Guosheng remarked. "Wounds on diabetic patients don’t heal easily, and it’s hard to avoid getting them wet in daily life. Since there was no pus, could we rule it out as a separate issue?"
Liu Banxia nodded. "It looked like it. So, we just have to wait for the culture results now?"
Everyone nodded reluctantly.
The main line of inquiry now pointed towards a series of symptoms caused by an infection, with the crucial step being the isolation of the bacteria. This required ti; it wasn’t sothing where results could be obtained an hour or two after starting the culture. This patient’s condition didn’t et the criteria for ergency surgery. However, for everyone involved, this actually made them more worried. Ergency surgery was generally about finding and fixing the imdiate problem. But infections? They were similar to sepsis; if one couldn’t identify the pathogen, it would remain a persistent headache. Not to ntion, this ti the infection had also triggered vasculitis, attacking the vessel walls.
But one thing Liu Banxia couldn’t figure out was: what kind of infection could simultaneously attack the brain and lungs? He had been pondering this. Unless it was a systemic disease, but such conditions would typically manifest quickly in liver and kidney function tests. However, the patient had been hospitalized for a considerable ti and had undergone two rounds of consultations, yet their liver and kidney functions were still normal. As for the pneumonia symptoms, apart from so coughing and fever, there wasn’t much else. So, was it possible that the patient’s situation was rely a coincidence? That the pulmonary embolism and cerebral embolism weren’t caused by the sa infection?
He was so worried, he found himself even more anxious than the patient’s family.
"Teacher Liu, why not take a rest now? Aren’t you still going out with Teacher Wang tomorrow?" Huang Bo approached him.
"I can’t sleep now," Liu Banxia said. "Let’s chat a bit. You heard what Miao Rui said, right? You guys will have to play your detective roles and help investigate when you go back to school."
"Teacher Liu, this task is quite daunting," Huang Bo said with a wry smile. "Although we know so underclassn, as dical students, where would we find so much free ti?"
"So it’s a very difficult task that must be completed. Didn’t you used to work in the student union? Don’t you have any contacts?" Liu Banxia asked.
"Teacher Liu, that was just in my freshman and sophomore years," Huang Bo responded. "Later, I couldn’t keep up. To graduate, I had to study hard and try to get so scholarships."
"Haha, that’s better than ; I never got a scholarship. If you ask , those who get scholarships are monsters. My head aches just looking at them," Liu Banxia laughed.
"Teacher Liu, actually Su Wenhao got the most scholarships. I think he only got a second-tier scholarship once, right? The rest were all first-tier. Now that’s a real monster," Huang Bo added fuel to the fire.
"Ah..., his family situation is a bit special. You guys probably knew about it sooner than I did, right?" Liu Banxia asked.
Huang Bo nodded. "I guess so, but not too much earlier. We’ve known about his family situation for a long ti, but we only learned about him returning ho to work more recently. Actually, I think his current choice is great. Working with you, he can learn real skills. In just these few months of internship, I feel like I’ve learned much more than I did studying in school."
"Flattering won’t do you any good; I can’t buy you chicken legs," Liu Banxia said. "Actually, improving your skills depends on the fundantals. I’ve always emphasized how important the fundantals are; this is sothing I’ve experienced firsthand. Once you have a solid foundation, you’ll achieve more with less effort in your future studies and work. That’s why I suggest you focus on a specific organ system for now, and then expand to other systems later. Although we’re in general surgery and perform many types of operations, if you can truly specialize in one area, it will be very important. This applies whether you’re publishing papers in the future or achieving success in a niche field. But don’t think you can slack off. You’re all mine to mold. Even if I haven’t received your ’pledges of allegiance’ yet, escaping my supervision will be quite difficult."
Huang Bo grimaced; this issue was indeed a perplexing one for all of them. Their work experience here had shown them that their future work would be very demanding. However, they also knew that if they wanted to master solid skills in less ti, following Liu Banxia was the right choice. The Ergency Center truly operated on a combined training model. It involved so many departnts, not just limited to general surgery. It wasn’t just the variety that made it good; the key was that many different dical areas were interconnected. By now, their reputation had spread throughout the dical school, a fact inextricably linked to the pressure Liu Banxia put on them and his training thods.
"Why the guilty look?" Liu Banxia stretched. "The patient’s situation is in your hands. Let’s see what the culture results look like tomorrow morning. Has the big devil spoken to you?"
When Liu Banxia went back to the rest room, Miao Rui approached Huang Bo.
"He made it clear to : it’ll be hard to leave the Ergency Center. What do you two think?" asked Huang Bo.
"Surrender, what else can we do?" Li Hao said. "After experiencing today’s consultation, I really can’t bear to leave here."
Miao Rui also nodded in agreent. "Interning with Big Devil Liu is addictive. Even if he tornts us a thousand tis, we’re still devoted to him like a first love. We can learn real skills here. Who else would trust us the way he does, unless they weren’t on the front lines anymore?"
The other two nodded in unison; that was just how it was. The atmosphere in the Ergency Center was good, and they could learn real skills. This made them sowhat reluctant to leave, afraid they wouldn’t adapt elsewhere.
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