Even though Liu Banxia and the patient urged her to eat, the patient's wife had no appetite in such a situation. It would be sowhat more reassuring if there was already a clear diagnosis and the treatnt was targeted.
She had been terrified when the seizure started. It was Liu Yiqing who cald her down, turning the patient over and explaining the situation to her simultaneously.
"Think carefully. Before today, can you recall any other symptoms? For example, problems balancing while walking, bumping into things with his feet, or dragging his feet while walking?" Liu Banxia continued to ask.
"Dr. Liu asked just now, but there really aren't any," the patient's wife replied.
"He does all the cooking and housework at ho to spare . He was fine this morning when he left ho. There was nothing abnormal."
Liu Banxia nodded. "Don't panic; we're just trying to understand more."
His consolation sounded sowhat hollow, but there was nothing more he could do.
"Teacher Liu, you should head back first. I'll stay here," Liu Yiqing said.
"Okay, I'll co back after the results of the lumbar puncture are out," Liu Banxia responded.
"Dr. Liu, you must cure Old Zhang. I don't know how I'd live without him," the patient's wife pleaded.
"Don't worry, we will do our best. That's why we've asked Liu Yiqing to stay here," Liu Banxia reassured her.
Back at the ergency center, he sent others to eat while he took over their duties.
"Has the diagnosis for the ergency patient from this morning co out yet?" Qi Wentai asked.
"We'll see in a bit. Have you eaten? You should go now; I can handle things here," Liu Banxia replied.
"I've eaten, just a few minutes after you did," Qi Wentai said.
"That's good. I've also discussed the chief resident transition with the director. I'll organize the reports today. After I step down, you'll take over directly. Wang Chao will start a bit earlier than you," Liu Banxia inford him.
"Then, I can finally relax. I won't need to monitor things so closely every day. I can go ho peacefully and have dinner with my wife."
"For the first week or so, you'll still need to help monitor things," Qi Wentai said.
Like Wang Chao, he also felt the pressure. Liu Banxia had set such high standards that even if he couldn't match them, he couldn't fall too far behind. It wasn't about competition. However, as the second chief resident of the ergency center, it would be embarrassing if the standards dropped significantly under his watch.
"Don't worry. By then, I'll just be able to go ho and sleep. The rest of the work won't change much. My focus will also have to shift more towards training and education, which presents its own set of challenges," Liu Banxia remarked.
"Haha, that has nothing to do with us. After all, you're capable, so you should bear more responsibilities," Qi Wentai joked.
"Oh, are we having a little internal eting here?" Wang Chao joined them just then.
"Consider it an early work handover. Are you taking a day off tomorrow or the day after?" Liu Banxia inquired.
"The day after tomorrow. I just checked on the patient who underwent a fecal transplant. I plan to do it again tomorrow, as this attempt hasn't been very successful," Wang Chao reported.
"That's a matter for your team; you're the experts. Don't lose heart too soon; there might be an adaptation period. Rember, we conditioned the previous patient for quite a long ti before the procedure," Liu Banxia consoled.
Wang Chao nodded. "This treatnt thod sotis really depends on luck. If the second fecal transplant still doesn't work, I'll recomnd surgery."
"Even though it might lead to a lower quality of life, it could potentially extend life. It's a bit regrettable if this second case fails. It might negatively impact the ergency center's reputation."
"You shouldn't carry such a burden. Any therapy can potentially fail," Liu Banxia advised.
"Accumulate experience; you build experience from the ground up. Or you could research and try other transplant thods."
"Why are you burdening yourself so much? Don't just consider yourself a tool. The screening and processing of so many donors has already taken up a lot of ti."
"Dr. Liu, here is the cerebrospinal fluid examination report for the patient you admitted this morning. I saw it was ready and brought it over," a nurse approached them and said.
"Thank you, I've been waiting for it," Liu Banxia quickly took the report.
The teratoma test ca back negative. This made Liu Banxia sowhat relieved, as it suggested the issue was likely encephalitis or a similar intracranial infection.
However, as he continued reading the report, he was taken aback. The only abnormality in the cerebrospinal fluid was a slightly elevated eosinophil count. This was sowhat consistent with the patient's blood test results. The patient's blood tests had also revealed nothing else beyond an elevated eosinophil count. This finding, however, made the situation very troubleso because it ant the patient's symptoms needed to be completely re-evaluated.
Aphasia could be a symptom of brain inflammation, but the airway obstruction and the recent seizure might indicate an allergic reaction.
The most common conditions associated with increased eosinophil counts are hypersensitivity disorders and certain skin diseases. Beyond that, only severe stages of so illnesses typically cause such an effect.
The term 'hypersensitivity disorders' here doesn't refer to psychological abnormalities; it describes an allergic reaction of the immune system. Urticaria, for example, is one type of hypersensitivity disorder.
If the patient were having a severe allergic reaction, it could indeed lead to airway obstruction and seizures.
I've treated patients with allergic reactions before, and their presentations can vary widely.
"What's wrong?" Qi Wentai asked, noticing his expression.
"The patient we received this morning fainted and was brought to the hospital. He then developed aphasia, followed by airway obstruction and a seizure," Liu Banxia explained.
"The CT scan was negative, and the cerebrospinal fluid and blood tests only showed an elevated eosinophil count as an abnormality. Perhaps my initial assessnt was wrong," Liu Banxia muttered, then continued, "The patient might have so kind of immune system disorder or an allergic condition."
"You two, don't just stand there. Take a look and see if you have any other ideas. This case is quite a headache, and Liu Yiqing is still upstairs in the ward with the patient."
The two of them took the cerebrospinal fluid report and began to examine it together.
"Was the onset of the patient's condition sudden? Was there anything unusual about his health before he ca to the hospital?" Qi Wentai asked.
Liu Banxia nodded. "After careful questioning, neither the patient nor his wife noticed any abnormalities."
"In that case, we can only screen for allergens. I also lean towards so kind of allergic reaction. Could it be that this reaction is affecting the coordination of his brain functions?" Wang Chao suggested.
"I've also considered that possibility," Liu Banxia nodded.
"However, we haven't had any definitive indicators for this patient since admission. Our initial assessnts might all be incorrect. Therefore, I need to be cautious. I must think it over carefully before proposing a new diagnosis."
The patient had already undergone nurous tests and procedures; Liu Banxia had to be extrely careful now.
CT scan, blood tests, cricothyrotomy, lumbar puncture... The latter two were surgical procedures, both invasive.
Could it be parasites? This was an idea Liu Banxia had considered and dismissed earlier, but now it resurfaced.
But if it is parasites, what's causing an allergic reaction like airway obstruction?
Parasites could indeed lead to an increased eosinophil count. If the cysticerci were small and located in the brain, a CT scan might not detect them.
But if parasites were present, the body would usually show so reaction, yet both the patient and his wife insisted everything had been normal.
Moreover, if it were parasites, given how close the couple was, they would likely have had similar exposure. It seed improbable that only the husband would be infected while the wife remained unaffected.
Parasites invading the brain isn't a common occurrence. For sothing like this to happen, they would typically need to reside in the host's body for a considerable ti.
After pondering downstairs for a while without a breakthrough, Liu Banxia found himself leaning more towards an allergic reaction. Different conditions within the spectrum of allergic reactions could also manifest with varied symptoms.
"Dr. Liu, are the test results out?"
Seeing Liu Banxia enter with the report, the patient's wife quickly asked.
"They're out now. We didn't find any signs of infection, and there's no indication of increased intracranial pressure. We can currently rule out encephalitis and ningitis, but we need to continue investigating," Liu Banxia said.
Hearing his words, the patient's wife felt sowhat relieved. At least it wasn't a brain disease.
"Teacher Liu, then what is the situation?" Liu Yiqing asked.
"Only an increased eosinophil count was found. I'm considering an allergic reaction or parasites. Does the patient have a habit of eating raw food?" Liu Banxia asked.
The patient's wife paused for a mont, then shook her head. "He doesn't eat raw food. Although he enjoys eating, he only eats cooked food. He seldom eats raw eggplant or cucumber, and we eat very few raw vegetables with dipping sauce."
"If he doesn't eat raw food, it's unlikely to be parasites. So, next, we can focus on investigating allergy-related diseases," Liu Banxia nodded.
This information aligned with his hypothesis, strengthening his suspicion of an allergy-related disease.
Just then, the patient's stomach rumbled. After a whole day of turmoil, he was hungry.
"Just wait a little longer. You can't eat with your throat in this condition," the patient's wife comforted him.
"Anyway, you've eaten plenty of good food since the New Year. For now, let your stomach rest. Once you recover, we'll eat more."
Hearing the patient's wife's words, Liu Banxia paused. Did I really misjudge?
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