I'm really an intern

Chapter 79 Can Willow Dark Flowers Be Clear?

At ten o'clock in the morning on Wednesday, the conference room of the Department of Infectious Diseases was neatly filled with bosses.

The whole hospital consulted, what a posture, the teaching secretary served tea and water to all the bosses in fear.

Chen Shishi followed Senior Brother He and sat in the last row, not daring to speak louder while panting.

It's really a group of big guys gathered together, and the momentum is compelling.

As the doctor in charge of the bed, Zhang Tianyang still sat in front of the front computer, unable to escape the fate of reporting medical records.

While chatting with the big guys, Professor Zhu took the time to glance at him, and then nodded slightly.

She didn't show any signs of stage fright at all, it's no wonder that she was optimistic about Dr. Zhang Zhang.

The last ones came were two big bosses from the laboratory department. All the big bosses were in place. Zhang Tianyang released the projection and began to introduce the disease.

Just like yesterday's general practice consultation, this time it was the big bosses of the whole hospital discussing and arguing.

Xiaoxi's condition is not just a matter of infectious diseases.

Since the initial onset started from the lungs, and the most serious organ damage was also the lungs, the experts in the respiratory department also expressed their opinions.

"I still agree to continue to use anti-tuberculosis therapy, after all, anti-tuberculosis therapy was effective before."

The boss next to him who was infected with internal medicine had never quarreled with anyone else yesterday, and he was already full of anger, so he went straight up at this time.

"Then how do you explain that he relapsed a month after taking anti-tuberculosis drugs?"

The head of the respiratory department is a well-cultivated old lady, half of her silver hair is well-groomed.

She was not angry when she was bullied, she just silently glanced at the bald professor of infectious internal medicine, then slowly took a sip of the warm tea in front of her.

"Maybe it's a problem with the anti-tuberculosis treatment plan, try adjusting the medicine."

The bald professor of infectious medicine still disagreed, "Which tuberculosis patient would be like her? This does not conform to our current cognition!"

"you're right."

The boss of the Department of Respiratory Medicine is still tepid, and he can be called the clear stream among a group of red-faced bosses.

"Then what treatment plan do you have?"

The bald professor of infectious internal medicine misfired.

"I do not have……"

Apart from these two, other bigwigs are also quarreling.

As the lesions have accumulated to the skin and bones, the bigwigs in dermatology and orthopedics also have something to say.

There is also the Laboratory Department. The various specimens sent for inspection yesterday, including skin purulent secretions, pustules in the throat, alveolar lavage fluid, and even a bone on the spine, have all been processed.

But other hospitals have not cultivated pathogenic bacteria in the past five years, and the head of the infection department euphemistically said that he is not very good here.

The bosses of the various departments who were not involved in themselves hid aside one after another, watching the fire from the other side with tea.

"It's rare to see such a scene..."

The director of obstetrics and gynecology is also a female professor. At this time, she is holding tea and sighing with the people next to her.

"It means this patient is very difficult!" The director of the Cardiology Department nodded his head, "I thought there would be a heart problem before I came here, but now I see the test results and I feel fine."

"Look at this film!"

The director of the obstetrics and gynecology department picked up the chest CT placed on the table and held it up to the light.

"Her lungs are dying, and it is estimated that there is no time to involve the heart."

……

Chen Shishi hid in the last row and watched a group of gods arguing in front of her, and a group of gods watched the fire from the other side, feeling in a daze that her world view had been impacted.

"So it turns out that the big bosses are arguing so lively..."

She looked at Zhang Tianyang who lowered his head thoughtfully behind the computer.

"Has Junior Brother started to be in a daze again?"

"There's nothing he can do if he doesn't go into a daze."

Senior Brother He is now at Zhang Tianyang's side this time, "Look, although the discussion was intense, it didn't give a guess of the cause and follow-up treatment plan that everyone can agree with."

"Without these two crucial pieces of information, what does it matter if you don't listen? Even if the symptoms can be treated properly, if they don't get rid of them for a day, the patient will not escape a tragic fate."

What Brother He said was indeed correct. The bosses argued and insisted on their own opinions, but there was still no way to determine the cause of the disease.

In the end, we can only decide to "handle what can be handled first".

First sent to the operating table, orthopedics and dermatology first deal with her bone lesions and skin abscesses.

Then, according to the opinions of the respiratory department, the medication was adjusted and the anti-tuberculosis treatment was continued.

"Okay, let's make a decision for now, does anyone have any ideas?"

As the professor in charge, Professor Zhu made a summary, "If there is no opinion..."

"Professor, I have an idea."

Zhang Tianyang, who had been watching the battle silently, raised his hand.

The eyes of all the big shots fell on Zhang Tianyang.

Professor Zhu frowned slightly, Doctor Zhang Zhang was usually very decent, why suddenly...

She coughed twice as a reminder, and then spoke.

"About this patient?"

Zhang Tianyang nodded, "Yes."

"About her illness?"

Zhang Tianyang nodded in response to the gazes of the big shots, "Yes."

"This little doctor is interesting."

The director of the Cardiology Department, whose buttocks had left the chair, sat down again and looked at Zhang Tianyang with some interest.

But I saw him unhurriedly opening a ppt that had been copied to the desktop a long time ago.

In fact, after he had a clear idea last night, he thought about how to implement his conjecture and treatment plan.

Secretly tell Professor Zhu?

This is a method, but what if Professor Zhu does not believe it, or thinks that he has proposed an idea that has not been proposed by the general practitioner consultation, and it cannot be right?

Although he has a good impression of Professor Zhu, this possibility cannot be ruled out.

After all, he was just an intern, and what he was facing this time was an intractable disease that had not been found out after five years of treatment.

Therefore, the whole hospital consultation is an opportunity.

On the one hand, he wanted to see if the big bosses had the same conjecture as he did. On the other hand, if his idea was wrong, so many big bosses were present and could correct him.

Big deal, get scolded.

Anyway, he has thick skin.

It's a pity that the bosses didn't think of going with him.

He clicked the mouse and clicked on the show.

The title of the ppt was hit in front of you big guys.

"Penicillium marneffei?"

The boss of the laboratory department frowned while sticking to the title.

"Do you suspect that the patient was infected with this thing?"

Faced with doubts, Zhang Tianyang took his time.

"Yes, teachers may not believe it, because this bacteria is a very rare opportunistic pathogen, and it often only infects HIV patients."

"However, there is a very, very small chance that it will also infect non-HIV patients."

Zhang Tianyang pressed the mouse, and the ppt jumped to a new page.

"Teachers, please take a look. This is the previous report I found on non-HIV patients infected with Penicillium marneffei. There were only 7 cases."

The several directors who were a little impatient and anxious to go back to deal with their own affairs all sat up straight again.

The old lady, the director of the respiratory department, stopped drinking tea, put down the quilt, and listened intently.

"Seven patients, six had skin lesions, five involved bone lesions, and all had lung lesions."

"Penicillium marneffei infection is divided into disseminated and pulmonary forms..."

After briefly introducing the cases he found and the characteristics of Penicillium marneffei, Zhang Tianyang began to explain the evidence to prove his point of view.

"This patient appears to have normal immunity on the surface, but I asked her family members carefully. She has been weak and sick since she was a child, and she is prone to colds, which gives the germs an opportunity."

"In addition, they live in the south all year round, and the humid climate will cause the spores of the bacteria to disperse in the air and be inhaled by the patients."

"Bamboo rats are an important source of infection for Penicillium marneffei. Although the patient had never used bamboo rats, I learned after asking that she had kept bamboo rats as pets."

"Penicillium marneffei is easy to be misdiagnosed as tuberculosis because it can stain the culture medium pink, and I called the laboratory department in Shanghai last night to verify this."

"So, based on the above, I think the patient may be infected with Penicillium marneffei."

After the words fell, Zhang Tianyang waited for the decisions of the big brothers.

"Really, could it be this kind of bacteria?"

As a member of the theater audience, the director of the Cardiology Department didn't understand these things very well, so he broke the silence at this time.

"what do y'all think?"

　Don't scold, just keep on scolding

　　

　

(End of this chapter)