Reasoning diagnosis: Big brother, your wife has been prescribed medicine!

Chapter 172 To make matters worse, there are new symptoms!

Yang Ming was a little excited when he saw Lin Yi.

Because he has long heard that there is a young doctor in the emergency department in the hospital, named Lin Yi, who has excellent knowledge and methods of diseases, but he has never seen him!

We were able to have a joint consultation today, and I happened to meet up too, to see if it was really as powerful as it was said!

"Don't say that, Deputy Director Yang, please sit down!"

After all, Yang Ming is also a senior, so Lin Yi naturally has to be more modest with him.

After Yang Ming sat down with the two attending physicians, Yang Ming looked at Lin Yi and said:

"Doctor Lin, what's the condition of the patient on your side, did you call us here?"

Lin Yi saw that all the staff had arrived, so he didn't write any ink, and went straight to the point:

"Okay, Deputy Director Yang, time is running out, so I'll start right away!"

"This patient is Ma Tao, 32 years old, who suddenly vomited and fainted while going down the stairs a few days ago, and was sent to the nearest hospital for examination."

"The test result was gastroenteritis, and some medicine was prescribed, but no problem was found."

"After going back, the patient was worried and came to find me."

"When I did a routine test on him, he didn't have a knee jerk in his left leg!"

When Lin Yi said this, everyone stared at Lin Yi closely, and made relevant records in their notebooks.

Lin Yi continued:
"Then, we performed a brain biopsy on him and found that he was infected with toxoplasmosis and had a false positive for HIV, and the tests were all negative!"

"Now his condition is very serious, and the muscle strength of his left leg is gradually losing, which means that the symptoms of toxoplasmosis are getting worse!"

After Lin Yi finished speaking, Yang Ming and the others couldn't help frowning.

Not AIDS, but have these symptoms?

Toxoplasmosis is closely related to AIDS. If he can be infected with toxoplasmosis, it means that there is a big problem with his immune system.

But it is not the cause of AIDS, so we have to find a breakthrough from other places...

Lin Yi looked around, and then asked:

"Do you have any ideas?"

After a long silence, Yang Ming was the first to ask Lin Yi:

"Has this patient ever had an organ transplant?"

The reason why Yang Ming asked this question was because organ transplantation might damage the immune system and cause immunodeficiency.

Lin Yi shook his head directly, and denied:

"No."

"What about his T-cell count?"

An attending physician next to Yang Ming asked immediately.

This is also a question they are very concerned about, because T cells are lymphocytes and play an important immune role in immune organs and tissues.

If its quantity changes, it will greatly affect the patient's immunity!

"I've arranged to have him checked, but the results are still pending."

Lin Yi looked at him and replied.

Yang Ming couldn't help but nodded slightly.

He has already arranged for relevant inspections, which shows that he has thought of this.

After thinking about it, Yang Ming wanted to find out how Lin Yi's disease knowledge and analysis ability were in terms of immunity.

So Yang Ming asked Lin Yi:
"Doctor Lin, the test results haven't come out yet, do you have any speculation?"

After Yang Ming finished asking, the two attending physicians beside him also stared at Lin Yi closely.

They have also heard that Lin Yi is so good, but they are also young people, so they are inevitably a little dissatisfied with him, and they always feel that he is too famous.

So they also wanted to see how brilliant Lin Yi's insights would be!

Lin Yi pondered for a moment, then said:
"Anyway, I'm still waiting for the result, so I'll tell you my thoughts."

"Okay, Dr. Lin, please tell me."

Yang Ming didn't expect that he really had some speculations, so he immediately stared at him with great interest and said.

"Now we can confirm through the patient's symptoms that he must be immunodeficiency."

"And since it is immunodeficiency, it is nothing more than a few situations."

"AIDS is a very strong possibility, but it has been ruled out by us now."

"There is also hairy cell leukemia, which can also be caused by viruses and malignant tumors."

"By the way, there are also some variant immunodeficiency, but this kind of situation is very rare."

Lin Yi finished speaking in one breath.

Listening to Lin Yi uttering these possibilities so smoothly without thinking, Yang Ming couldn't help but nodded in admiration.

Although he is not a doctor of professional immunology, but the level of relevant knowledge is indeed in place!

The two attending physicians next to him also swallowed unwillingly.

They knew in their hearts that if they were suddenly asked to mention these possibilities, they would have to think for a while before they could remember.

And what does the variable immunodeficiency he mentioned at the end refer to?
Not only them, Yang Ming also had some doubts.

But it was not easy for them to ask Lin Yi.

After all, this is their old profession, the knowledge of the immunology department. Wouldn't it be too bad for them to ask an emergency doctor?

At this moment, the door of the conference room was pushed open, and Chen Qiang walked in with a report in his hand.

"Brother Yi! The results of Ma Tao's inspection report are out!"

Chen Qiang walked towards Lin Yi quickly while talking.

"Oh? It's out, show me quickly!"

Lin Yi couldn't help being shocked, and said immediately.

After Lin Yi received the report, he first scanned it roughly, and then told everyone the general content of the report:

"The general examination report showed that the lymph nodes in the patient's neck were slightly enlarged, about 3mm in size."

"And there were cysts in the armpits, in the abdomen, and in the kidneys."

After listening to Lin Yi's report, Yang Ming frowned and shook his head slightly, saying:
"There's nothing wrong with the lymph nodes in this neck, and the cyst is insignificant, certainly not the cause."

"From this point of view, no tumor was found in his body. It seems that his illness has nothing to do with the tumor."

An attending physician next to Yang Ming couldn't help nodding his head in agreement after listening to it, and then his eyes lit up, and he said directly:

"Then we can check for hairy cell leukemia next!"

But as soon as his words came out, he was immediately rejected by Yang Ming:
"No! Can't check for hairy cell leukemia!"

"What... what's wrong? Deputy Director Yang."

The attending physician couldn't help looking at Yang Ming, and asked hesitantly.

Yang Ming looked serious, and said in a deep voice:
"Because we have no way to check for hairy cell leukemia!"

"No way? It shouldn't be, we just need to observe whether the spleen is enlarged, can't we be sure?"

"Yes, Deputy Director Yang, why can't this work?"

The two attending physicians next to him immediately looked at Yang Ming and asked in doubt.

"An enlarged spleen does not necessarily mean that a patient has hairy cell leukemia."

Suddenly, Lin Yi on the opposite side spoke directly.

Several people were startled, and all looked at Lin Yi.

"Although people with hairy cell leukemia usually have an enlarged spleen, it is undoubtedly not feasible to make an accurate judgment based on this."

Lin Yi continued to add.

"Even if it can't be judged by splenomegaly, we can use other methods to detect it."

"It doesn't mean that it can't be tested."

An attending physician was unconvinced.

It was not easy for him to ask Yang Ming these questions directly, but at this time Lin Yi happened to be in the lead, so he pointed the finger at him directly.

With a calm face, Lin Yi said slowly:
"It is true that other methods can be used to detect, but this other method requires an operation on the patient and then a biopsy of his spleen."

"But the patient is now severely immunocompromised, and the menstrual blood circulates mostly through the spleen!"

"If we operate on him, think about the consequences!"

After Lin Yi finished speaking, the scene suddenly fell into silence.

Yang Ming looked at Lin Yi in surprise, because what he said was the reason why he denied the detection of hairy cell leukemia.

And he can think of this directly, the knowledge reserve is really strong!

The two attending physicians in their own department immediately paled in comparison!
But then he couldn't help being calm again.

This is normal, otherwise his name would not be circulated in the hospital!

After listening to Lin Yi's answer, the two attending physicians turned their heads to look at Yang Ming, and after seeing his expression, they immediately bowed their heads and fell silent.

Immediately afterwards, an attending doctor still couldn't help but raised his head and asked Lin Yi:
"What would be the consequences if you had an operation?"

"Simply put, it's sepsis!"

Lin Yi said directly.

They naturally know that sepsis is that pathogenic bacteria invade the blood circulation, grow and multiply in the blood, and then produce toxins, causing systemic infections.

If this disease is serious, it can be fatal!
But why did he say that if an operation is performed on a patient, it will cause sepsis?

Then, they couldn't help thinking about it.

After a few seconds, they finally figured it out!

Generally speaking, bacteria that invade the blood circulation system in normal people will be cleared by the immune system.

But if a person's immune system is defective, there is no way to clear it up.

The spleen is the main way of blood circulation.

If the spleen is operated on, then indeed, the consequences will be unimaginable...

Thinking of this, they couldn't help but get chills down their spines...

If you really do this, you will be in big trouble!
It's just...it's really not easy for this kid to think of this in an instant!

At this moment, the door of the conference room was pushed open again!

A nurse hurried in and said immediately:

"Doctor Lin, there is something wrong with Ma Tao again!"

"What's happening?"

Seeing the nurse's expression, Lin Yi hurriedly asked her.

"He just had symptoms of dyspnea! And his blood oxygen has dropped to 85!"

"what?!"

Hearing the nurse's words, everyone present suddenly exclaimed.

There is no clue about the diagnosis of hairy cell leukemia now, and now this situation occurs again, which is simply worse!

"Go, go and have a look first!"

Lin Yi immediately got up and walked out.

Others in the conference room also got up one after another and went out together, wanting to check on the patient's condition.

A group of people came to Ma Tao's ward in a mighty manner.

At this time, Ma Tao was lying on the hospital bed with his mouth open, breathing hard!

And his blood oxygen is still gradually dropping!
"Quick, get intubated!"

Seeing this, Yin Liang immediately shouted.

"Yes!"

The medical staff next to me agreed and acted quickly.

After a while, the intubation was finally successful!
Only then did Ma Tao take a deep breath.

Everyone couldn't help but breathe a sigh of relief.

"What's going on, why is it suddenly like this?"

Wu Jiang stared at Ma Tao with a painful expression, shook his head and said.

After Lin Yi came to the ward, he turned on the live camera, in order to let the water friends better understand the development of Ma Tao's condition.

After seeing this scene, the water friends couldn't help launching a barrage:

"What's the situation? Why is this brother so serious!"

"It's scary in this state!"

"When I came here, I looked alive and well. Why does it seem like I'm dying at night?"

"This brother is too disobedient. He even told me not to ask the anchor to see a doctor!"

"He just won't listen!"

"What should I do? Has the cause not been found yet?"

Seeing that the situation calmed down temporarily, Yin Liang walked to Lin Yi and said to him:
"Brother Yi, Ma Tao's respiratory system is now severely damaged."

"Severely damaged respiratory system?"

Lin Yi couldn't help frowning, and said in his mouth:
"It shouldn't be...why is the respiratory system damaged? It's definitely not caused by toxoplasmosis."

Immediately afterwards, Lin Yi immediately looked up at Yin Liang, and said to him:

"It is now necessary to immediately find out the cause of the damage to the patient's respiratory system!"

"That's it! Go and do silver dyeing for him!"

Silver staining is a method of detecting proteins in polyacrylamide gels, and some pathogens can be identified based on the detected proteins.

"Okay! I'll arrange it now!"

Yin Liang didn't dare to delay, and immediately acted as soon as he promised!

"Doctor Lin, the patient's situation is really too complicated now, do we need to invite people from the respiratory department to consult together?"

Yang Ming looked at Lin Yi, frowned and asked tentatively.

Lin Yi shook his head and said:

"I don't think it is necessary for the time being, because his respiratory system is damaged now, it must be a symptom, not a cause."

"I think our primary goal now is to find out the cause as soon as possible!"

After Lin Yi finished speaking, Yang Ming couldn't help but nodded in agreement, and then said:
"Although that is the case, we now suspect that he may have hairy cell leukemia, but his immune system has been damaged in such a way that we have no way to test and confirm it."

"This is a nuisance!"

"Should we consider other possibilities?"

After Yang Ming finished speaking, the scene fell into silence for a while, and no one had a good solution.

Everyone couldn't help muttering in their hearts, this situation is really rare, this is a hard stubble!
"We can only wait for the results of silver dyeing to come out."

After a while, Lin Yi spoke first.

"Ah."

Yang Ming nodded slightly.

After a while, Yin Liang walked in.

"Silver Dyeing results are out!"

After entering, Yin Liang immediately said to Lin Yi.

"How is the result?"

"It was found that Ma Tao's respiratory system was damaged due to Pneumocystis carinii pneumonia!"

Pneumocystis carinii pneumonia is an interstitial plasma cell pneumonia caused by Pneumocystis bacterium, which often occurs in immunocompromised young children!

And when it appears in an adult patient, then this patient has a high probability of suffering from hairy cell leukemia!
(End of this chapter)