This doctor has a system

Chapter 450 515. How about I treat you to dinner?
"Don't be depressed. Think about it, it's not like she didn't give anything." Li Youliang comforted him with a smile, "That patient looks good..."

It seems quite beautiful.
She has a good figure and fair skin, and she doesn't look old at all.
"The age gap is too big." Li Youliang concluded, "You definitely wouldn't want to be in my shoes."

"I do." Fan Yulong said.

"You can't do it even if you want to. You can't do anything with your looks." Li Youliang said, "I have sharp eyebrows and big eyes, but you have eyes that are as small as slits..."

"The first time we met, I thought you looked down on us and didn't even open your eyes."

"You are definitely blind." Fan Yulong said, "Professor Gao, am I not handsome?" He turned around and asked.

"Yulong, how about I treat you to dinner?" Gao Feng hesitated and said.

"Waiter, give me one of your signature dishes." Fan Yulong said casually flipping through the menu.

"Are you sure?" asked the pretty waitress, "We have more than 40 signature dishes, and the three of you can't finish them all."

"No, you are not humble at all." Fan Yulong said dissatisfied, "Only the ones you are good at are called signature dishes. Everything you know how to cook is considered a signature dish."

The customer did say this, but she forgot to tell the chef.

Yes, Gao Feng is already preparing for the next cardiopulmonary resuscitation.

Gao Feng stood up immediately.

The one who felt uncomfortable was an old lady. Her eyes were wide open, one hand was pinching her neck, and the other hand was beating her chest desperately.

Gao Feng thought that the best thing to eat was the braised pork. It was bright red in color when it was served. The meat tasted crispy, fat but not greasy, which suited his taste very well.

"No, it's my two good brothers who are paying the bill." Fan Yulong pointed at Li Youliang and Gao Feng.

"Uuuuuuuuuuuuuuuuuuuuuu If something happens to my mother, I won't be done with you!" The man burst into tears, and the waiter on the side was also scared to death.

allergy? Laryngeal edema?
Gao Feng frowned. That would be difficult. There was nothing in the restaurant. It seemed that he could only wait for the ambulance.

Several waiters also ran over quickly.

"Is your sign so big?"

He told the waiter, but one of the dishes was still sprinkled with chopped peanuts.

"Yes, but it has to be expensive. I won't eat the cheap ones."

But it will take at least ten minutes for the ambulance to arrive. In the old lady's situation, I'm afraid.
If the larynx is edematous, cardiopulmonary resuscitation may be problematic for a while. The airway cannot be opened, and the success rate of cardiopulmonary resuscitation is very low, almost zero.

"Quick, call an ambulance!"

Finally, 4 dishes were served, Kung Pao chicken, braised pork, steamed sea bass, stir-fried baby cabbage, and a spicy and sour belly soup.

"Help!"

"Haha, maybe the chef has a problem with his understanding of himself." The waiter laughed, "Brother, how about I recommend some to us?"

"What's going on?" Li Youliang stepped forward and asked.

"Brother, can we go back and reimburse?" the waiter asked.

"It must be an allergy!" A middle-aged man's forehead was covered with sweat. "My mother is allergic to peanuts!"

The three of them were eating happily when someone from the next table suddenly shouted.

The environment inside the restaurant is definitely safe and the floor is flat, which is an advantage.
"That's wrong." Gao Feng stared at the old lady for dozens of seconds and suddenly felt something was wrong. How could this look like
By the way, it looks like I was choked by a foreign object!
"Did she just eat something?" Gao Feng hurriedly stepped forward and asked, "Did she choke?"

"What?" The old lady's son was stunned for a moment, "I don't know. My mother suddenly choked like this? I don't know."

The old lady, who was almost suffocated, nodded crazily when she heard what he said.

Gao Feng quickly hugged the old lady from behind and started the Heimlich maneuver.

After a few blows, a date core spurted out of the old lady's mouth.

"Ouch... Ouch." The old lady lay down directly on the ground. She waved her hand to signal others not to touch her, "Let me take it easy for a while."

After working on it for a long time, the situation finally became clear. A pot of pork rib soup was served just now. There was a jujube in it, which must be seasoning. The old lady put it in her bowl.

While she was eating, her grandson's arm brushed the cup. There was hot water in it. She hurried to help her and sucked the date core in with all her strength.

The silly son thought his old mother had a food allergy and kept howling. The old lady kept pointing at her throat and tried to say jujube, but her voice was obviously not as loud as her son's.
"Why did I give birth to a useless thing like you!" The old lady had already gotten up from the ground. "Your son made me choke on the date kernels. You bastard said I was allergic!"

"You two, father and son, work well together. Are you going to work together to see me off today?"

"Grandma!" the grandson cried, having frightened the child just now.

"Don't be afraid, grandma is fine." The old lady quickly hugged the culprit.

"Thank you, brother, let me kowtow to you." After the old lady's son was about to kneel down, Gao Feng quickly stopped him.

"No, it won't happen, it won't happen." In the end, the other party insisted on paying for their meal.

The three of them were strolling towards the hospital when a Toyota Alphard drove past them.

"Uncle Zhang, who are the people outside?" asked a little boy inside.

"Master, the people outside are all cattle and horses."

"What are cows and horses?" the little boy was very curious.

“If they don’t work hard, they won’t be able to work for you,” said the driver, Uncle Zhang.

"Uncle Zhang, are you also an ox and a horse?"

"Yes, Master. I am just like them." Uncle Zhang said softly.

"I haven't seen my mother for several days, and I don't know if it's fun in the hospital." The young master frowned.

"It's not fun in the hospital. It's a place where diseases are treated." Uncle Zhang said, "Master said, the young master will go back after taking a look at it. There are a lot of bacteria in there."

At this time, the infectious disease department was conducting an in-hospital multidisciplinary consultation, and the patient was a 30-year-old woman.

The main complaint is: intermittent fever for more than 1 year.

The patient visited a local hospital more than 2 years ago due to low-grade fever in the afternoon. Chest CT showed a patchy shadow in the upper lobe of the left lung. At the time, he thought it was a tumor and was frightened to death on the spot.

Fortunately, the sputum smear for acid-fast bacteria was positive, and he was diagnosed with tuberculosis. He was given anti-tuberculosis treatment with isoniazid, rifampicin, ethambutol, and pyrazinamide.

Three months later, the regimen was adjusted to HEZ. A follow-up chest CT scan showed improvement in lung shadow absorption and partial calcification. After that, the medication was discontinued as directed by the doctor.

Originally, he thought it was just a simple case of tuberculosis, but what happened next made the patient suffer so much that the doctor, who had already had a Mediterranean brain, became bald.

One month later, the patient developed fever again, with a maximum body temperature of 1°C. Chest CT showed another patchy shadow in the upper lobe of the left lung.

A lung puncture biopsy was performed at a local hospital. Pathology showed coagulative necrosis, and acid-fast staining revealed a highly suspicious Mycobacterium tuberculosis line. Recurrence of pulmonary tuberculosis was considered.

He was given anti-tuberculosis treatment with HREZ + levofloxacin, but his symptoms did not improve significantly. He still had low fever every afternoon. After 8 months, he stopped taking all anti-tuberculosis drugs due to low white blood cells.

That month, the patient visited the Department of Infectious Diseases of Union Hospital for the first time for a clear diagnosis. The blood test showed positive TSPOT, the erythrocyte sedimentation rate was 36 mm/h, and a contrast-enhanced chest CT was performed.

"This is a film from that time." The doctor in charge called up the image from the computer.

During hospitalization, the patient's body temperature gradually increased, reaching a maximum of 41°C, with obvious chills and high fever. CRP was 83.91mg/L, blood PCT was 13.98ng/ml, and blood anaerobic culture was negative, so bacteria were considered.

Antibiotic treatment with linezolid and moxifloxacin was given. The patient's body temperature returned to normal 2 days later, and the inflammatory indicators dropped significantly after 1 week.

Later, due to low white blood cell count, the anti-infective drug linezolid + moxifloxacin was discontinued.

After his condition stabilized, both the patient and the doctor in charge breathed a sigh of relief, and his family also went through the discharge procedures.

But things are far from over.

“Half a year later, the patient visited our hospital again due to fever and discomfort. Bronchoscopy showed an old lymphatic fistula in the lingual segment of the left lung. The lavage fluid molecular test for mycobacteria was positive. The type of bacteria was Mycobacterium tuberculosis complex and X-pert was positive. , low TB-DNA content, rpo-B gene mutation, isoniazid resistance gene mutation, bronchial brush smear and lavage fluid acid-fast bacteria smear were all negative.”

"Based on the patient's symptoms and previous history of anti-tuberculosis treatment, consider diagnosing multi-drug-resistant pulmonary tuberculosis. "Reported by the bed doctor.

"According to the guidelines, he was given bedaquiline + linezole + moxifloxacin + cycloserine + clofazimine anti-tuberculosis treatment, and his condition improved and he was discharged after one month."

"Instruct him to take medication regularly after discharge."

I have to say that this diagnosis and treatment is very standardized, and no one else can find anything wrong with it.

But this time something went wrong again. Less than a month after being at home, the patient developed fever again, with a maximum body temperature of 38.7°C, intermittent coughing, phlegm, and chest tightness.

At this time, the patient's mentality collapsed.

“After being admitted to hospital this time, a bronchoscopy was performed, and the results were the same as before. NGS of the bronchoalveolar lavage fluid detected Haemophilus (946 sequence numbers), Candida (21 sequence numbers), and Lymphofollivirus (68 Sequence number), Mycobacterium (sequence number 47), consider combined Haemophilus infection, and give "imipenem-cilastatin sodium" anti-inflammatory treatment;"

"The patient's symptoms of cough and sputum have improved, but he still has intermittent chills and high fever, with a body temperature up to 40°C, and scattered rashes on the extensor sides of both lower limbs. The symptoms can be improved after hormone treatment."

"Complete autoimmune antibody examination, anti-Sm antibody is positive, anti-β2-glycoprotein 1 antibody is elevated, anti-nuclear antibody ANA titer is elevated, anti-UI-snRNP antibody is positive, immunoglobulin IgA is elevated, autoimmune system is not excluded disease."

"After consultation with the rheumatology and immunology department, the patient was diagnosed with undifferentiated connective tissue disease. He was treated with prednisone and chloroquine sulfate, and the fever symptoms improved."

"But..." the doctor in charge said with a dry mouth.

Three months later, the patient developed fever again, and a chest CT scan showed that the left lung lesion was enlarged.

"Hey, this case is not simple." Someone said.

This is nonsense. To put it simply, it is nothing more than a multidisciplinary consultation. Moreover, due to the financial ability of the patient’s family, all the big names came today.

Academician Bao is also among them.

(End of this chapter)