Sleepless Doctor

Han Guangyun quickly set up a group, brought Mr. Wu in, and then had a group video chat.

Mathieu tidyed his hair to make himself look more energetic.

Director Tang's room is a bit dark, with a familiar background, and it looks like her office.

"Director Tang, Teacher Wu wants to ask about the patient's condition on the video, and prepare the patient's information on your side." Matthew cleared his throat and said.

"Mayuan, you haven't rested yet? Why do I look like a medical dispute in the medical office?"

"I'm afraid I will have to toss about something. I have been sleeping in the unit recently." Matthew De said lightly.

In fact, there are other reasons why he didn't go home.

"Let me see, yes, the results of the sputum culture are back. There may be more evidence that the patient has not been infected by the new type of pneumonia." Director Tang took the mobile phone and sat at the desk.

Soon, Wu Mian joined in.

The streets are cold,

nobody,

There is no car.

Wu Mian was sitting on the steps, with a small head coming up next to him, Chu Zhixi should be his eyebrows.

"Oh? The Mayuan didn't go home." Wu Mian said with a smile, "Are you worried about the infection of your family? Can you still be able to sleep in the medical office every day?"

"..." Matthew De sighed.

"Or the people in the community don't let you in?"

This sentence is even more heartbreaking.

Matthew De felt that Mr. Wu just picked it up and said that there is a big happy event today, but he even said so heartily.

"Director Tang, you are also in the office."

"Well, when I go home, the community said that people in the hospital should not go back because they are afraid of carrying the virus. I thought about it, and it seems to be too." Director Tang said lightly, "The hospital is particularly unwelcome now, and people who despise the chain transmission are very unpopular. quick."

"Well, it's normal." Wu Mian didn't complain. With a cigarette in the corner of his mouth, he took out the lighter and lit it, and after taking a sip, he said, "The community is not easy. My mother became a volunteer and controlled the community with the street and neighborhood committees. , It’s snowing every day against the wind."

Matthew Dee looked at Wu Mian and Chu Zhixi in the video, and hadn't seen them in just over ten days, and he felt like a world away.

Professor Chu with long and fluttering hair kept a small flat head, deep strangle marks on his forehead and bridge of nose, and faint blood stains could be seen in some places.

The same is true for Teacher Wu, and with the back of Director Tang's office, Matthew is sad and sad all his life.

I don't know which day is the head of those days.

"Director Tang, talk about the patient's condition."

Director Tang began to report on the medical history.

It was relatively simple when reporting to Matthew De, and very detailed when reporting to Wu Mian.

"Physical examination: The patient was conscious, temperature was 36.7℃, breathing was 26 minutes, blood pressure mmHg, SO293%, non-invasive ventilator, %.

The superficial lymph nodes of the whole body were not palpable and enlarged, the jugular vein was not distended, the breathing movement of the lungs was slightly enhanced, and the lower lungs could be heard and scattered wet rales. The rest of the cardiopulmonary and abdominal examinations were not special, and there was no edema in both lower limbs. "

"Laboratory examination showed that white blood cells and inflammatory indicators were elevated-white blood cell count 13.05×109L, neutrophil percentage 88.3%, erythrocyte sedimentation rate 64mmh, procalcitonin 0.21ngmL]"

"CD4 has an absolute count of 48cellul, and CD8 has an absolute count of 59cellu.

Pathogenic examination: sputum culture: more Aspergillus fumigatus complex (3+), serum GM test positive (0.12). "

"The result of sputum culture is Aspergillus fumigatus?" Wu Mian asked.

"Yes, Mr. Wu. The results of sputum culture have not come back during the afternoon consultation, so everyone is more inclined to the new type of pneumonia. After all, the patient is a hard worker, suddenly fever, blood oxygen saturation drops, and a ventilator is needed to assist breathing. It is the diagnostic criteria for new pneumonia. Plus lung CT..."

"Did the results of alveolar lavage come out?"

"Not yet, tomorrow morning." Director Tang said, "Based on the results of sputum culture, a preliminary diagnosis of "pulmonary aspergillosis" was given. Voriconazole + moxifloxacin was given for anti-infection, methylprednisolone anti-inflammatory treatment, and non-invasive ventilator assisted ventilation was continued. ."

"Ms. Wu, the problem now is that the cause of the diffuse interstitial changes in both lungs of the patient is unknown. Aspergillus infection cannot explain the disease."

"I am going to do a biopsy of the right lower lung."

"No need." Wu Mian said with a cigarette in his mouth. "From the perspective of the patient's current situation, the possibility of a pleural reaction on the needle biopsy is relatively high, and emergency treatment may be needed."

"..." Director Tang was taken aback.

Wu Mian did not explain why, and continued, "I suggest to adjust the medication, changing moxifloxacin + voriconazole to dafukang + piperacillin and tazobactam."

"Ms. Wu, what kind of disease do you consider?"

"I have some judgments, but I'm not sure. I heard the medical history. When the patient had an attack 4 years ago, he was working in a field. All the information at that time was missing?"

"Yes, Teacher Wu."

"Ask where to work, let me see if I can ask someone at the local hospital for information." Wu Mian said lightly.

As he spoke, he spat out a mouthful of eye circles leisurely. When Matthew saw his eyes, his new life was quiet. Teacher Wu looks in a good mood, this is the best news.

Director Tang is overjoyed. Having previous information is of great significance to the diagnosis of patients~www.wuxiaspot.com~Ma Xiude sighs in his heart that Mr. Wu has to spend a lot of time looking for past information for such trivial matters. He is a little serious. Too much.

Soon, Director Tang asked that the patient worked in Jiangnan Province 4 years ago. He only knew the city but not which hospital he went to.

"Let me find it, and send me the patient's ID number."

"Ms. Wu, it's very troublesome."

"It's okay." Wu Mian said, "In recent years, the big data health system has been built, and some cities in the south have uploaded the data in the image database. After all, the CT machine can save the data for up to six months, so it must be cleaned up once, or the old cow will pull it out. The broken car won't turn at all."

In the video, Wu Mian's mask was pulled on his chin, with a cigarette dangling from the corner of his mouth, and he smoked silently, without seeing any movements of him.

After smoking a cigarette, Chu Zhixi's voice came, "Brother, I found it."

"Let me take a look."

"The chest CT performed when the patient was suffering from tuberculosis 4 years ago showed multiple small nodules and cluster shadows affecting both lungs." Wu Mian said, "This patient is a bit interesting."

Han Guangyun didn't know what Wu Mian was talking about in a daze.

Director Tang knew that she asked for the first time, "TB should not have obvious infection lesions, and the patient is a young man with no other underlying diseases, and has been engaged in physical activity for a long time. Why do such serious infections occur repeatedly?"

"Let's do a genetic test...Is this inspection carried out by the Second Hospital?" Wu Mian said, "If it doesn't work, I will leave you with a call. It belongs to me, a patient."

"Um?"

"The boss of Lesotho Genes is still living under Laoya Mountain." Wu Mian said with a smile, "Director Tang contact him to see if it is a gene defect related to cilia movement."

"Primary ciliary dyskinesia?" Director Tang was stunned.