Doctor: It's reasonable to perform surgery on yourself.
Chapter 326 A clue in one sentence! The clues of the strange disease!!
From the abdominal CT scan, there was no tumor mass, and several tumor indicators were not high.
This means that the possibility of tumor fever is not high.
On the other hand, rheumatology and immunology tests did not bring good news.
Rheumatoid factors and other factors were all negative, and rheumatic immune diseases were also ruled out.
"Everything is normal?"
Xu Qiu turned off the test and re-read the patient's hospitalization records, trying to find some clues.
The three common causes were not considered, and it was not an easy task to further confirm the cause of repeated fever.
"Drug fever?"
At this time, Xu Qiu had this guess in his mind.
Clinically, many drugs have side effects including fever.
For example, Luo Di took amphotericin B, which is used in the treatment of brain-eating amoeba deworming.
In addition, antibacterial drugs such as penicillin, ampicillin, amoxicillin; anti-tumor drugs cisplatin, carboplatin; anticoagulants, etc. ... are countless.
Regardless of whether it is drug fever or not, Xu Qiu can only give it a try at this moment.
After all, the patient's condition is getting worse and worse. Every day the fever is delayed, one day is consumed, and the possibility of recovery is even slimmer.
Clinical work is a trade-off.
As long as the benefits are greater than the costs, it can be done.
A truly perfect treatment plan cannot exist.
In fact, stopping all drugs that may cause fever is also a helpless experimental move by the general chief physician when he reaches this step.
This will certainly lead to the deterioration of severe pneumonia that has been controlled, or even a resurgence.
However, compared with the recurrent fever of unknown cause and incurable, this cost is high but not unbearable.
"Go to the ward again."
However, at this moment, Xu Qiu stopped.
Whether to choose this plan of killing one thousand enemies and hurting eight hundred is still under discussion.
He needs to confirm again until he is sure that he has no clues!
...
ICU.
This time Xu Qiu only did a simple physical examination.
When he came for the first time, he had already done a detailed examination and confirmed that there was no abnormality.
With Xu Qiu's physical examination ability,
he could draw the conclusion of "no obvious abnormality" from his examination bed, which means there is really no problem.
The re-examination was just a routine to see if there were any new lesions.
"Doctor Xu, I have thrown away my magnifying glass. Today I used a microscope to look at the dandruff that fell from my daughter and found..."
Xu Qiu: "..."
Director Jiang and others had stiff faces, wanting to laugh but unable to.
"No problem."
Xu Qiu quickly completed the physical examination, and as expected, there was no abnormality.
Tao Changhan's daughter said angrily: "Dad, why don't you fight for it? Look at what disease you have. Even Doctor Xu has come to see you twice!"
The old man on the bed did not change his expression. He tilted his head and said nothing.
However, at this moment, Xu Qiu caught a detail.
At the moment of tilting his head, Tao Changhan's eyes twitched slightly.
Xu Qiu suddenly remembered something.
He quickly connected a bunch of clues, and finally it became smoother and smoother. The final answer was about to come out, and his thoughts were instantly clear.
"You said before that the patient had a cheerful personality before?" Xu Qiu looked at the medical record in his hand and asked quickly.
Ms. Tao looked a little proud: "Yes, he takes after me."
Director Jiang and others twitched their mouths.
Is there such a description for a daughter taking after her father?
However, it can also be seen that the father and daughter usually don't get along too seriously.
Ms. Tao said with regret: "At the beginning of the year, he often hooked up with the old lady in the nearby park, doing Tai Chi in the morning, ballroom dancing in the morning, walking in the park in the afternoon, and square dancing in the evening. We thought he could find a partner, but a month ago, he suddenly became a different person. He didn't respond to anyone and didn't go out."
At this moment, all the doctors' faces became serious.
Changed into a different person...
These four words are extremely important in clinical practice.
Sudden personality changes and long-term abnormal emotions may be lesions of the central nervous system or mental illness!
No one had asked about this situation before.
The respiratory department is busy correcting the shock of severe pneumonia, and his life is hanging by a thread.
Sent to the ICU, the pneumonia infection has become more serious, and the medical staff are also focusing on controlling the progression of severe illness and preventing and treating recurrence.
In addition, the patient was intubated and connected to a ventilator throughout the whole process, so he couldn't speak.
This also made everyone ignore that he was not only unable to speak, but also had a sudden change in personality that led to mutism!
"Yes, mutism!" Director Jiang was not a pushover. After finding the key point of the question, the answer immediately popped up in his mind.
Xu Qiu nodded and affirmed.
Mutism.
This is a disease in which the speech organ has no organic lesions and the intellectual development is normal, but the patient is silent.
It often occurs in children with withdrawn personalities.
Common causes of mutism include hysteria, affective mental disorders, or schizophrenia.
Director Jiang thought for a moment, "If it is mutism, could it be... he is schizophrenic?"
He used to be cheerful and dissolute, but now he stays at home.
This extreme contrast, in addition to personality changes, may also be a different personality.
However, if it is schizophrenia, there will be no ICU, and Xu Qiu will have nothing to do. The psychiatric department of Linhai First Hospital is not very good, and he has to be sent to a special psychiatric hospital.
"It is also possible that he was rejected by an old lady and never recovered from it." The attending doctor made a bold assumption.
"No."
At this time, another doctor who looked one-fifth as handsome as Xu Qiu shook his head: "Does what you said have anything to do with repeated fever?"
The atmosphere in the ward suddenly stagnated.
Director Jiang was also stunned.
One-fifth Xu Qiu said: "In fact, not only these mental illnesses have mutism, but some brain tumors may also cause taciturnity. It may cause tumor fever."
The real Xu Qiu glanced at him and praised slightly, "I haven't seen you before, are you new to the ICU?"
Director Jiang consciously took a step forward, "Oh, I dug it out... There is something, right? I usually train collapse like this.
Young people, don't be afraid to show yourself, don't waste the opportunities given by our predecessors."
One-fifth Xu Qiu: "That's right, Director Jiang should have guessed it a long time ago, and specially helped me rule out all mental illnesses."
...
The diagnosis has a clue again.
Mutism, brain tumors, tumor fever
These three words became the key to Tao Changhan's case.
"What should we do? Do a brain CT scan?"
Since it is suspected to be a brain tumor, the simplest way is to take a film.
But the problem is that at this time, Tao Changhan is extremely difficult to get out of the ICU, let alone be sent to the imaging department. It is a big question whether he can survive after the CT scan.
"What should we do?" Director Jiang looked at Xu Qiu, one-fifth of Xu Qiu.
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