This Doctor is Great

Could it be "Hantavirus"?

And then triggered "hemorrhagic fever with renal syndrome"?

Zhou Mo looked at the literature about Hantavirus in front of him.

Hantavirus can cause two diseases: one causes pulmonary syndrome (HPS), and the other causes hemorrhagic fever with renal syndrome (HFRS).

Among them, "hemorrhagic fever with renal syndrome" is divided into five stages: febrile stage, hypotensive shock stage, oliguric stage, polyuric stage and recovery stage.

"Patient Xie Mingtao is very similar to the first period of fever!"

In the literature, the description of the "fever period" is like this.

Acute onset, with fever (38°C-40°C), three pains (headache, low back pain, orbital pain), and nausea, vomiting, chest tightness, abdominal pain, and diarrhea in some people...

All of the above, except for low back pain, orbital pain, and chest tightness, all the others! !

correct,

There is another very critical place:

"Hemorrhagic fever with renal syndrome" will cause thrombocytopenia.

Isn't this exactly the same as the strange blood test result of the patient Xie Mingtao? !

Totally consistent with monism!

One Cause, Explains All Symptoms!

Zhou Mo was extremely excited, and quickly took out a few papers on "Hemorrhagic Fever with Renal Syndrome" and started brushing them up.

30 minutes later,

Zhou Mo called his teacher Zhang Luojia.

"Teacher, are you resting?"

"not yet."

"I seem to have found the cause of that Xie Mingtao?"

"Found it? Why?"

"Hantavirus!"

"You mean 'hemorrhagic fever with renal syndrome'? "

"Yes, all the current symptoms of the patient are consistent with the various symptoms of the initial stage of this "Hemorrhagic Fever with Renal Syndrome"..."

"I'm in the office here, come over here..."

"good."

soon,

Zhou Mo quickly came to another office, where there were several senior doctors.

They are all staying up late.

"Come on, let's talk about it in detail..."

"Teacher, according to the information I checked just now..." Zhou Mo spoke out his judgment in every detail.

Teacher Zhang Luojia pondered and nodded: "It's really possible that it's Hantavirus."

This hantavirus, only in the first stage (febrile stage), can cause systemic problems, such as systemic poisoning (nerve (brain), digestion, eyes), kidney damage, capillary damage (skin, mucous membrane bleeding, and even intestinal tract bleeding, vomiting blood and blood in the stool),

"Walk!"

Teacher Zhang Luojia got up.

"Go to the neurology department?"

"right."

The two left the gastroenterology department, and then went to the neurology department.

...

Neurology.

At this time, Dr. Zhang was also having a headache for this patient.

Re-examination of the blood routine showed that the white blood cell count was 15x10E9/L, which did not go up further, but the platelet count was only 50x10E9/L, which has further dropped compared to the previous one.

Moreover, he found that the patient's blood pressure was dropping, and now it has dropped to 80/45!

unknown reason!

But rehydration is still going on.

Why does blood pressure keep dropping?

At this moment,

Zhang Luojia and Zhou Mo came to the ward.

Doctor Zhang was surprised: "Hey, you two haven't got off work yet?"

Teacher Zhang Luojia: "No, Zhou Mo found a disease just now, which is very similar to the patient. I think the possibility is very high, so I came to take a look."

Doctor Zhang suddenly cheered up: "What is the disease?"

Teacher Zhang Luojia: "It's Hantavirus!"

"Hantavirus?" Dr. Zhang thought for a while and said, "You mean hemorrhagic fever with renal syndrome?"

Zhang Luojia nodded: "That's right, that's it."

Dr. Zhang hesitated: "I'm really not familiar with this disease. Is it from the nephrology department or the infection department?"

Zhang Luojia: "Yes, it's from the Department of Infectious Diseases."

Dr. Zhang: "Then let the doctor from the infection department come over for consultation..."

Zhou Mo took advantage of this opportunity to observe the patient Xie Mingtao.

It was found that his spirit was even worse, and he was lethargic.

Compatible with Hantavirus.

At this time, the wife of the patient Xie Mingtao said gratefully to Zhou Mo: "Thank you, Dr. Zhou, my husband has made you worry."

Zhou Mo: "Your husband, have you ever gone to the toilet or peed?"

The patient's wife shook her head: "No."

Zhou Mo nodded. This is more in line with kidney damage. After kidney damage, there will be problems with urination.

"I want to see your husband's skin... no problem..."

"Doctor Zhou, do whatever you want!"

soon,

Zhou Mo lifted the shirt of the patient Xie Mingtao!

really!

There are red dots in many places!

Is it a rash?

Or a bleeding point?

The judgment method is very simple. Zhou Mo pressed the red spot on the patient's chest with his hand.

Do not fade.

Obviously, it's a bleeding point.

The rash is going to turn white!

This further confirms the symptoms of "Hantavirus Renal Syndrome Hemorrhagic Fever": capillary damage, thrombocytopenia, and continuous bleeding...

Then opened the sleeves and trouser legs, there were also many bleeding spots!

"Teacher, there are many bleeding spots on his body!"

Zhou Mo informed Zhang Luojia and Dr. Zhang of his discovery.

"Hey, it's really..."

"I think it's Hantavirus more and more!"

After about 20 minutes,

The doctor on duty from the infection department arrived.

"What the hell is tonight? I'm so busy..." the infection doctor complained.

"This patient is suspected to be Hantavirus-related renal hemorrhagic fever, please help me..."

"Hantavirus?"

Now the infection doctor is interested.

Very rare.

After understanding the situation, the infection doctor couldn't help but nod:

"It's really similar!"

"Let's draw blood, make an epidemic hemorrhagic fever IgM..."

"yes!"

Blood was drawn and sent to the laboratory for examination (urgent).

The infection doctor asked the patient's wife: "Do you have mice in your house?"

The patient's wife nodded: "Yes, our house is on the first floor, sometimes there are mice..."

Infection doctor: "That's right... Mice are common carriers of hantavirus. If they are contaminated by food, people may be infected with hantavirus..."

Waited another 20 minutes,

Soon, the results of the laboratory came back.

Positive! !

In other words, there is indeed a hemorrhagic fever!

Next, the patient will be transferred to the infection department for treatment.

I have been transferred three times, from the emergency department to the digestive department to the neurology department and then to the infection department... This patient Xie Mingtao can be regarded as 'uniquely blessed'.

During transfer procedures,

Doctor Zhang looked at Zhou Mo in Shennei: "Your name is Zhou Mo, isn't it, Gui Pei?"

Zhou Mo: "Yes, teacher."

Doctor Zhang smiled: "When will you come to the Department of Internal Medicine for regular training? Then I will take you..."

Obviously very satisfied with Zhou Mo.

This disease in front of me,

It is very confusing.

The patient's meningitis and intracranial hypertension were prominent, blinding everyone's eyes and ignoring the condition of the rash and kidneys.

There is also shock. I always thought it was ordinary septic shock, but I didn't think it was hemorrhage and hypotension caused by Hantavirus.

If Zhou Mo hadn't brought up the hantavirus, it is estimated that the neurology department would continue to deal with brain infection, which would take many days. In the end, it would take consultations with multiple departments to find out the real cause.

Zhou Mo is a great hero! !

.

I'm dizzy today, only this update, it's hard to write, my head is like a paste~~~