I really don't want to be a doctor

Chapter 140 Strange Fever

"Uncle Wang, does grandma have a fever every day? When do you usually have a fever? Continuous or intermittent?" Jing Xiaoran asked.

Uncle Wang knew that Jing Xiaoran was a medical student, so he thought it was because of his status as a medical student, so he asked him out of habit.

He replied: "He will have a fever after a period of time, 1-3 times a day, about 37.5 degrees to 39 degrees, usually more common in the afternoon."

Jing Xiaoran wanted to continue to ask some questions, but at this time, Grandma Wang suddenly woke up.

Although her body was very weak due to the long-term fever, Grandma Wang still forced herself to smile and said, "Xiao Jing, why did you bring two children here? Children are rarely allowed to come to places like hospitals."

Immediately afterwards, Grandma Wang struggled to sit up.

Uncle Wang hurriedly stopped him and said, "Mom, don't worry about it. Brother Jing and the others are not outsiders. You just need to lie down and rest."

Father Jing also said from the side: "Aunt Wang, rest well, we will accompany you for a while."

Seeing this, Grandma Wang had no choice but to give up, lying on the bed and sighing: "Oh, it's just because this disease is so tormenting."

Long-term fever is not only a kind of loss to the body, but also has a certain negative impact on the mind.

Xiaoxiao sat beside Grandma Wang, took her wrinkled hand with her small hand, and said softly: "Grandma, you have to be obedient, and the disease will get better if you are obedient. Xiaoxiao was also sick before, but I am very obedient. Now The beans are ready."

Grandma Wang laughed softly when she heard it, "What Xiaoxiao said is, then grandma should listen to your Uncle Wang carefully."

Xiaoxiao nodded fiercely: "Yeah."

At this time, the door of the ward was suddenly pushed open.

A hale and hearty old doctor with half-white hair and a Pisces stethoscope around his neck walked in.

He was surrounded by four middle-aged doctors, and behind him was a group of young doctors. At a glance, there were dozens of them.

Judging from this posture, it should be a teaching round.

One of the middle-aged doctors walked up to Uncle Wang and said softly, "This is an old professor who was hired back by our hospital. He came to see Auntie in person today to study her condition."

"Thank you, Director." Uncle Wang nodded hastily, then left from the bed, giving up his seat to the group of doctors.

Jing Xiaoran also led Xiaoxiao, and stood in the corner beside the ward with Father Jing.

Ever since Jing Xiaoran saw this old doctor at first sight, he recognized him as Professor Yang Wei, a famous Chinese hematologist.

In the previous life, until Jing Xiaoran came to work in the emergency department of the city hospital, this old doctor was still active in the clinic.He is not only good at the treatment of hematological diseases, but also an excellent doctor of internal medicine.

If there is any intractable disease in the whole hospital, Professor Yang Wei will definitely be invited to study the condition.

"The resident doctor in charge of the bed first reports the patient's medical history to Mr. Yang," said the middle-aged doctor.

As soon as he finished speaking, a petite female doctor stepped out from the crowd.

"Mr. Yang, I was the one who saw this patient when he came to our department."

Professor Yang nodded slightly, motioning for the female doctor to continue talking, and he began to help Grandma Wang with her physical examination.

"A 68-year-old female patient was admitted to the hospital with recurrent fever for 6 months. Before 6 months, the patient developed fever without obvious inducement, and it occurred intermittently, fluctuating at 37.6-39.6°C, obviously in the afternoon or at night, and decreased or returned to normal in the morning. 3~4h."

"The patient has been diagnosed and treated in many large and small hospitals in Fancheng, and visited the Department of Infectious Diseases, Oncology, and Emergency Department. During this period, he has drawn blood, filmed, biopsy, and blood culture many times, and checked for infections, tumors, rheumatism, and blood diseases. I have also done X-ray, color Doppler ultrasound, CT, MR, whole-body PET-CT scan, muscle biopsy, bone marrow biopsy and other invasive examinations, but still can't find any cause of fever..."

Professor Yang asked: "How is the patient's examination in our hospital this time?"

The female doctor continued after hearing the words: "This time I checked the routine items in the hospital, and also checked the infection, tumor, and blood diseases again."

"Abnormal white blood cells, including a high proportion of neutrophils, repeated three times and still the same. Lactate dehydrogenase LDH also increased. Inflammation indicators erythrocyte sedimentation rate ESR, C-reactive protein CRP were increased, and the rest were normal."

Professor Yang had finished the examination, and said in a deep voice, "What treatments are you giving now?"

"In our department, antibacterial, antiviral, and antifungal treatments are currently used. Antibiotics and even the high-level antibiotic imipenem are used, but it still doesn't help." The female doctor said.

"Well, I already have a general understanding of the patient's condition." Professor Yang nodded.

Jing Xiaoran could hear it very clearly.

All of Grandma Wang's inspection items were normal except for slightly elevated white blood cells and lactate dehydrogenase, but these two inspections were not specific.

"For all the doctors present, whether they are attending doctors or residents, or even the interns following behind, you can speak out what you think." Professor Yang said to everyone.

As soon as the words fell, one of the resident doctors stood up and said, "Mr. Yang, the patient's inflammatory index has increased, and I still tend to be inflammatory infection."

Professor Yang didn't speak, and a middle-aged doctor next to him said: "If the white blood cells are high, it is concluded that it is an infection? Where is the patient's infection focus? Then why are these antibacterial drugs ineffective?"

The young resident was speechless immediately, because Grandma Wang had checked her whole body and found no signs of infection.

"Ms. Yang, I think it might be the window period of some disease." Another attending doctor said.

The window period generally refers to the period from when the virus is infected to when the corresponding antibody can be detected. Since the antibody cannot be detected, the window period cannot be diagnosed clinically, but there is often a certain amount of virus in the blood, which is actually already An infection has occurred, but has not yet been detected in the blood.

The middle-aged doctor retorted: "The patient has been treated for 3 months, basically passing the window period of most diseases, so I think it is unlikely to be this kind of disease."

At this time, Professor Yang looked at the middle-aged doctor: "Director Sun, what about you, what do you think?"

This middle-aged doctor is Sun Chenghai, the director of the Department of Hematology.

He was tall, with a strong voice, and he wore a delicate pen in the coat pocket of his white coat.

"Ms. Yang, in fact, we gave a small dose of hormone therapy, which proved to be effective, but after the hormone was stopped, the symptoms of fever returned." Director Sun walked to Grandma Wang's bed and said.

"Yes." Professor Yang nodded slightly.

"And everyone has overlooked a very important point. When the patient had a fever, scattered rashes appeared on the body. The rash was light red. There was no raised skin surface and no itching sensation. It was mainly distributed on the back and both thighs. Director Sun said, "After the patient's body temperature returned to normal, the rash disappeared, but it didn't completely disappear, and part of it still remained."

Director Sun gently lifted the clothes on the back of Grandma Wang, and everyone looked at them one after another, only to find that there were scattered rashes on it.

Director Sun went on to say: "So I am more inclined to be rheumatic immune disease, but the rheumatoid factor and anti-nuclear antibody in the rheumatology examination are negative, which is a bit of a contradiction."

Professor Yang showed a rare smile, and said: "The observation is careful, in-depth, and well-founded, but the results are somewhat biased."

Jing Xiaoran was also lost in thought.

He had intermittent fever for 6 months, and rash appeared during fever. Only leukocytes and lactate dehydrogenase were elevated, and all other inspection items were negative.

"What is the cause of the fever?"

……

(End of this chapter)