This doctor has a system

Chapter 322 303. Drug-resistant pneumonia
  The employees of Fengxin Technology gathered around the entrance of the laboratory, and everyone was talking about the two notification documents.

"This old Liu is quite unlucky," said an insider. "He told the truth in front of the big boss, which caused Mr. Hu to be scolded by the big boss and Mr. Li."

"Isn't that right? I asked why Mr. Hu's face was blue yesterday. I thought it was because of the cold."

"Then what's going on with Wang Liang?" A new employee asked, "Can't you check your phone while at work? I think everyone usually..."

"No one cares about this." The person on the side said, "This kid deserves to be smart."

The north wind was biting, and Wang Liang felt that his heart was also cold.

"That's too much!" He was very dissatisfied with the result. "In the end, nothing happened to you!"

"I am considered a leader at my age." Yue Penghui said cheerfully.

"Besides, based on our relationship, we will deal with everyone the same." He comforted Wang Liang and said, "Besides, if it's only 1000 yuan, I'll give you 3200 yuan!"

"Is Director Gao here?" a middle-aged man asked as he brought a 14-year-old girl to the general practitioner's office.

"I am, are you?"

"Hello, Director Gao, my name is Wen Taihe. I come from Qixian County. I contacted you through Director Shen the day before yesterday." The middle-aged man said.

When he said this, Gao Feng remembered this. Director Shen had indeed called him two days ago, saying that a patient with refractory pneumonia was going to the outpatient clinic to see him, but then there was no news.

He didn't take this matter to heart either. The thoughts of patients and family members were always changing at all times.

"Originally we thought about coming directly, but then an acquaintance introduced us to a traditional Chinese medicine hospital." Wen Taihe explained, "I also thought that western medicine treatment was ineffective, so I wanted to try traditional Chinese medicine."

"The doctor over there prescribed Chinese medicine for a few days."

"Is it effective?" Bu Zhengyang asked from the side.

This is obviously nonsense. If it were effective, people wouldn't come.

"It has no effect. I still have a fever and cough." Wen Taihe looked sad, "The child still has some chest tightness today."

"What did the Traditional Chinese Medicine Hospital say?" Gao Feng asked.

"It is better to consider pneumonia and let him be hospitalized for treatment." Wen Taihe replied. After repeated thinking, he finally decided to come to the Provincial People's Hospital.

Two years ago, his father recovered at the Provincial People's Hospital. At that time, his condition was so serious that a tertiary hospital in Guangdong sentenced him to death.

"Pull it back, there's no point in further treatment. Elderly people still pay attention to returning fallen leaves to their roots." said the doctor in charge.

He spent 1 yuan to hire a transport truck to bring his old father from Guangdong to the province. At that time, he was planning to bring him directly back to his hometown. His younger brother had notified relatives in advance, and the coffin was ready, and it was still made of cypress wood.

Generally speaking, the wood for making coffins can be cypress, pine, nanmu, willow, paulownia, and cypress.

Juniper wood has a hard texture, high density, natural antiseptic properties, is not easy to decay, and has a light fragrance, making it suitable for making high-end coffins.

Of course, golden nanmu is also good.

Wen Taihe's father was not moving much when he was carried into the car. Since the body becomes stiff after death, the driver suggested that he put his father's shroud on now.

"Otherwise it will be difficult to put it on when the time comes."

"Let me help you." The driver looked anxious at his clumsiness, so he stopped the car.

Wen Taihe supported his old father, and the driver helped put on the shroud. After finishing the work and getting ready to set off, he suddenly saw an ambulance passing by with Provincial People's Hospital 120 written on the body.
  Wen Taihe didn't know what was going on at the time, and was inexplicably shocked.

"Don't go home yet. If it doesn't work, go to the Provincial People's Hospital here and have a look." He hesitated, "See if we can do some more resuscitation."

The driver looked at the patient who had a lot of air coming out and a little air coming in and shook his head helplessly. However, it was none of his business what the family members wanted to do. He was only responsible for getting money.

The old father stayed in the provincial medical intensive care unit for 10 days and was discharged from the hospital 2 months later. He still walked out on his own and is still in good health.

Because of this experience, Wentai still believes in the medical level of the provincial hospital.

Wen Yushan, female, 14 years old, occupation: student.

Like most of her peers, Wen Yushan is very busy with her studies. Although she is only in junior high school, she still has endless exercises and test papers to complete every day.

This is the current situation in China. Comparatively, exam-oriented education makes people suffer a lot.

When you go to elementary school, your parents will tell you: Elementary school is very important, and whether the foundation is solid depends on this stage.

When you go to junior high school, the teacher will tell you: Junior high school is very important. Whether you can go to a better high school depends on these three years, so work harder!

When you go to high school, your parents and teachers will tell you: Try harder! Just wait until you go to college. You can have fun when you go to college.

In fact, when you go to college, you will find that you cannot really relax at this stage, and studying for a PhD also requires a lot of energy.

Elementary school may only be compared with peers in a township, junior high school may have to compete with peers in a county, and high school may have to stand out in the city.

When you go to college, you have to compete with your peers from across the province and the country.

Most people will discover their own mediocrity at this time. You were originally proud in the eyes of your family and teachers, but here you will find people who are better than you, and you will slowly disappear from everyone.

Wen Yushan was competing with her peers in the county at this time. She was not very smart, so she could only work harder.

10 days ago, Wen Yushan felt a little uncomfortable when she woke up in the morning. Her throat was a little dry and her body was a little weak.

Since the symptoms were not very obvious, she didn't pay much attention.

She felt obviously uncomfortable at noon. She kept feeling cold and her head and throat began to hurt.

"Huang Jiaxin, are you cold?" she asked her deskmate.

Huang Jiaxin said she was not cold.

"Do you have a fever? Why is your face so red?"

Wen Yushan hurried to the school infirmary. The school doctor was very enthusiastic and took out a thermometer and asked her to measure her temperature.

The school infirmary of the junior high school has no business at all. There is a large oxygen cylinder and a medical first aid kit inside, as well as some commonly used drugs.

"38.1°C." The school doctor picked up the thermometer and took a look. "She must have a cold." He gave Wen Yushan a box of compound paracetamol tablets.

Wen Yushan soon started sweating after eating it, her body temperature also dropped, and her headache and sore throat were relieved a lot.

Just when she thought she was cured, she started to have a fever again at night, so she continued to take medicine.

Then if you have fever the next morning - take medicine; if you have fever at night - take medicine. The condition has not improved and she still has a slight cough. Wen Yushan went to the infirmary again. The doctor suggested that she go to the hospital for a blood test.

Wen Taihe rushed to the school immediately after receiving the notice from the teacher, and took his daughter to the county hospital.

"The blood test is okay, and the blood count is not too high." The doctor from the respiratory department of the county hospital said, "It's probably a respiratory infection, so I need to take some medicine."

The doctor prescribed Cefaclor Dispersible Tablets, Pudilan Oral Liquid, Cough Oral Liquid and other drugs for Wen Yushan, and told her to take them on time.

"If your body temperature exceeds 38°C, you can take an ibuprofen."

Wen Taihe took his daughter back home. He felt that her daughter was not in good condition at the moment and her study efficiency was definitely not good at this time. It would be best to rest at home for two days and then send her back when she no longer had a fever.

However, Wen Yushan's condition did not improve after taking the medicine. She still had recurring fevers and her cough became more and more severe, especially at night. The cough kept her awake all night.

This made Wen Taihe worried. He thought about it and decided to take his daughter to the hospital for infusion.

After being admitted to the respiratory medicine department of the county hospital, the doctor completed the examination for Wen Yushan. The blood routine showed that the number of white blood cells was slightly elevated, C-reactive protein was 21 mg/L (normal value 0-10 mg/L), and other liver and kidney functions, cardiac enzymes, There were no obvious abnormalities in electrolytes and coagulation functions.

"It is necessary to take a CT scan." Seeing her coughing so badly, the doctor in charge suggested.

Wen Taihe was very cooperative and quickly took his daughter to the imaging department.

Chest CT results suggested bronchopneumonia in the right lower lung.

"There is indeed inflammation in the lungs, but not many high inflammation indicators." The doctor in charge communicated with Wen Taihe about the condition, "I think it is most likely mycoplasma pneumonia, which has become popular recently."

"We don't quite understand either. It's up to you how to treat him." Wen Taihe said.

Doctors at the county hospital gave Wen Yushan azithromycin injection, which is the first choice drug when minors are suspected of mycoplasma infection.

Since mycoplasma does not have a cell wall, commonly used antibiotics such as cephalosporins and amoxicillin are ineffective against it.

As soon as the azithromycin was administered, Wen Yushan felt uncomfortable.

"My arm hurts so much!"

"This is a common adverse reaction, and many people feel pain." The nurse comforted, "I'll slow it down for you."

It is very common to experience arm pain during azithromycin infusion. It is mainly caused by the drug stimulating blood vessels. Most people can tolerate it, but a small number of people experience severe pain.

Wen Yushan belongs to a small group of people. Every time she loses, she feels a knife-like pain in her arm.

After persisting for 4 days, she quit.

The doctor in charge did not force it anymore, because Wen Yushan's condition had not improved at all, and she still had recurring fevers and frequent coughs.

"Adjust the antibiotics." The superior doctor said during the ward round. "It may not be a mycoplasma infection."

Wen Yushan took cefoperazone sodium and sulbactam sodium for another four days in the county hospital, but her condition still did not improve.

The day before coming to Z State, she had another chest CT scan. The results showed that the inflammation on the right side had increased a lot, and there was also leakage in the left lung.

"The condition has gotten worse." The doctor in charge felt a lot of pressure, "If it's not possible, go to the city hospital."

Wen Taihe was very worried and simply took his daughter to Z state.

Gao Feng carefully looked at the patient's two chest CT scans. The latest one was indeed much worse than before. No wonder the patient still has some chest tightness.

"Director Gao, what's going on with my daughter?" Wen Taihe was extremely anxious now.

"Based on the chest CT, it is indeed very consistent with the symptoms of mycoplasma pneumonia." Gao Feng said.

However, the patient has been treated with azithromycin for mycoplasma infection in the county hospital, but his condition has not been relieved, which is very strange.

"Let's hospitalize her first, and then we'll check her in detail."

"Suspicious pneumonia: Wen Yushan's condition continues to worsen, which has caused considerable psychological pressure on her and her family. Please help her find out the cause of the progression of the condition in time. Completing the task will earn you 15 skill points. Failure will result in Deduct 20 skill points." The system released the task at this time.

"What did you think about it?" Gao Feng asked.

"I think it doesn't matter what kind of pneumonia it is, just use antibiotics together. We can cover it widely." Bu Zhengyang expressed his thoughts.

The patient's condition has been getting worse, and the family members must be very anxious. At this time, timely medication is needed to curb the progression of the condition.

Everyone else basically had the same idea.

Gao Feng thinks this is actually not a good idea. The patient is only 14 years old. His current main symptoms are fever, cough, and mild chest tightness. Overall, his condition is okay.

Still, we should actively find out the cause of the disease and treat it more appropriately.

"Give her a bronchoscopy tomorrow and send an NGS of the lavage fluid." He made a decision, "Zhengyang, go talk to the patient now."

"Then are you taking any more medicine today?"

"Atomize her and give her oxygen." Gao Feng said casually.

Of course, in the afternoon, Wen Yushan developed a fever again, and her body temperature was measured at 38.4°C. After taking the antipyretic drug acetaminophen, her body temperature gradually dropped to normal.

After Gao Feng returned, he carefully reviewed the relevant literature on mycoplasma pneumonia and learned a lot.

As the name suggests, mycoplasma pneumonia is an acute lung inflammation caused by Mycoplasma pneumoniae. It is mainly characterized by dry cough and fever. It can be transmitted through droplets and direct contact. Most patients have a good prognosis, and some may develop severe pneumonia.

There are many drugs for mycoplasma pneumonia. Commonly used antibacterial drugs include macrolides such as roxithromycin and azithromycin, quinolones such as levofloxacin and moxifloxacin, and tetracyclines such as doxycycline and minocycline.

Minors generally use macrolide drugs, the most commonly used of which is azithromycin.

Patients over 18 years old can use quinolones such as levofloxacin and moxifloxacin.

Tetracycline drugs are not widely used at present because they do not have any advantages compared with the first two drugs.

Take doxycycline among the tetracyclines. Its antibacterial spectrum is not as broad as levofloxacin, and its safety is not as high as azithromycin.

Tetracyclines are prohibited for children under 8 years old because they can cause discoloration of children's teeth (tetracycline teeth), enamel regeneration, and inhibit fetal bone growth.

When Gao Feng was a child, there was a classmate in his class with dark brown teeth. At that time, he was just curious. Now that he thinks about it, it must be tetracycline teeth.

"Is it drug resistance?" He suddenly thought of this.

The bronchoscopy went smoothly, and the testing company quickly sent someone to receive the specimen.

(End of this chapter)