This doctor has a system

Chapter 598 660. Adult Still's Disease

"Oh, this is the new doctor Gao in the palace." Director Tian introduced, "The other one is his assistant."

"A new imperial physician?" Old Zhou looked at Gao Feng curiously. "Why do you look so young?"

"Good morning for school." Director Tian said casually, "Let him take a look at you."

Mr. Zhou developed a fever more than 20 days ago. At that time, everyone thought he had a cold, so they gave him some antipyretics and cold medicine. But the effect was not good, and he still had a recurring fever. Over time, Mr. Zhou's mental state deteriorated.

"The blood test results were a little high, but there were no other problems." Director Tian said, "By the way, the chest CT scan showed enlarged lymph nodes under the armpits and slight inflammation in the right lung."

Gao Feng picked up the film and took a look at it. Logically, this inflammation should not have caused the fever for so long.

"No other symptoms?"

"He seemed to be allergic to something 5 days ago and developed a rash on his body." A voice sounded at this time.

A tall nurse came in, his voice was a little soft.

"This is Mr. Zhou's ward nurse, Wu Hao," Director Tian introduced. "He is most familiar with Mr. Zhou's condition."

"He had a cough for a few days before, but it recovered quickly." Wu Hao said, "When he had a fever, he was in a very bad mood and didn't want to move. Sometimes he even complained of leg pain."

"There doesn't seem to be anything else," he confirmed.

Gao Feng carefully looked through the previous test results and seemed to have some idea in his mind.

"Let me check your genitals." He said to Lao Zhou.

Although Lao Zhou regarded himself as an emperor, he also knew that he had to see a doctor if he was sick, so he was very cooperative when he heard the words.

After undressing, Gao Feng immediately saw the orange-red papules on the man's torso and abdomen. Zhou's armpits and inguinal lymph nodes were enlarged, and his liver could be felt under his ribs.

"It's most likely adult Still's disease." Gao Feng said.

成人still病（AOSD）是一种多基因多因素自身炎症性疾病，以发热、关节痛和（或）关节炎、皮疹为临床特征。据估计，全球AOSD的年发病率为0.16/10万~0.62/10万，患病率为0.73/10万~6.77/10万，好发于16~35岁成年人，多见于女性。

Common clinical manifestations of this disease are fever, rash, arthritis or joint pain. Fever is the most prominent symptom of AOSD and also appears the earliest. The typical fever type is remittent fever, with body temperature often reaching above 39°C, usually once a day.

Rash is another major manifestation, which is often seen on the trunk and limbs, but can also be seen on the face. It is orange-red macules or maculopapules, usually accompanied by fever and is transient. The rash on Lao Zhou is quite typical.

Director Tian had no idea about the concept of adult Still's disease, but fortunately the omnipotent Baidu answered his questions.

"Oh, I've never seen this disease before."

Having worked in a mental hospital for most of his life, Director Tian has almost maxed out his professional skills. He can tell at a glance whether a person is mentally ill or not.

But when faced with difficult and complicated problems in other professions, there is nothing we can do, as everyone has their own expertise.

The more you learn, the more tired you become, and the faster you die.

"Let's try this treatment first and see how it works," Gao Feng instructed.

There is no specific diagnostic method or unified diagnostic criteria for adult Still's disease. For suspected patients, the most recommended method is to use the Japanese Yamaguchi criteria or the American Cush criteria for exclusionary diagnosis.

In Lao Zhou's case, he could try the medicine first to see if it worked. But in Gao Feng's opinion, the diagnosis should be correct.

"Thank you so much for your help." Director Tian, ​​who was in a good mood, thanked Gao Feng. Most of the patients here were long-term hospitalizations, so he still cared about Lao Zhou very much.

“You’re welcome.” Gao Feng replied with a smile.

As they were talking, a fat old man in hospital gown walked towards them. Under the puzzled gazes of Gao Feng and Li Youliang, he punched Director Tian in the face.

"Who is this?!" Li Youliang was shocked. "He must be crazy..." He then shut his mouth. It was obvious that if the other person was not crazy, he would not be hospitalized here.

"Lao Ma! Why did you hit me?!" Director Tian was very angry, "How did I offend you?"

"Why did you ask me to turn off the TV?" The mentally ill patient Lao Ma was even more angry. "It's clearly not time yet!"

"I beat you to death!"

After he said that, he wanted to rush up again, but by then everyone else had already run over and several nurses grabbed him.

"Old Ma, it's already past time." A nurse said to him, "Didn't I just tell you?"

"Oh, this old Ma's memory has gotten worse." Another nurse said, "Could it be that his condition has worsened?"

"What are you waiting for? Double the dosage starting today!" Director Tian shouted, covering his eyes.

Seeing Director Tian’s miserable appearance, Gao Feng felt a little sympathy.

"Is the risk factor in our normal work so high?" Li Youliang asked.

"It's not like I haven't been beaten in years..." Director Tian was a little depressed. "This old Ma has a simple mental illness and doesn't talk much normally."

Who knew that this would happen to him today.

It was already time to get off work when Gao Feng returned to the Provincial Hospital. He did not stay in the department for long. He carefully read the test report of the red yeast rice health products.

At this time, in a large conference room more than 2000 kilometers away, a discussion was taking place.

"Takashima-kun, I don't quite understand what you mean." A little island was questioning, "Do you know how much profit the factory in Osaka can bring to the company in a year?"

"Now is not the time to talk about profits." Chong Shang Zhenmu's expression was very serious, "The product line has been contaminated. This is a very serious problem. We must stop production immediately and do a thorough disinfection!"

As soon as he finished speaking, there was a chaotic sound of communication around him.

Okamura Pharmaceutical is also an old pharmaceutical company. It was once well-known internationally. However, due to the island country's medical winter decades ago, the company almost went bankrupt. Fortunately, they finally survived.

The company has developed well in recent years, and its leaders have a clear understanding of the company's strength. Damu Pharmaceutical is not interested in developing new drugs, and the huge investment is beyond their ability to bear.

By deeply cultivating the field of health care products, we have achieved many results in recent years, among which the best-selling red yeast rice health care products are one of them.

The factory in Osaka was built at the expense of a lot of manpower and resources in order to solve the problem of insufficient production capacity, but some problems have occurred recently.

"There is a problem with the selection of strains." Maki Takagami, the person in charge of quality control, explained the cause and effect to everyone, "We found citrinin in the samples we randomly inspected."

(End of this chapter)