Rebirth in the medical world

Chapter 197 Strict isolation
Regarding SARS, Ouyang Chenhui has a long list of memories in his mind!
SARS first occurred in Philadelphia, USA on February 2002, 2 (Sunday)
A woman was hospitalized with headaches, fever, chills and vomiting while attending an annual meeting at a Philadelphia hotel, but died the day after she was admitted.In the incident, more than 80 people were suspected of being infected and went to the hospital for treatment, and 7 of them were hospitalized for treatment.Both the American and British media reported on this at the time, but there was no follow-up.A woman fell ill and died the next day According to local media reports, on February 2002, 2 (Sunday), a mortgage company held its annual meeting in a hotel in the suburbs of Philadelphia.A woman collapsed suddenly during the reception and was sent to hospital for treatment, but died the next day.
The deceased, Helmstreet, was 45 years old and was from Kingston, Massachusetts.When she was admitted to the hospital, she developed headache, fever, nausea and vomiting, and inflammation of both lungs.
Authorities said on the day of Hemstreet's death that she died of bacterial pneumonia.The hospital's night shift manager said the hospital was quarantined between 2am and 10am that Sunday.And on Monday, authorities said Hearst also contracted Neisseria meningitis.Seven people were suspected of being infected and hospitalized. The authorities also quarantined the hotel for 8 hours on the day of Hemstreet's death.About 80 people who may have been in contact with Hemstreet were examined in the emergency department, and the hospital gave antibiotics to several of them who had been in close contact with Hemstreet.
Another seven people (7 male and 1 female) were hospitalized with flu-like symptoms.One of the women who had been in close contact with Hemstreet had to be admitted to the hospital's intensive care unit with symptoms of pneumonia and no meningitis.

In China, SARS first appeared in FS City, Guangdong Province, China in early November 2002.Because the patient had pneumonia symptoms, it was classified as atypical pneumonia at that time, and the Chinese media generally referred to it as "SARS".Afterwards, the disease quickly spread to Hong Kong through tourism, commerce, and immigration, and then spread from Hong Kong to Vietnam, Singapore, Taiwan, and Toronto, Canada. In May 11, the epidemic in BJ and Hong Kong was the worst. In the summer of 2003, the number of infected patients decreased day by day, and the disease was completely controlled. In November 5, sporadic cases reappeared in Guangzhou, and in March 2003, suspected cases of SARS were discovered again in BJ, but none of them turned into an epidemic again.

It is now November 2002, so far, he has not heard any news about SARS!He has been paying attention to information in this area recently. He has been paying attention to news, newspapers, and all media tools, but there is no trace of it!

Could it be that the epidemic that first started in Guangdong appeared in Kyoto this time?
Ouyang Chenhui had a lot of doubts in his heart, but the matter was so important that he didn't dare to delay, so he whispered in Mr. Bruce's ear about the situation of the patients in the Department of Respiratory Medicine!
Bruce was startled, he is not a professional respiratory doctor, but under such circumstances, since they found him, it shows that they have full trust in him!So, he still has to go and take a look!
"My colleagues, I am very sorry that I have to go away for a while. There is a patient whose condition is getting worse. I want to go and see. This is my email address. If you have any questions, you can email me in the future. , let's discuss together!" Bruce bowed his hands apologetically, and put a card with his contact information on the table!Then I hurriedly followed the visitor to the respiratory department!

The patient was just admitted to the hospital this afternoon. When he was admitted, he had a headache, dizziness, nausea and vomiting, and a high fever of 39 degrees five!He was admitted to the emergency observation room with acute upper respiratory tract infection. The first doctor at that time prescribed antipyretic injections and antibiotics for him. At the beginning, the patient's body temperature dropped slowly, but the fluid had not been infused yet. The patient's body temperature It came back up again, this time it was as high as forty degrees!At that time, the doctor thought it was a bacterial infection, so he urgently did a blood test during the high fever period. The report showed that except for a slight decrease in white blood cells, all other indicators were normal, which did not support the possibility of acute infection at all!At this time, the patient's symptoms became more and more serious, and even had difficulty breathing!Therefore, the emergency doctor urgently asked the respiratory doctor for consultation, and then transferred to the respiratory department for hospitalization!
After he was hospitalized, a doctor in the respiratory department performed a series of examinations on him. The chest X-ray showed ground-glass degeneration in multiple lobes of the lungs!Preliminary diagnosis of lobar pneumonia pending!
Less than four hours after the patient was hospitalized, he suddenly had acute dyspnea again, accompanied by profuse sweating, and his body temperature remained high!The doctors in the respiratory department panicked. After the emergency treatment failed, they thought of Professor Bruce, a doctor of medicine who was still in the hospital!
As soon as Bruce entered the ward, he did a simple examination on the patient as usual, and then looked at the medical records. Bruce's judgment was basically similar to that of the doctors in the respiratory department, and he also suspected that it was an acute lobar pneumonia!As for which pathogenic bacteria caused it, it is still impossible to infer!This requires bacterial culture!
Ouyang Chenhui also looked at this patient carefully, basically all the examinations that should be done have already been done, and many examination results have not yet come out!Now the doctor has given him a large dose of antibiotics and corticosteroids, trying to bring his temperature down!

Ouyang Chenhui remembers that there were many SARS patients who used glucocorticoids to cover up their illness and delay the timing of treatment!

But if this patient is not SARS, but just ordinary bacterial pneumonia, such treatment is understandable!

For a while, Ouyang Chenhui was helpless, he had no choice but to look at the patient's lungs!I saw that the patient's lungs were obviously inflated!Severe edema, hyaline membrane formation!Severe alveolar organization, pulmonary interstitial fibrosis.There are microthrombosis in small blood vessels!
These are all the familiar words he saw in the autopsy reports of SARS patients in various medical literatures in his previous life!All of them have been confirmed in this patient!

So this patient is likely to be the suspected patient of SARS in the legend!

"Mr. Bruce! Can I say a few words?" The matter is of great importance, and Ouyang Chenhui must not be careless. He knows the influence of this plague on China and the world!Therefore, no matter whether Bruce has authority in the medical field or not, he must remind him of the most important isolation system of SARS!
Professor Bruce was also somewhat puzzled about the clinical symptoms of this patient. He is not a professional respiratory doctor, so he did not dare to draw conclusions easily. Seeing that Ouyang Chenhui had something to say, he also wanted to hear his opinion!
"Ouyang, tell me, to be honest, I am also very confused now!" The biggest difference between foreigners and Chinese is that they dare to face up to their own shortcomings, while Chinese, once they reach a certain height, even if they don't understand, I dare not admit it!

Seeing that Professor Bruce nodded in agreement, he said slowly: "We all know that pneumonia refers to the inflammatory reaction of the terminal airways, alveoli and lung interstitium! Pneumonia can be caused by bacteria, viruses, fungi, parasites, etc. Caused by pathogenic microorganisms, radiation, inhaled foreign matter and other physical and chemical factors. Bacterial pneumonia can be cured within seven to ten days after appropriate antibiotic treatment. Viral pneumonia is milder and drug treatment has no effect. But the condition rarely lasts for more than seven days. These two types of pneumonia are the ones we see more clinically, and they are also a qualitative understanding of pneumonia in the minds of our clinicians! But we should also know that in all textbooks There is such a thing. In the classification of pneumonia, in addition to bacterial pneumonia, fungal pneumonia, and viral pneumonia, there is also a type of pneumonia that is not well defined, called atypical pneumonia. Regarding this type of pneumonia, everyone The textbooks are all mentioned in one stroke. In clinical practice, we have never encountered or diagnosed such a case. Therefore, everyone does not have a clear understanding of this pneumonia, but not seeing it does not mean that it does not exist. We Is it possible to imagine this boldly, whether this patient is a severe pneumonia caused by a brand-new bacterium or virus?" Ouyang Chenhui talked a lot.He didn't know if what he said could sound a wake-up call to Professor Bruce and all the respiratory doctors present.

Professor Bruce obviously listened to his explanation. For a long time, he didn't speak, as if he was thinking about something!
In fact, when Ouyang Chenhui mentioned atypical pneumonia, he remembered one thing, that is, in February 2002, a case of a pneumonia patient suddenly exacerbated and died in Philadelphia in the United States !

At that time, this incident aroused strong repercussions in the United States. Although he was not a doctor in the respiratory department, he had heard a lot about it. When Ouyang Chenhui mentioned it this time, he also thought: Maybe a brand new disease is spreading. !
Bruce knows that when a new disease appears, it will inevitably cause mass death and panic. This is due to our lack of understanding of this disease!
"Ouyang, what do you think we should do now?" Mr. Bruce asked calmly.

"Before we find out the real pathogenic bacteria of the disease, I think we should deal with it according to the worst plan! First, isolate the patient closely and observe the changes of his condition closely! In addition, we all had close contact with this patient , we all need to be isolated and observed for a period of time to ensure that we are not infected by suspicious germs!" After Ouyang Chenhui finished speaking, he looked at everyone with a serious expression!

The doctors in the respiratory department looked at each other. From their point of view, it was understandable for Ouyang Chenhui to have this consideration, but just relying on his words, they had to mobilize teachers and mobilize people for isolation and treatment, and the isolation was all Those who have been in contact with patients, this is a bit too much, so everyone I look at you, you look at me, no one has a word!
"I agree with Ouyang!" Bruce was the first to raise his hand!
(End of this chapter)