(Thanks to my friend zHL, book friend 150916120606029, and Pirate Flag Xinuo monthly pass for encouragement)

In fact, postoperative infections are also very common if there are more patients. But it is also very rare for such a patient to have such a rapid and special seizure.

Because the most common infection is a knife infection, which can manifest itself on the wound. There are redness, swelling, heat, pain, exudate, etc., most of which are also caused by staphylococci and streptococcus.

The patient's wound was clean, and the infection was developing quickly.

After all, it takes time for bacteria to multiply, and this patient has just been pushed into the ward, I'm afraid Su Wenhao hasn't explained to the patient clearly what needs to be paid attention to.

"Mr. Liu, what do you think of the situation?" asked Wang Chao after calming down for a while.

"I don't know, maybe the patient has other diseases, we haven't found out. Liu Banxia frowned and said.

"Otherwise, the normal postoperative infection would not have been able to attack so quickly, and perhaps the patient's appendicitis would have masked the rest of the condition. ”

Wang Chao glanced at the patient, and now he was a little unconscious, and he couldn't ask the patient.

Liu Banxia carefully recalled the inquiries when receiving the patient, and he needed to find some clues in those questions and answers.

The patient was rushed to the hospital after fainting, and the symptoms of acute abdominal pain were obvious. Rebound tenderness is also evident at the McCere's point, and blood test results are consistent with symptoms of acute appendicitis.

There was no problem at all in diagnosing appendicitis, and then the patient was a little unlucky, he ...... Unlucky?

Thinking of this, Liu Banxia's eyes lit up.

"Attention, everyone, listen to me. Liu Banxia said.

"Anyone who has just come into contact with a patient, don't touch their mouth and nose, and disinfect their hands. The patient's bed sheet should be sealed and disposed of separately, and the two patients in the same ward should be moved to the bed. ”

"I took samples of these stains from the patient's bed sheets for a latex agglutination test, and I judged that the patient might be infected with Clostridium difficile. After the test results came out, vancomycin was given orally, immunomodulatory therapy, probiotics, and colonoscopy. ”

Hearing his words, even the nurses who were busy in the ward were stunned for a moment.

"The patient took a variety of antibiotics in about half a month, and at the same time had diarrhea and a sharp drop in blood pressure, which was very consistent with Clostridium difficile infection. Liu Banxia explained.

Even these nurses know how domineering Clostridium difficile can be, because C. difficile is a superbug that often breaks out in hospitals.

The name has the word difficult, but also because this bacterium is very resistant, and the ones that can have some effect at present are vancomycin and metronidazole.

And these two drugs are only barely effective.

"Su Wenhao, have you already contacted the patient's family?" Liu Banxia looked at Su Wenhao again.

Su Wenhao nodded, "He hasn't married yet, and his parents are rushing over." ”

"Notify me when the time comes, and I'll explain. Liu Banxia said.

This germ is too special, too complex, and too domineering, and he is worried that it will be difficult for Su Wenhao to stabilize the emotions of the patient's family. Because a big possibility of this disease is the loss of patients.

The big guys are also taking action again, and no one can wear gloves in the nursing work of the general ward, and the transmission route of Clostridium difficile is fecal-oral transmission.

From now on, all of the patient's excreta will need to be sealed separately for transport. Even if you haven't been diagnosed yet, you need to follow such a plan.

Just five minutes after returning downstairs, the patient's parents rushed over.

"I'm your son's attending doctor? At the moment his situation is somewhat complicated. Liu Banxia said.

"Was the appendix surgery done successfully? But now he may be infected with Clostridium difficile and we are still waiting for the final test results. After the diagnosis? We will treat you accordingly. ”

"When you see him later? Masks and gloves are also required. Because this germ is contagious, special attention is required. ”

"Doctor? Is it serious?" asked the patient's father.

Liu Banxia hesitated for a moment and nodded, "If it's really diagnosed?" That's going to get serious. Have you had diarrhea lately?"

The patient's parents shook their heads.

"That's good? Later, if it is confirmed, we will need to contact his unit. Liu Banxia said.

"Clostridium difficile is extremely resistant to antibiotics, and the external infectious agent is mainly transmitted through fecal-oral transmission, and the internal attack is caused by the use of large amounts of antibiotics. ”

"Is this pathogen a normal flora in the human gut? But after an overdose of antibiotics? It will kill a lot of bacteria in the intestines, and Clostridium difficile will develop and eventually break out. ”

"Not only is this germ difficult to treat, but because it is a normal flora in the gut, there is a high probability of recurrence after recovery. ”

"Does it get worse with every relapse? It can also be very difficult to heal. If I am diagnosed, will I contact the director of the Department of Internal Medicine? He was invited to come and participate in the treatment work. ”

Although the test result has not yet come out, although the system has not given a hint to complete the task? But now he is very sure that this is Clostridium difficile.

All the symptoms match? None of them will be pseudomembranous enteritis.

Exactly? When the patient is admitted? Clostridium difficile has already begun to break out. After the operation, these Clostridium difficile were given an opportunity, which is why they manifested themselves so quickly.

Instead of letting the old couple know these bad news again and again, it is better to tell them directly.

"Doctor, can it be cured?" said the patient's father again.

"Theoretically, it is possible to recover by adjusting the body, but every patient's situation is different. Liu Banxia said.

"When the results are in, we will also do a colonoscopy on the patient to see if there is already damage in the intestines. Clostridium difficile produces enterotoxins, which cause massive intestinal water loss and necrosis. ”

"Another toxin produced is called cytotoxin, which causes local cell necrosis of the intestinal wall, directly damaging the intestinal wall. At this point, we need to assess the patient's condition before we can determine the next course of treatment. ”

"Doctor, can you tell me how sure you are of cure?" was the third sentence asked by the patient's father.

Liu Banxia was stunned for a moment, and could see that the patient's parents were very excited, but they were still restraining their emotions.

"I can't give you an exact answer at this time, but I can assure you that we will do our best in the hospital. Liu Banxia said.

"Thank you, please. The patient's mother said this, and tears flowed uncontrollably.

Liu Banxia sighed in his heart, this thank you is a bit heavy, because he is not sure at all now.

A nurse was arranged, and the patient's parents were taken to the ward after taking precautions.

"Mr. Liu, I have been diagnosed, and it is indeed Clostridium difficile. At this time, Wang Chao also ran back and said with a solemn face.

The postoperative recovery patient task of sudden infection is completed

Gain 300 XP, 500 Diagnostics Skill Proficiency, and 2 Glory

This mission is rated as Flawless, gaining 500 XP points, 500 diagnostic skill proficiency points, and 5 glory points

Congratulations to the host for raising the level to level 50, 132895/138900, gaining 1 attribute point and 5 glory points

The host level reaches level 50, and the system mall is new, please check it by yourself

"Mr. Liu, what should I do next?

"You take it for colonoscopy first, and I'll go to Director Xiao to bump into it, it's the first time I've seen such a patient. Liu Banxia said.

There is really no way, the routine practices in the books are enough to provide better help to patients.

"Yo, how can you be a busy person and still have time to run this way?" Seeing Liu Banxia coming in, Xiao He joked.

"Director Xiao, I have something to ask for. We have seen a patient with Clostridium difficile who is currently given oral vancomycin for colonoscopy. Liu Banxia said.

Hearing his words, the smile on Xiao He's face also put away, "There is not much that can be done, that is, to hydrate and regulate protein, increase immunity, and adjust intestinal flora." ”

"Then there is to see if the intestines are damaged, and you are doing a colonoscopy, which should also be taken into account, and these are also your surgical work. By the way, you've taken care of the prevention of infection, right?"

Liu Banxia nodded, "It's already been done, and I've also contacted their company through the emergency personnel, and someone from their company will come over for an inspection later." ”

"Extrapolating backwards from the available conclusions, he should have had an outbreak of Clostridium difficile before he was admitted to the hospital. Because of this, high fever and low blood pressure broke out as soon as I entered the ward after surgery. ”

"That's the most difficult part, because I'm worried that I've done some damage to my intestines. In that case, you can only have a colostomy, right?" Xiao He asked.

Liu Banxia nodded again, "If it doesn't matter if you lose water and have bleeding spots, I'm afraid of necrosis." I have a headache when I think about it, and it's also because I have taken a lot of antibiotics in half a month. ”

"The country has always been spreading this knowledge, but not many people really care. Xiao He said.

"This may also have something to do with our living habits, some headaches and brain fever are uncomfortable, so they will turn over some medicine at home and top it. ”

"Director Xiao, then I'll go back first, and I have to guard the results of the colonoscopy. The patient's parents were very restrained, but this made me feel uncomfortable. Liu Banxia said.

"Okay, go ahead, if you need me to come over for a consultation again, call me directly. Xiao He nodded.

Liu Banxia personally came over to discuss his condition, instead of calling himself for a consultation, which was a sign of respect for himself. He is also very optimistic about Liu Banxia, and will also give Liu Banxia a convenience.

Liu Banxia, who walked back, had a headache, because he felt that the patient's first attack was the so-called "gastrointestinal cold", and this time it belonged to the recurrence stage.

As he said, every time you relapse, the chance of cure is lower.