At ten o'clock on Wednesday morning, the conference room of the Department of Infectious Medicine was neatly filled with bigwigs.

The whole hospital consulted, what a big posture, the teaching secretary sincerely served tea and poured water for the big guys.

Chen Shishi followed Senior Brother He and still sat in the last row, not daring to make a loud noise.

It's really a group of bigwigs gathered together, and the momentum is compelling.

Zhang Tianyang, as a doctor in charge of the bed, still sits in front of the computer, unable to escape the fate of reporting medical records.

While chatting with the bigwigs, Professor Zhu took the time to look at him, and then nodded slightly.

There is no stage fright at all, and it is not a loss to the little Dr. Zhang Zhang that she is optimistic about.

In the end, the two bigwigs from the laboratory department came, all the bigwigs were in place, Zhang Tianyang put the projection out and began to introduce the condition.

Just like yesterday's general consultation, this time it was the big guys of the whole hospital who discussed and quarreled.

Xiaoxi's illness is not just a matter of internal medicine.

Since the initial onset of the disease starts in the lungs, and the most serious organ damage is also the lungs, the big man in the respiratory department also expressed his opinion.

"I am still in favor of continuing to use anti-tuberculosis therapy, after all, anti-tuberculosis treatment has been effective before. ”

The big guy who was infected with internal medicine next to him didn't quarrel with others yesterday, and he was already holding his breath, so he went straight to it at this time.

"Then how do you explain that he relapsed a month after taking anti-tuberculosis drugs?"

The boss of the respiratory department is a fairly cultivated old lady, and half of her silver thread is well kept.

She didn't get angry when she was scolded, she just silently glanced at the bald professor of infectious internal medicine, and then slowly took a sip of the warm tea in front of her.

"Maybe it's a question of anti-tuberculosis treatment regimens, try adjusting the medicine. ”

The bald professor in the Department of Infectious Medicine still disagrees, "What tuberculosis patient would be like her? This is not in line with what we know now!"

"You're right. ”

The big guy in respiratory medicine is still tepid, and he can be called a clear stream in a group of red-faced bigwigs.

"Do you have any treatment options?"

The bald professor who was infected with internal medicine was dumbfounded.

"I don't have ......"

In addition to these two people, the other bigwigs are also fighting each other.

Due to the accumulation of lesions to the skin and bones, dermatology and orthopedic bigwigs also have something to say.

There is also the laboratory department, and various specimens sent for testing yesterday, including purulent skin discharge, pustules in the throat, alveolar lavage, and even a bone in the spine, have already been processed.

But other hospitals have not cultivated pathogenic bacteria in the past five years, and the boss of the infection department euphemistically said that he is not good at it.

The bigwigs of various departments who were not implicated in themselves hid to the side, holding tea and watching the fire from the other side.

"It's hard to see a scene like this......"

The director of the Department of Obstetrics and Gynecology is also a female professor, and at this time she sighed with tea and the person next to her.

"It means that this patient is very tricky!" the director of the cardiology department nodded, "I thought there would be heart problems before I came, but now I feel fine when I look at the test results." ”

"Look at this film!"

The director of the obstetrics and gynecology department pinched the chest CT on the table and held it up to the lamp.

"Her lungs are dying, and she probably won't have time to implicate her heart. ”

......

Chen Shishi hid in the last row to watch a group of immortals quarrel in front of her, and a group of immortals watched the fire from the other side, feeling in a trance that her worldview was a little impacted.

"So the bigwigs quarreled so lively......

She looked at the computer again, and lowered her head to Zhang Tianyang thoughtfully.

"Is the junior brother starting to be in a daze again?"

"He can't help it if he's not in a daze. ”

Senior Brother He appeared on Zhang Tianyang's side this time, "You see, although the discussion is intense, there is no guess of the cause and follow-up treatment plan that everyone can agree on. ”

"Without these two key pieces of information, what does it matter if you don't listen to them? Even if you can deal with the symptoms, if you don't get rid of them for a day, the patient will not be able to escape the tragic fate. ”

What Senior Brother He said was indeed right, the bigwigs quarreled and insisted on their own words, but there was still no way to determine the cause.

In the end, you can only decide to "deal with what can be dealt with first".

She was first taken to the operating table, and the orthopedic and dermatology departments first treated her bone lesions and skin abscesses.

Then, according to the advice of the respiratory department, the medication is adjusted and the anti-tuberculosis treatment is continued.

"Okay, then let's decide for now, does anyone else have an idea?"

Professor Zhu, as the professor in charge, concluded, "If there is no opinion......

"Professor, I have some ideas. ”

Zhang Tianyang, who had been watching the battle in silence, raised his hand.

The eyes of the bigwigs all fell on Zhang Tianyang.

Professor Zhu frowned slightly, Dr. Zhang is usually very decent, why is he suddenly ...... now

She coughed lightly twice as a reminder before speaking.

"About this patient?"

Zhang Tianyang nodded, "Yes." ”

"About her cause?"

Zhang Tianyang responded to the gaze of the big guys and nodded, "Yes." ”

"This little doctor, it's kind of interesting. ”

The director of the cardiology department, whose butt had left the chair, sat down again and looked at Zhang Tianyang with some interest.

saw that he unhurriedly opened a PPT that had already been copied to the desktop.

In fact, after he knew it in his heart last night, he thought about how to implement his conjecture and treatment plan.

Tell Professor Zhu secretly?

This is a method, but what if Professor Zhu doesn't believe it, or thinks that he has put forward the idea that the general consultation has not been put forward, it can't be right?

Although he had a good impression of Professor Zhu, he did not rule out the possibility.

After all, he was just an intern, and this time he was facing an incurable disease that had not even been found out after five years of treatment.

Therefore, the hospital-wide consultation is an opportunity.

On the one hand, he wants to see if the bigwigs will have the same conjectures as him, and on the other hand, if his own ideas are wrong, so many bigwigs present can also correct him.

Big deal, scolded.

He's thick-skinned anyway.

It's a pity that the bigwigs didn't think of going with him.

He clicked the mouse and clicked on the screening.

The title of the ppt hit in front of the big guys.

"Penicillium marnefi?"

The big guy in the laboratory department frowned while sticking the title.

"Do you suspect that the patient is infected with this thing?"

In the face of doubts, Zhang Tianyang was not in a hurry.

Yes, teachers may not believe it, because it is a rare opportunistic pathogen and often only infects HIV patients. ”

"However, in very small probability, it can also infect non-HIV patients. ”

Zhang Tianyang pressed the mouse, and the ppt jumped to a new page.

"Teachers, please see, this is the previous report I found of Penicillium marnefi infection in non-HIV patients, only 7 cases. ”

The directors who were originally a little impatient and anxious to go back to deal with their own Corey affairs sat up straight again.

The old lady, the director of the respiratory department, stopped drinking tea, put down the quilt, and listened attentively.

"Of the 7 patients, 6 had skin lesions, 5 involved bone lesions, and all had lung lesions. ”

"Penicillium marnefi infections are divided into disseminated and pulmonary ......"

After a brief introduction to the cases he had found and the characteristics of Penicillium marnefi, Zhang Tianyang began to elaborate on the evidence that supported his opinion.

"This patient, on the surface, seems to have normal resistance, but I asked the family carefully, she has been weak and sick since she was a child, and she is prone to colds, which gives the germs a chance to take advantage of it. ”

In addition, they live in the southern region all year round, and the humid climate causes the spores of the germs to disperse in the air and be inhaled by the patients. ”

"Bamboo rats are an important source of Penicillium marnefi, and although the patient had never used bamboo rats, when I inquired, I learned that she used to keep them as pets. ”

"Penicillium marnefi is easily misdiagnosed as tuberculosis because it can stain the medium red, and I called the laboratory in Shanghai last night to verify this. ”

"So, with all that said, I think the patient might be infected with Penicillium marnefi. ”

The words fell, and Zhang Tianyang waited for the decision of the big guys.

"Really, could it be this fungus?"

The director of the cardiology department, as a member of the theater, did not know much about these things, and broke the silence at this time.

"What do you think?"