"After being diagnosed with pneumonia, he refused to be hospitalized, saying that he would be prescribed medicine to take it home, but the doctor did not agree, saying that he had to be hospitalized, and then he was hospitalized, so I asked him for leave." The man's wife went on to complain, "What if I don't go home from the hospital?" I won't deal with it if something happens, and I don't know what he's thinking. ”

The man's face was slightly red, but he didn't refute it, and his wife said him.

"Later, I was hospitalized, I still had a fever, a fear of cold, a cough, he also said that he had no strength all over, his hands and feet were sore, the doctor said that he still had pneumonia, and he would have to stay for a few more days, but he still didn't get better after a week, you see, it's still burning......" The man's wife pointed to the man.

Guo Xiang glanced at the man's face and his face was not very good, took the thermometer on the table, shook it, "Measure it again." ”

The man sat down, put the thermometer under his armpit, and took it out after a few minutes, 39 degrees, not low.

Guo Xiang frowned, looked at the medical records, pneumonia is antibiotics, most pneumonia is caused by bacteria, mainly Streptococcus pneumoniae, Mycoplasma pneumoniae, Haemophilus influenzae, etc., clinicians generally use antibiotics to treat.

It is indeed written in the medical record that relevant drugs have been used, but how can it not work?

If it is pneumonia, the treatment will definitely be effective, and a hospital can't even cure ordinary pneumonia, how is it possible?

"After suffering so many crimes, the result is still not cured, what a broken hospital, it is not as good as a small outpatient clinic in our community." The man's wife complains.

"Auntie, we don't know the reason just by looking at it like this, we may have to be hospitalized and investigated slowly, and we can't just use medicine, right?" Guo Xiang said, "On the other hand, we are not a public hospital, and it is more expensive to see a doctor, so I don't want to lie to you......

The middle-aged man and his wife glanced at each other, "It's expensive, as long as it can be cured, human life is always more important than money." The man's wife said.

Guo Xiang nodded, this woman can still carry it clearly.

"Then we will be hospitalized first, we may have to do a lot of tests to find out the cause, and this disease may be a bit complicated." Guo Xiang said.

"Okay, I'll go through the hospitalization procedures." Women are decisive.

Xing Ming gave the patient a bill, and then did some examinations first, and it was indispensable to take a film, although it was done in other hospitals, it was still necessary to make sure.

Then the blood routine and an electrocardiogram are done.

When the results came out, everyone looked at it together, and sure enough, there was still pneumonia, and the blood phase was high, that is, the blood white blood cells were high, indicating that there was inflammation.

Judging from the electrocardiogram, there is no sign of arrhythmia, but the heart rate is a little faster.

However, the patient has a fever, generally speaking, the fever raises the body temperature, and each increase will increase the heart rate by about 15 times per minute, so it is normal for the patient with a fever to have a fast heart rate.

"However, aminotransferases, cardiac enzymes and troponin are also a little high, will there be a problem with the heart?" Xing Ming said that he is a cardiothoracic surgeon and has some experience in this area.

"Is it possible to have myocarditis? It is also possible that there is inflammation of the liver. Xing Ming said.

Guo Xiang frowned, "It stands to reason that pneumonia will be effective if it is treated like this, but there are only two reasons why it is ineffective, one is that the antibiotics he used are ineffective and do not cover the germs, so he may have to try another one." Second, it is possible that the patient has other diseases that have not been discovered, so the treatment is ineffective. ”

Xing Ming and Xu Wei both nodded, although Xu Wei is an obstetrician and gynecologist, but the medical theory is the same, so although it is a man who sees a doctor this time, they still discuss it together.

"Let's try to change his antibiotic first." Guo Xiang said, Xing Ming nodded, and gave a doctor's order, because he was the first to receive the treatment, so the middle-aged man was his patient, he was the attending patient, and he was naturally the one who paid the bill.

"Give him another cardiac ultrasound to see if there is any problem with his heart function." Xing Ming said.

Guo Xiang nodded, now that the cause is unknown, he can really only take the elimination method.

"The patient said that he had chest tightness and shortness of breath, coupled with fever and aching limbs, which was like myocarditis." Xing Ming said, "But myocarditis is generally caused by a virus......

Pneumonia is bacterial, myocarditis is viral, uh, a little complicated.

"Take antibiotics first, and then check your heart." Guo Xiang said, after all, it's just speculation now.

The man was hospitalized and changed to new antibiotics, and during this period, he also did a cardiac ultrasound, and there seemed to be no problem. I did an ECG again and there was no abnormality.

Everyone is a little worried, what is the reason?

Some people may say how could the doctor not know, don't they all have a fever?

However, there are hundreds of causes of fever, and it may not be possible to record them all in a book, so it is impossible to try them one by one, and I don't know how much the examination fee will cost.

Although it is a private hospital, it can't be so pitiful, and it will be scolded by others.

Tumors can also have fever, but generally not to that high, almost 40 degrees, so it can be ruled out.

"Could it be some kind of infectious disease?" Xu Wei said, "It can't be AIDS, right?" ”

"It's unlikely, there are still very few people in the country now, and that person doesn't look like he has been abroad......" Guo Xiang shook his head.

Think about what are the more common infectious diseases in later generations, dengue fever, scrub typhus, leptoplasmosis, and so on.

Guo Xiang said his thoughts, Xing Ming shook his head, "We're not in the south, it's not that hot, right......?"

"It's hard to say, it's a little cooler in the morning and evening, it's still very hot during the day, and it was very hot last month, and he got this disease last month......" Xu Wei said.

"In the south, these are generally caused by humid and sultry weather, and there are many mosquitoes." "Ask him if he had been to the south last month. ”

"I'll ask." Xing Ming said.

I asked, I really went, and I went on a business trip last month.

"Check the blood again." Guo Xiang said. She remembered that there was a time when scrub typhus was quite serious, because it was just a small insect bite that did not attract people's attention and caused death, and it is possible that the patient had been to the south.

Moreover, scrub typhus can also cause fever, chills, headache, and pneumonia and other symptoms, which is very likely.

Blood was drawn again, Charitsial antigen, and the result turned out to be negative.

No? Guo Xiang frowned, how could it not be? Did you not find out or because of something?

"Go and see if he has any eschar on him." Guo Xiang said.

Scrub typhus has a very obvious feature, that is, after being bitten by scrub worms, the wound will fester, and then a black eschar will form, which is obvious, but it is not painful or itchy, so some people may not pay attention to it at all.

Moreover, scrub insects generally bite delicate and moist places, such as the perineum, groin, armpit and other places.

The two nodded, if there is really eschar, it must be scrub typhus, and there is no need to do other examinations.

I called the patient, stripped naked and checked it carefully, and made the patient blush, but I didn't see anything.

"No?" Guo Xiang frowned, "Have you read carefully?" ”

"I saw it, I took it off, I looked at it before and after, the patient lay on the bed and pouted his ass to show us......" Xu Wei said a little embarrassed, women have seen too much, and it is the first time to look at a man so carefully.

Guo Xiang chuckled, would Dr. Xu be embarrassed?