"Open your mouth wide and take a throat swab for you, it may hurt a little this time, hold back."

Gu Jiashu instructed as he gently rubbed the film on the patient's throat with a cotton swab.

As expected, the film did not fall off.

The pseudomembrane of the throat produced by general diseases can be easily peeled off.

The patient's illness is strange.

With a little force on the hand, the film peels off a corner, and blood immediately oozes out, staining the red cotton swab.

It's pseudomembrane shedding and bleeding again!

It was the same as the little boy in the clinic just now, except that the symptoms of the old woman in front of her were more serious.

"Probably diphtheria."

Gu Jiashu didn't speak loudly, but the ward immediately fell silent.

One of the doctors was the first to ask, "Diphtheria?" No way? This disease has been gone for decades and hit the jackpot today? ”

Although some doctors have questions, everyone knows Gu Jiashu's diagnostic level, and since the infectious disease expert said that it was diphtheria, it is very likely that it is.

"Since it could be diphtheria, it is an infectious disease, and the patient needs to be transferred to the infectious disease unit, and their ward can be isolated and treated. The emergency room should be disinfected to be careful about infecting other patients. "There is a doctor who suggests.

It seems that the consultation specialist has made a diagnosis, and the sick old woman will soon be transferred to the infectious disease ward.

"Ahem!" Gu Yanan reminded loudly.

Gu Jiashu immediately heard that it was Xiaomei's voice.

When I turned around, I saw Xiaomei and other CDC people standing outside the door.

"Director Gu came just in time, and there is another suspected diphtheria patient."

In front of outsiders, Gu Jiashu's title to the little sister has always been "Director Gu".

When someone from the disease control came, the doctors in the hospital were no longer surprised and knew that another infectious disease had occurred.

At this time, everyone basically didn't come to join in the fun, and immediately dispersed, busy with their own work.

Soon only Gu Jiashu, the patient, and the patient's family were left in the ward.

Gu Yanan, Zhou Lao, and Xiao Chu walked into the ward.

Looking at the patient on the hospital bed, Zhou Lao's eyes lit up, and he whispered in Gu Yanan's ear, "The neck is swollen like a cow, and there is a rancid smell in the mouth, typical diphtheria symptoms." ”

Gu Jiashu: "This is the emergency department, first transfer the patient to the infectious disease ward, and we will go to the infectious disease department to tell you if there is anything." ”

Infectious disease ward.

The newly arrived female patient was placed in a separate isolation ward.

The accompanying family member was the patient's wife, a man in his 60s.

In the next ward is the little boy Lele, who was admitted to the outpatient clinic before, accompanied by his mother.

Outside the ward, Gu Jiashu explained the condition of the two, "From the severity of the symptoms to infer the onset time, the older Ms. Li had an early onset of the disease, and the little boy Lele had a late onset time, which one did you investigate first?" ”

Gu Yanan has already obtained the medical records of two patients, one of which says Little Red Flower Kindergarten.

Lele is a student of Little Red Flower Kindergarten, and Ms. Li is the principal of Little Red Flower Kindergarten.

It is definitely no coincidence that two patients appeared in the same place.

"Ms. Li." Gu Yanan made a decision.

Inside Chief Lee's hospital room.

Although Li Yuanchang was seriously ill and had symptoms of systemic poisoning, he was conscious and could answer Gu Yanan's questions.

The basic questions are roughly the same, name, age, place of work, living environment, people you have recently come into contact with, and places you have been.

Dean Li had some difficulty speaking, and most of the questions were answered by family members.

She has not gone out recently, and the place where she lives is home and kindergarten.

Gu Yanan also focused on asking Director Li about his vaccination history.

But because of the long time ago, she can't remember whether she has been vaccinated against diphtheria.

Zhou Lao calculated according to the birth time of Director Li that China began to implement the national immunization program in 1978, and Director Li was born before this, and it is likely that he had not been vaccinated with the tetanus-pertussis triple vaccine.

People born before 1978 are more susceptible to the disease if they have not been vaccinated against the disease.

Considering that people who have not been exposed to the diphtheria, tetanus ”

Elder Li Yuan's wife was very cooperative, "Well, I am 9 years older than my wife, I retired a few years ago, and I have been raising birds and planting flowers and plants at home. My wife is also at retirement age this year, but she usually likes to get along with children, so she has been busy in kindergarten. ”

Those who are 9 years older than the patient are less likely to have been vaccinated.

"Have you been feeling sick lately?" As the first close contact, Gu Yanan is very concerned about the physical condition of Elder Li Yuan's wife.

"Three months ago, my left eye started to be a little red and swollen and painful, so I went to several hospitals and was prescribed eye drops, but the results have not been good since I used it. I also wanted to go to a big hospital to have a good look, but I didn't expect my wife to suddenly fall ill and be hospitalized. ”

Close contacts also have symptoms!

Although not a typical symptom of diphtheria, infection cannot be ruled out.

Gu Jiashu immediately examined Elder Li Yuan's wife.

Worried about the spread of pollution, Gu Jiashu found an eye examiner from the ophthalmology department.

After examination, it was found that the patient's conjunctiva was mixed with hyperemia, and a round grayish-white lesion with a diameter of about 4 mm could be seen in the subnasal quadrant of the cornea.

The lesion is as deep as the stromal layer!

Upon closer examination, it was found that the rest of the cornea was transparent, the anterior pupil was normal, and the inner eye and intraocular pressure in the left eye were normal.

After the inspection, Gu Jiashu felt bad.

This grayish-white lesion is supposed to be caused by a bacterial infection.

However, the patient has been ineffective with multiple antibiotics before, and it is likely that Corynebacterium diphtheria infection is present.

Gu Jiashu immediately performed a corneal scraping for Elder Li Yuan's wife and sent it to the laboratory department for bacterial culture and drug sensitivity experiments.

A copy of the specimen is also kept for the CDC laboratory.

"Depending on your condition, it is recommended that you also be hospitalized."

The close contacts showed symptoms, and Gu Jiashu advised both Mr. and Mrs. Li to be hospitalized.

The patient was very cooperative and re-admitted to the hospital.

Coming out of Chief Li's ward, the CDC and his party went directly to the ward of Lele, a patient next door.

With penicillin, Lele's condition stabilized significantly.

Lele's mother was still wiping her tears just now, and seeing that Lele's condition improved, her expression was much more relaxed.

The flow questions asked Lele are basically the same as before.

One of the most important points is that Lele had major heart surgery before, so many vaccines were not administered in time, which is one of the reasons why he is prone to illness.

Lele usually does two-point activities at home and in the kindergarten, and the people in contact with the kindergarten teachers and classmates and people at home.

Judging from the time of onset, Gu Yanan speculated that it should be Director Li who transmitted the disease to Lele.

After asking the questions and collecting the specimens, the CDC team prepared to go back to the laboratory and wait for the results of the on-site flow investigation and the laboratory results on Lu Li's side.

Coming out of the infectious disease ward, Gu Jiashu wanted to go to the administrative building, and it was rare to go downstairs with Gu Yanan and his party, but when he arrived in the hall on the first floor, he found that someone was fighting.

Several people scuffled together.

A nurse went to persuade her to fight, but she was pushed and fell to the ground.