Zheng Qi: "Thank you, Sister Jiahui, I have a fever and a rash, I should be fine soon, I am just worried that my disease will be transmitted to other people, so I want to rest at home for a few days." ”

Li Jiahui: "It sounds very serious, you don't want to drag it at home alone, it's best to go to the hospital to see, we are very good at the First People's Hospital of Haishi, I have acquaintances in the hospital, do you want to help you contact in advance?" ”

"No, I'm taking medicine, if it really doesn't work, I'll go to the hospital again."

"Okay, remember to get some rest."

The young man remembers that when he had a rash when he was a child, he stayed at home for 7 days and the rash subsided naturally, so he planned to rest at home this time as he did when he was a child.

He found the remaining antipyretic medicine from the family before, ate two tablets, and reluctantly drank a bowl of gruel, and lay on the bed, but at night he became more and more unwell.

He vomited all the food he had eaten during the day, and he felt that his whole body was swollen, especially on the sides of his neck, armpits, and thighs, and he touched it hard with his hands.

Young people feel that they are not mildly ill, could it be a tumor?

He wanted to go to the hospital immediately, but now he was dizzy and couldn't walk.

Fortunately, the mobile phone was next to him, and he dialed the 120 emergency number with his mobile phone, and soon, the ambulance came to the door.

——

Lianhai First People's Hospital, Office of Infectious Diseasesman.

Gu Jiashu was reading materials in the doctor's office when the phone on his desk rang.

The director of the gastroenterology department called and asked Gu Jiashu to go to the gastroenterology department to consult a newly admitted patient.

Gu Jiashu happily agreed.

In the gastroenterology ward, a young man with a sallow face lies on a hospital bed.

Dr. Li, the head of the Department of Gastroenterology, distributed the medical records to the experts from various departments who came for consultation.

Gu Jiashu got the medical record file and flipped through it from beginning to end.

The young man on the hospital bed was Zheng Qi, a 26-year-old man, who had been taken to the emergency room by ambulance the night before.

Symptoms of admission were nausea and vomiting, high fever, and maculopapular rash all over the body.

The emergency physician recommended hospitalization and transfer to a gastroenterology ward.

First, it was treated as acute food poisoning, but the course of the disease did not improve, and the patient Zheng Qi began to develop neurological symptoms.

The chief doctors of several departments first checked the patients on the bed, looked at the symptoms, asked a few questions, and then went to the doctor's office in the gastroenterology department together and began to discuss the condition.

"Patients with erythematous macules and manifestations of multi-system damage may be systemic lupus erythematosus."

"Autoimmune disease? Probably not, the patient now has a persistent high fever, low white blood cells, low platelets, and a tendency to bleed, which is more like an infection with some special pathogens. ”

"What infection?"

"Typhoid fever?"

Dr. Li, director of the Department of Gastroenterology: "I asked the laboratory department to do a typhoid test, and it was negative, not typhoid fever." ”

"Low platelets? Could it be a hemorrhagic fever? The doctor who spoke looked at Gu Jiashu.

Gu Jiashu shook his head, "There are no symptoms of Sanhong, it's not hemorrhagic fever." ”

"The patient's lymph nodes are obviously swollen, and when he asked the patient just now, he said that he had been to the vicinity of Qingcheng Mountain for wind collection, I remember that the area of Qingcheng Mountain should be an old plague epidemic area, could it be bubonic plague?"

Gu Jiashu still shook his head, "The plague is also called the Black Death, the patient has no obvious bruising symptoms, and from the perspective of the time of onset, the onset speed is obviously slower than the course of the plague. ”

"I see a black eschar on his foot, could it be anthrax on his skin?"

Gu Jiashu still shook his head, "Cutaneous anthrax generally has a history of contact with domestic animals or wild animals, and the patient did not admit it. ”

"I remember a patient in the hospital who was infected with leptospirosis because he ate half an apple contaminated with rat feces, and it seems to be similar to this symptom, could it be leptospirosis infection?"

Gu Jiashu then shook his head, "If it is a leptospira infection, the patient will have very obvious gastrocnemius pain, and there is generally no rash and eschar. ”

"The patient said that when he was collecting wind in Qingcheng Mountain, he saw a farmer kill a rat, and he had a close observation, estimating that the infection was related to the rat, would the disease be contagious? I think the patient should be transferred to the infectious disease unit. ”

The doctors who consulted all looked at Gu Jiashu, especially Dr. Li from the Department of Gastroenterology, and asked Gu Jiashu directly, "Doctor Gu, you are an infectious disease expert, don't shake your head all the time, what do you think it will be?" ”

"The patient has eschar on his legs, red macules, high fever, swollen lymph nodes, and a history of wild bush exposure, which I suspect may be jungle typhus."

"Jungle typhus?" A doctor asked, "Isn't that scrub typhus?" Do you suspect that the patient has been bitten by a chigger mite? ”

Gu Jiashu nodded, "The patient has seen farmers fighting rats at the foot of Qingcheng Mountain, and the chigger mites on the body of the mice will leave the body of the mouse after death and escape in all directions, the scrub mites are very small and not easy to be detected, and the patient may be bitten by the scrub mites that escaped from the rat in the process, thus being infected with scrub typhus." ”

"What now? Patient transferred to the infectious disease unit? ”

Gu Jiashu sighed, "Okay, arrange for the patient to be transferred to the infectious disease ward, this season is originally the high incidence season of scrub typhus in our Lianhai City, and we will receive several cases every year, this patient's symptoms are quite typical, but there are many complications, so I don't dare to confirm it at first, I will let the laboratory department do an examination of scrub typhus." ”

The doctors who participated in the consultation were a little dissatisfied, especially Dr. Li from the gastroenterology department, "Dr. Gu, you are not interesting enough, you can see that the patient has scrub typhus early in the morning, and you still let us discuss it here for so long?" ”

"I also have the current speculation based on everyone's discussion, it was originally a multi-department consultation, and everyone's own opinions should be expressed, and this patient has so many complications, neurological symptoms and multi-organ damage have appeared, and it is safe to listen to everyone's opinions.

Well, since it has been decided that our infectious disease department is responsible, I have to go back to give the patient a treatment plan, and I have to notify the CDC of this disease, and there are several such diseases at a time, and I don't know if there will be new cases in the future, so I have to be prepared. ”

At this point in the discussion, Gu Jiashu directly called Xiao Zhang, the doctor in the department, and asked him to hand over the patient to the gastroenterology department, and gave a series of medical instructions, which antibiotics to use for combined treatment, and so on.

After instructing the doctors in the department, Gu Jiashu hung up his mobile phone, and one of the doctors who participated in the consultation talked to Gu Jiashu with a smile, "Doctor Gu, you are the director of the infectious disease department of our hospital, and your sister works in the Municipal Center for Disease Control and Prevention, and is also an infectious disease expert, you brothers and sisters are the two major experts in the field of infectious diseases in our city, I heard that your sister has not yet been targeted, I have a distant cousin, who is a teacher in a college town, and he is also a young talent, you see ......."

"Wait." Gu Jiashu interrupted the doctor, "My sister already has a boyfriend, who is a police officer, although the marriage date has not yet been set, the relationship between the two is very good. ”

Gu Jiashu decisively rejected the idea of the doctor in the same hospital to introduce the object to his little sister, and now he said it at this consultation meeting, and the trouble of introducing the object to the little sister in the future will be saved, thinking about the fact that the little sister was urged to marry by her parents before, he didn't want to make trouble for the little sister again.

Besides, Nan Hanfei is good, although the little sister has not nodded and agreed, but looking at Nan Hanfei's posture of chasing the little sister, the two should be together in the future, and he himself is also very satisfied with this future brother-in-law.