My sister Li Jiahui has been allergic to peanuts since she was a child, and she accidentally ate food with peanuts a few times before, but she had a large area of urticaria on her body, and once she almost died, but fortunately she was hospitalized in time and saved her life.

"Sister, did you touch peanuts again? You see blisters on your arms. ”

Li Jiahui felt itchy on her arms as soon as she entered the door, but she didn't expect that there was already a large blister at this time, just like the rash on her whole body because of eating peanuts before, which was unbearable.

"I didn't eat peanuts." Li Jiahui looked at the rash on her arm and was extremely surprised, "I know that I am allergic to peanuts, and I am very careful about what I usually eat, so it is impossible to eat peanuts." ”

Li Yixuan reached out to hold his sister's arm, found that his sister's arm was very hot, and then reached out to test her forehead, which was also hot.

"Sister, you have a fever!"

Li Yixuan got up from the bed and helped his sister to the bed, "Sister, you can't have a cold, you can take a rest, I'll find you cold medicine and anti-allergy medicine." ”

Li Jiahui felt very cold, and there was a sweet and strange taste in her mouth, not like eating sugar, but feeling a little thirsty and uncomfortable.

"How can you just take medicine? It is not yet known what the cause of the fever is. Aunt Zhang, pour me a cup of hot water first. ”

Aunt Zhang went to pour hot water, and her younger brother Li Yixuan stayed by the bedside, staring at the rash blisters on her sister's arms, her brows furrowed together, "Sister, where are you still itching?" Do you have a rash other than your arms? I remember the last time you ate peanuts and you couldn't breathe, how do you feel now? Is it okay to breathe? ”

Li Jiahui knows the symptoms of systemic allergies, and now she has blisters on her body, which is really like eating peanuts before, but thinking about this morning's breakfast is the same as usual, there must be no peanuts, why do you have allergic symptoms?

Aunt Zhang brought a glass of warm water, Li Jiahui took two sips, and felt that in addition to the sweet taste in her mouth, there was also a strange taste, which I couldn't describe, it was a feeling I had never felt before.

After two sips of water, the symptoms did not subside, but felt more and more tightness in the chest.

Then a sweet smell welled up in my throat.

Li Jiahui coughed, coughed violently and spit out a mouthful of blood.

Seeing the blood, everyone panicked.

Li Jiahui coughed up blood, her breathing became more and more unsmooth, and her complexion turned from ruddy to purple.

Li Yixuan was the first to react and shouted loudly, "Aunt Zhang, call 120 to call an ambulance!" ”

——

Linhai First People's Hospital, Department of Infectious Diseases.

After Li Jiahui was sent to the People's Hospital on the same day, after being examined by an emergency doctor and treated with emergency allergies, her body temperature still did not drop.

The peripheral blood was examined again, and the white blood cell count was very high, and an infection was suspected, so he was transferred from the emergency department to the infection department and was placed in the infection ward.

Attending physician Yoshiki Tani.

After being hospitalized, Li Jiahui still had a high fever, bruises around her lips, and shortness of breath.

Gu Jiashu had a second physical examination at the bedside.

Touch the back of the neck and get slightly stiff.

Got meningitis?!

Could it be a bacterial infection?

Gu Jiashu decided to give Li Jiahui a spinal tap to remove cerebrospinal fluid.

Lumbar puncture, it can be very painful.

Li Jiahui was lying on the hospital bed, very resistant to Gu Jiashu's next examination.

"Dr. Gu, why do you need a lumbar puncture? I just have a cold, or maybe I'm allergic to something, so why don't I just get my blood checked? ”

Gu Jiashu patiently explained, "You now have meningeal irritation, and checking cerebrospinal fluid is the most intuitive and reliable way. ”

Li Jiahui checked Gu Jiashu's resume as early as the last time her younger brother Li Yixuan was hospitalized, and knew that he had saved patients infected with Ebola virus, and his professional level was one of the best in China, and he was a very professional doctor.

Li Jiahui decided to believe Gu Jiashu, "Okay, I hope we can find the cause as soon as possible this time." ”

Prepare the puncture needle, sterilize, puncture ...... Clear liquid flows out.

Aseptic meningitis!

Could it be a viral infection?

Gu Jiashu sent the extracted cerebrospinal fluid to the laboratory department for testing.

Until the cause is identified, only symptomatic treatment is possible.

The younger brother Li Yixuan stayed by his sister's bedside, saw Gu Jiashu send away the specimen, and gave a doctor's order, but did not explain what the cause was, so he asked behind Gu Jiashu: "Doctor Gu, what is my sister's disease?" ”

"At present, the preliminary judgment is aseptic meningitis combined with pneumonia, and the specific cause needs to be further examined."

Li Yixuan has been ill for a long time and knows all kinds of medical terms, "The reason why my sister has a fever is because of meningitis and pneumonia?" So why coughing up blood? ”

"Chest CT showed diffuse alveolar damage in both lungs, and coughing up blood was due to lung damage."

Li Yixuan: "Lung damage is due to infection? ”

Gu Jiashu shook his head, "I'm not sure, it may be an infection, but it doesn't rule out the possibility of chemical pneumonia." ”

Although Li Yixuan knew all kinds of medical terms, he was not a real doctor after all, and he was confused by Gu Jiashu's explanation, "It means that the cause of my sister's illness is unknown, and the current treatment may not be useful?" ”

"Symptomatic treatment is what we can do right now."

When the attending physician said this, Li Yixuan also understood that his sister could only continue to be hospitalized for observation and treatment now.

Xiao Zhang, a young doctor from the Department of Infectious Diseases, suddenly rushed to Gu Jiashu, "Doctor Gu, Doctor Zhao from the Oncology Department just called to find you for a consultation. ”

"What patient?"

"An old lady in her 70s, who had ovarian cancer surgery two months ago and recovered well, was hospitalized today with a sudden high fever and hemoptysis, and had a CT scan, which showed pneumonia, Dr. Zhao asked you to come for a consultation."

"Okay, I'll go over now."

——

The First People's Hospital, Oncology Ward.

An old lady in her 70s was lying on a hospital bed, her eyes slightly closed, the corners of her mouth bloodshot, and a middle-aged woman in her forties stood next to the bed.

The woman was talking to Dr. Zhao, the head of the oncology department.

Dr. Zhao saw Gu Jiashu and handed over the case in his hand.

Gu Jiashu looked down at the old lady's case while listening to the conversation between the woman and Dr. Zhao.

Middle-aged woman: "Doctor, I am the nanny who takes care of Mrs. Zhang, she was fine when she took a nap at noon today, and when she got up in the afternoon, she suddenly said that she felt uncomfortable, couldn't breathe, headache, dizziness, and she suddenly coughed up blood and fainted before she got out of bed, I hurriedly called 120, and Mrs. Zhang's son also notified that they were rushing here." ”

Gu Jiashu looked at the case file and learned that the nanny reported that Mrs. Zhang had vomited once after getting up at noon before admission, and had a fever, confusion, and coughing up blood.

After admission, physical examination showed that he was in a shallow coma, no rash and bleeding spots were found on the skin, both pupils were equally large, there was a light reflex, the neck was slightly resistant, the muscle tone of the limbs was increased, and the chest CT examination showed diffuse infiltrates in both lungs.

Dr. Zhao was initially diagnosed with central nervous system infection, and was treated with mannitol, furosemide and other dehydration to lower intracranial pressure, and high-dose penicillin intravenous infusion anti-infection treatment.

For now, this treatment option can.

Dr. Zhao approached Gu Jiashu and asked in a low voice, "Dr. Gu, what do you think is the infection that would have such a sudden onset?" And so fast? ”

Gu Jiashu was also very curious about the cause, "Let's take a cerebrospinal fluid to check first." ”

Dr. Zhao: "I know that the cerebrospinal fluid is suctioned, and I have just been sent to the laboratory department, and the clear liquid can be seen with the naked eye, and it feels like aseptic meningitis, I want to ask if she thinks this is a viral infection?" Could it be a virulent infectious disease? She lives in a villa in the western suburbs, where the last monkeypox virus infection broke out. ”

Dr. Zhao from the oncology department is haunted by the last monkeypox outbreak.

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