Cyanobacterium marnefi is an opportunistic pathogen that has suddenly become known to many people recently, and compared with relatively common pathogenic bacteria such as Staphylococcus aureus, its biggest feature is that it has different biological properties - it is a fungus.

In the natural environment, Cyanobacterium marnefi is by no means uncommon. It is widely distributed in the subtropical regions of Asia, from the Indian Peninsula to the Indochina Peninsula, and almost all of the fungi that have been isolated from Penicillium spp. in recent years have been reported. In China, Cyanobacterium marnefi is especially found in Hong Kong, Macao and Taiwan, Liangguang and Jiangxi and Hunan.

It is one of the main pathogens of opportunistic bacteria in HIV patients, but there are increasing reports of infection in non-HIV patients. There are more and more reports of malnefi cyanomycosis in immunocompromised patients, patients with autoimmune diseases, and those who need to take immunosuppressive drugs for a long time, and there are even some concerns about whether it is because this strange fungus is starting to mutate.

"The most important feature of this disease is that the symptoms are very similar to those of tuberculosis. Yuan Ping'an explained in detail to Sun Lien the characteristics and differential diagnosis direction of Cyanobacterium marnefi, and then asked, "Has the patient ever eaten bamboo rats, sugar cane, and bamboo shoots?"

"What?" Sun Lien was stunned, "I know the other two...... But what is a bamboo rat?"

"It's a ...... A rodent, not small, living mainly on bamboo, it looks like a large mouse. Yuan Ping'an obviously has never eaten this "rodent", and his description seems a bit general, "It is said that in the Liangguang area, there are many people who eat this animal. ”

Sun Lien nodded inexplicably, no wonder some people always joke that Cantonese people eat everything - especially Fujianese.

"If it's really Cyanobacterium Marnefi, it's not difficult to treat. Yuan Ping'an took Sun Lien's copy of the case, found the medical record number on it, and entered it into his computer to read it. "Amphotericin can be cured after about four weeks of continuous treatment. However, problems such as bone damage have to wait for the patient's body to recover on its own......"

Yuan Ping'an looked at the case while telling Sun Lien about the key points of treatment of Marnefi cyanomycosis, the more Sun Lien listened, the more strange he felt, he interrupted Yuan Ping'an's explanation, and asked curiously, "How do you know about this disease?"

"It's similar to the previous heparin insensitivity. Yuan Ping'an smiled, a little proud but a little gloomy, "The earliest paper in China that discovered and summarized the infection of non-HIV patients with Marnefi cyanomycosis was made by Director Wang of the Laboratory Department of the Association and the Laboratory Department of the First Affiliated Hospital of the General Hospital of the Whole Army, as well as the Department of Communication, Respiratory Medicine, and Pathology. ”

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The four words "we are in the same association" are said lightly, but when they come out of Yuan Ping'an's mouth, they have a completely different meaning. He studied at Tongxie and started his career at Tongxie. Although he switched from neurosurgery to emergency medicine, he at least achieved the position of chief resident physician in the emergency department of Tongxie Emergency Department, which is the number one emergency department in the country.

Yuan Ping'an is actually really good.

"Now, of course, we have to say, 'They're all in this together.'" Yuan Ping'an seemed to suddenly find something wrong with the content of his words, and he smiled and changed his words, "After this review was published at that time, it attracted a lot of discussion among laboratory doctors in the two regions. ”

Sun Lien nodded, and said with some regret, "When I went to the association, I was too in a hurry, otherwise I might have been able to meet Dr. Wang." ”

Yuan Ping'an stared at Sun Lien for a while, and after a moment of silence, he shook his head and said, "I can't see it." After a pause, he continued, "Director Wang suddenly fell ill last year, and he was gone. ”

Sun Lien and Yuan Ping'an fell silent together. Just as the air froze, Sun Lien's mobile phone rang just right, breaking the suffocating silence.

"Dr. Cao?" Sun Lien suddenly came to his senses when he looked at the call number, and he rushed ahead and said, "We have some clue about that patient!"

On the other side of the phone, there was no sound.

"Hey?" Sun Lien yelled two more words into the phone, as if there was some sound, but it sounded like a meaningless noise from the friction of the phone in his pocket.

"What's wrong?" asked Yuan Ping'an, "What's wrong?"

Sun Lien hung up the phone, frowned and shook his head, "It should be that the phone didn't lock the screen and the result came out, right?"

There was a noise outside the door, and the two glanced at each other, and Sun Lien had a bad premonition.

"Go out and have a look. Yuan Ping'an saw that Sun Lien's expression was not quite right, he stood up from his seat, put on a white coat, and walked out with Sun Lien.

Pushing open the door of the small conference room, a wave of panic and urgent shouts rushed towards the two of them.

"Tourniquet, bring the tourniquet!"

"800CC blood type B, hurry up!"

"Monitor, get out of the way, the monitor is coming!"

"Pressurized blood transfusion, push ECMO over, and the technical team will be there soon!"

"The two venous passages are not enough, and the central venous catheter needs to be buried, are the people from the anesthesiology department coming?"

The rescue room is usually very noisy, but it is like a vegetable market, and everyone's voices are not as calm as before, and the panic that almost spreads to the entire rescue room, Sun Lien has experienced it for the first time.

"What's wrong?" Yuan Ping'an looked at the place where a bunch of doctors had gathered, while Sun Lien was more direct, he grabbed the little nurse on the side and asked, "New patient?"

"The doctor on the outside of the urology was stabbed by the patient!" the little nurse put down a sentence, and then got into the crowd, "Let one let, let one let!

The crowd parted a crack under the scolding of the little nurse, and at that moment, Sun Lien saw a familiar and pale face from the crowd. The expression of that face was helpless, panicked, and painful. Keep your eyes closed and open them once in a while.

It's Dr. Cao.

Sun Lien felt that there was a buzz in his head, and he couldn't hear any other sounds.

"Cao Xin, male, 28 years old. Pericardial filling (00.01.14), penetrating hepatic injury (00.01.25), open pneumothorax (00.03.11), fracture of the fourth rib (00.03.35), cephalic vein rupture of the left limb, (00.04.31)"

Sun stayed where he was, watching his roommate lie on the emergency bed, his face as pale as Dr. Cao's. Both hands began to tremble.

"What are you doing in a daze? Go and save people!" Yuan Ping'an looked back and saw that his leader was actually standing in place, looking frightened, and suddenly became anxious. He grabbed Sun Lien's arm, and then dragged him to the bed.

"Doctor Sun, Doctor Sun!" he slapped Sun Lien on the back a few times, and woke his leader back from shock and stupefaction. "What are we supposed to do?"

Sun Lien blinked, glanced at Yuan Ping'an, and then at Cao Xin. Dr. Cao's blood pressure has dropped rapidly from 110/85 to 85/55 on the monitor, while his heart rate has risen to 138 beats per minute.

Sun Lien grabbed the syringe on the rescue bed and stabbed Dr. Cao into the chest. It was exactly two centimeters below the fruit knife.

Sun Lien pulled the push rod on the syringe, and a stream of blood poured into the syringe. As 20 milliliters of blood were withdrawn, Cao Xin's heart rate immediately dropped to 110 beats per minute, and his blood pressure began to rise.

"Acute hemopericardium. Yuan Ping'an knew what was going on at a glance, "Quick, send it to the operating room immediately!"