Chinese Medicine: Starting with Daily Intelligence

Chapter 531: Chapter 531: Positive

The woman really had sold blood.

Upon hearing her words, everyone present immediately tensed up.

As medical professionals, they knew all too well what that meant.

Selling blood was often linked to malignant, blood-borne infectious diseases like AIDS, hepatitis B, and hepatitis C.

If the patient was carrying any of these viruses, it would pose a huge potential threat to all the medical staff in the ward, and even to the other patients.

Lin Guorui’s expression instantly grew grave.

Zhao Chunxiang seemed to sense the sudden shift in the atmosphere. The looks of sympathy she’d received were now tinged with vigilance and caution. Her face turned pale, and she asked nervously,

"It’s... it’s been three or four years... That... that shouldn’t be a problem, right?"

"It can’t be, right? Everyone was doing it back then, and I never heard of anyone getting sick..."

Standing to the side, Lin Guorui looked at the woman, shook his head helplessly, and said in a stern tone, "Ma’am, selling blood is illegal in our country. Those places aren’t clean, and it’s very easy to contract diseases."

"Sigh... You’re just too..."

Lin Guorui trailed off, unable to finish his sentence.

The woman’s ignorance was certainly frustrating, but more than that, it was pitiful.

Poverty had limited her understanding and pushed her into this abyss.

But now was not the time to dwell on right and wrong.

The most important thing was to get a diagnosis and save the patient.

Lin Guorui turned to Li Xu. "Doctor Li, what are you considering?"

Li Xu shook his head and said, "I’m not certain either. It’s just a suspicion."

"I just reviewed all the patient’s records. I noticed the previous tests focused mainly on tumors and genetic metabolic disorders, but a comprehensive infectious disease screening was never done. Moreover, the testing for certain specific fungal and bacterial infections was also insufficient."

"It’s just..."

Li Xu paused, then brought up the key term: "I suspect one possibility—cryptococcosis!"

As soon as he said it, the surrounding doctors all furrowed their brows and began searching their minds for information on the term.

’Cryptococcosis... that’s not common at all.’

But once it was brought up, the more they thought about it, the more plausible it seemed.

Cryptococcal infection is one of the most common fungal infections of the central nervous system.

After infection, it leads to increased intracranial pressure, causing headaches, vomiting, and even hydrocephalus.

At the same time, it can damage the central nervous system, leading to optic nerve damage, optic neuritis, and can even affect the function of the hypothalamic-pituitary axis, causing disordered growth hormone secretion, which in turn leads to developmental delays.

A physical examination might reveal signs of meningeal irritation, such as an unsteady gait, neck stiffness, and a positive Brudzinski’s or Kernig’s sign.

These symptoms were a very close match for the child’s condition.

And most importantly...

As internal medicine doctors, they were all aware of an unwritten rule: cryptococcal meningitis is often one of the most common opportunistic infections in AIDS patients.

It could be called the "shadow" of AIDS.

There were other patients and their families in the ward. Li Xu didn’t want to cause a panic without conclusive evidence, so he kept his explanation brief.

But Lin Guorui and the on-duty doctor clearly understood.

The on-duty doctor’s face turned a little pale. He quickly asked in a low voice, "Doctor Li, should I go write up the orders now? For a cerebrospinal fluid India ink stain and an HIV antibody screening?"

"Oh, right, should I have the family members tested as well?"

Li Xu nodded. "Yes, test them all. For the sake of a definitive diagnosis, and for everyone’s safety."

"Talk to them in a bit. Be tactful about it."

On the surface, all of this was an inference based on the patient’s history and symptoms.

In reality, Li Xu was already completely certain.

He hadn’t figured it out yesterday because the pulse was too weak, and with the child being so young, there were too many interfering factors.

"Alright, Ma’am, don’t be nervous," Li Xu soothed. "We’re just doing a few more tests to confirm the diagnosis. You want to know what’s wrong with your child as soon as possible, right?"

Although Zhao Chunxiang was scared, she still nodded. "I’ll do whatever the doctor says. As long as you can find out what’s wrong, I’ll do anything."

...

Back in the doctors’ office, Hu Qiming followed him in.

He had been studying under Lin Guorui.

In the ward just now, he had also heard Li Xu’s deduction and had already formed his own suspicions.

"Li Xu, are you... suspecting the patient has AIDS?"

Hu Qiming asked, lowering his voice.

Li Xu nodded, poured a glass of water, and said calmly, "Yes. After all, cryptococcosis of the central nervous system is just too similar to the patient’s situation."

"And if you look at the patient’s current symptoms combined with the history of the illness..."

"The child’s mother has a history of selling blood three or four years ago. At that time, the child was about two years old. Before the age of two, the child was mostly normal. But after turning two, these strange symptoms began to appear."

"Don’t you think that’s a bit of a coincidence?"

"HIV can be transmitted through breast milk. If the mother was infected while selling blood, then transmitted it to the child through breastfeeding, causing the child’s immune system to collapse and leading to a subsequent cryptococcal infection..."

"Sometimes, a medical diagnosis is just like that. You have to connect all the seemingly unrelated coincidences. When all those coincidences can be explained by a single thread, you’re close to the truth."

Hu Qiming felt a chill run down his spine. He couldn’t help but give a wry smile. "Just close? I’d say it’s already a sure thing, isn’t it?"

Li Xu smiled and shook his head. "Medicine has to be rigorous. Until the report from the lab comes back, everything is just speculation."

"A hair’s breadth of deviation can lead to a thousand miles of error. What if the child just has a simple, primary cryptococcal infection? The probability is low, but it’s possible."

"Let’s wait for the results."

Hu Qiming nodded, his admiration for Li Xu’s rigorous approach growing. "Alright, I’ll go keep an eye on the ward. I’ll also head over to the lab to hurry them along, put a rush on it. I’ll let you know the moment the results are in."

「Four hours passed.」

Around noon, Hu Qiming rushed into the office with a grim expression, holding several report forms.

"Li Xu, the results are in."

He placed the forms on the desk and took a deep breath. "It’s exactly as you predicted."

The report clearly stated:

[Patient Zhao Chunxiang: HIV Antibody (+), Confirmatory Test (+)]

[Patient Zheng Xiaobao: HIV Antibody (+), Confirmatory Test (+); Cerebrospinal Fluid India Ink Stain: Cryptococcus neoformans detected]

Li Xu stared at the red plus signs. Although he had expected it, his heart still felt heavy.

For that impoverished family, these few thin sheets of paper were nothing short of a devastating catastrophe.

But at the same time, it was also the beginning of hope.

Now that the cause was found, they could prescribe the right treatment.

...

「City Hospital of Traditional Chinese Medicine, Ward 19F.」

When the two reports stating "HIV Positive" were placed in front of Zhao Chunxiang and her husband, they were completely stunned.

Zhao Chunxiang collapsed into her chair, her eyes vacant as if her soul had been torn from her body.

Her husband, a simple and honest farmer, squatted in the corner, clutching his head in his hands and letting out suppressed, desperate sobs.

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