The Enhanced Doctor

Chapter 1256: Chapter 1256: Listeria?

"Teacher Liu, the latest results from the lab have come out. The Gram stain of the cerebrospinal fluid is positive for Gram-positive bacteria."

Xu Yino hurried over to report the latest findings.

Liu Banxia looked at Wang Huan and Zhang Ping from the neurology department, "Share your thoughts, I’ve already introduced the basic situation."

"The common Gram-positive bacteria are not that many, like staphylococci, streptococci, pneumococci, anthrax bacillus, diphtheria bacillus, tetanus bacillus, etc.," Zhang Ping said.

"Let’s first conduct a thorough examination of the patient, to see if there’s a wound somewhere that accidentally got infected, leading to the current meningitis."

"There’s really no other way, we can only wait for the culture results. Medication is already being used, let’s see how effective it is, given the efficacy of penicillin is quite good. What’s the current situation?"

"The current situation is relatively stable. We’ve also contacted other relatives at home, and we’ll take the child away first," Xu Yino said.

"I’ll take them for an examination now, and if there are no external wounds, I’ll also get a dental CT to see if it’s caused by tooth decay."

After saying this, Xu Yino hurried off to check the patient.

"Really impressive, very meticulous," Zhang Ping said.

"How is the patient with the infection caused by picking at the acne in the oral triangle?" Liu Banxia asked.

"Still in the ward, just transferred from the ICU three days ago," Zhang Ping replied.

"He came in relatively late and really walked a round at death’s door. Hopefully, this patient won’t deteriorate as quickly, and hopefully, the medication we provided will have some effect."

The tone was somewhat helpless, because this conversation seemed somewhat irresponsible. But there was no choice; this was the current reality.

It was also because of the rapid development of society now, with the fast-paced updating of various medications, that many bacteria, during their evolution, have acquired a certain degree of antibiotic resistance.

No antibiotic in the world can boast it can handle all bacteria. These antibiotics all have certain limitations.

Moreover, Liu Banxia and the others don’t dare to use medications recklessly now. Penicillin often works quite well. If the infecting bacteria are really resistant to penicillin, we’ll have to switch medications later.

This requires caution. Using too many types of antibiotics can also harm the patient.

But under the current circumstances, not using medication is not an option, we can’t let the patient suffer without aid.

So even if it’s a very helpless operation, we have to proceed this way.

"Did you have any feelings during the on-site craniotomy for that patient today?" Zhang Ping asked again.

"How could there not be? My heart was on edge the whole time," Liu Banxia said with a wry smile.

"But what can you do? You can’t just watch him be tortured to death by elevated intracranial pressure. The tension wasn’t as high drilling the first hole, but the pressure was even greater when drilling the second."

"It’s pretty good, encountering on-site craniotomies is rare. But it can really save a life and made today’s rescue mission very perfect," Zhang Ping said.

"News already came through before you returned, saying your orthopedic skills are incredible. Not only very fast, but also very effective."

"The fracture patients brought to our hospital are handled very smoothly by Wu Mingyu and the others, saving them a lot of time."

"I was just doing some manageable tasks then, my legs and feet were always quite inconvenient. Luckily, there were not more critical patients showing up, as the rescue conditions were really not very good," Liu Banxia said.

"After returning, I mentioned that from now on, always wear a seatbelt when riding in a car. No matter how advanced the technology of the car is, or how good the safety measures are, the seatbelt is a very important guarantee."

"Also because there are too many cars now; if it were a few years earlier, there wouldn’t have been so many cars. Year by year the quantity has increased, and now I don’t drive to go out for meals," Wang Huan said.

"Parking is too tough, the time spent finding a space, you can finish your meal. It’s better to just take a cab, saving trouble, and it’s okay to drink alcohol."

It’s considered a rare break time, situations where everyone is this idle are really few and far between.

It also happens to coincide with the prohibition on setting off fireworks this year; otherwise, it would be absolutely impossible to enjoy such leisure. Every year there are patients injured by fireworks, no matter how much you remind, or how careful you are, it’s not of much help.

After a while, Xu Yino and Li Hao came over.

"How did the examination go?" Liu Banxia asked.

"Teacher Liu, we didn’t see any wounds. We’ve also asked the patient and his wife, and they have no recollection," Xu Yino said.

Upon hearing Xu Yino’s words, everyone frowned.

If that’s the case, this bacteria could be quite complex and difficult to tackle.

"I’ve already ordered a dental CT for the patient, let’s send it and have a look," Xu Yino suggested.

"However, the patient says his teeth are always in good condition. He’s never had toothaches or cavities. It doesn’t seem like impacted wisdom teeth damaging neighboring teeth."

"We should ask the professionals then, what do you think?" Liu Banxia asked.

"If it’s not an external injury and dental cavities are ruled out, it’s most likely something ingested, right? Or perhaps inhaled accidentally somewhere," Wang Huan said.

"But isn’t this kind of bacteria too severe? Anthrax bacteria do have similar effects, but that can’t be it. If there were such epidemic areas, we would have been notified a long time ago."

"Is there still no result from the cerebrospinal fluid culture?" Zhang Ping asked.

Xu Yino nodded, "No positive results yet, but the urinalysis shows hidden blood. The patient’s platelet count is somewhat low, which might be related to this."

"The critical thing now is to identify what exactly the bacteria are. Do you think the patient’s severe diarrhea might be related to eating something unclean?" Liu Banxia said.

"What if the patient’s meningitis and diarrhea were caused by something they ate? Is that possible?"

"It’s quite possible since the diarrhea and fever started at the same time, right?" Zhang Ping asked.

"Yes, the fever came first, and a few hours later, there was some stomach discomfort. But it wasn’t so severe then; it only became really serious today," Xu Yino hurriedly said.

"The whole family ate the same food, and his wife and child didn’t have any issues. I confirmed this with them, and they said they’ve always eaten together."

"But the patient usually has lunch near the workplace, and that was with colleagues. If there’s a problem, it’d be a case of mass food poisoning, right?"

"Let’s wait for the CT results first. If it’s not an issue caused by dental cavities, then we’ll focus on the food," Liu Banxia nodded.

Xu Yino hurriedly ran out. There weren’t many patients today, so the CT scan was done quickly. She had to get the results and report back immediately.

"This is quite a headache. The patient’s condition suddenly became so complicated," Liu Banxia said.

"I guess it’s not those common bacteria, or else the lab would have had the results by now. What could it be? It’s really perplexing," Wang Huan said.

"There’s no other way, let’s wait for the patient to come back, and then we’ll all check it out together," Liu Banxia said.

"By then, consider what to ask. Patients often leave things out when describing their symptoms. It’s not like they’re doing it on purpose; they just really didn’t think of it at the time."

Wang Huan and Zhang Ping nodded. This situation is very likely.

After diagnosing so many patients, even if you ask directly, they might not remember. Not to mention that even as doctors, we can’t think of everything.

The latest test result reported by Xu Yino over the phone showed that the teeth are fine. Although two wisdom teeth are missing, it’s because they never grew in.

"Let’s take a stroll," Liu Banxia said.

"There’s no other option, but even if they ate something, it shouldn’t be like this," Zhang Ping muttered.

Outside, Xu Yino and the others were pushing the patient back.

The state of the couple wasn’t great. The patient’s current condition was truly worrying.

"Think carefully, is there anything you ate that your family didn’t?" Liu Banxia asked.

"Doctor, what can I eat? Why don’t you believe me? How could I have secretly eaten something without my wife and kids?" the patient said with a bitter smile.

"You’ve misunderstood; that’s not what I mean. If you did sneak something and ended up in this condition, I’d even give you some credit," Liu Banxia said with a smile.

"Based on the current examinations, we’ve ruled out the possibility of an external injury. So we suspect you might have eaten something contaminated, and possibly there’s an ulcer in your digestive tract, leading to direct blood entry."

"Think again, is there anything you alone ate that your wife and kids don’t like? And also think if there’s any other past medical history."

"Any information you provide now could be helpful for our diagnosis. This meningitis is very unusual, especially since it’s not mosquito season, so it can’t be mosquitoes."

"As for other medical history, I don’t have hypertension or diabetes, and my heart is in good condition too," the patient thought hard but shook his head.

"Um... does hives count as medical history?" the patient’s wife asked softly.

"When did you have hives?" Liu Banxia asked with a frown.

"It was a few months ago. He had a rash, but it cleared up in a few days," the patient’s wife said.

"So, have you eaten any cold dishes taken from the fridge, or cold dishes from outside?" Liu Banxia asked the patient.

"Don’t I eat those all the time?"

The patient asked in response.

"Let’s do a Listeria test," Zhang Ping suggested.

Liu Banxia and Wang Huan both nodded.

But the patient’s couple seemed confused, not knowing what it was all about.

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