N-A-A Chapter 706
Chapter 706
Before leaving work.
The patient had not yet considered whether to have a lung biopsy.
Lin Feng went straight home.
He was less worried about this patient, and although the test results ruled out the possibility of cryptococcal pneumonia, the possibility of lung cancer was much smaller.
He also believes that patients will eventually be willing to undergo a lung biopsy.
The next day.
As soon as she arrived at the hospital, Xiaoru told Lin Feng that the patient had promised to do an examination.
Hearing this, Lin Feng smiled.
As expected.
After breakfast, Lin Feng came to the ward.
After watching the patient sign the biopsy list, he began to set about the patient's lung piercing.
After coming to the CT room.
Under the guidance of CT, Lin Feng successfully removed the pathological tissue in the patient's lung.
The whole process was also very smooth.
The patient is safe and sound.
After returning to the ward, he said to Lin Feng: "Doctor Lin, will this soon be able to find out what kind of disease I have?" "
"That's right! Lin Feng nodded.
The results of the lung biopsy done today will probably be available tomorrow afternoon.
But that's a pretty fast time.
After the lung puncture, the patient still had a low-grade fever and coughed up blood from time to time.
Wait until the results come out.
Lin Feng smiled.
There are no cancer cells in the pathological tissue.
No Mycobacterium tuberculosis.
However, a large number of cryptococcal spores are seen on the pathological smear, and the PAS stain is positive.
The commonly used pathological smear staining method for cryptococcus is this PAS staining, and now this staining is positive.
This means that there are cryptococcal growths in the pathological tissue, and pathologists have seen many cryptococcal spores growing.
Now it can finally be closed.
The patient was clearly diagnosed with "cryptococcal pneumonia"!
Go around in circles.
The patient's pigeons are not innocent.
It is still their feces that they have this cryptococcus in their feces, and the patient is a painter who feeds the pigeons whenever he is looking for inspiration.
Listening to the words of the patient's wife, it is obvious that these pigeons are not taken care of.
Then only the patient takes care of himself, and if he has contact with the pigeon for a long time, it is inevitable to deal with pigeon droppings, and eventually inhale these cryptococcus, resulting in illness.
However, the patient does not have AIDS, no blood system diseases, no diabetes and other underlying diseases that affect immunity, his immunity should be no problem, it is reasonable to say that it is unlikely to be infected with cryptococcus to cause pneumonia!
In the end, Lin Feng could only classify the patient into the probability of one in 100,000.
The patient heard that he was diagnosed with cryptococcal pneumonia and was completely relaxed.
Fortunately, it wasn't lung cancer, otherwise he wouldn't have known what to do.
Several of his friends have been diagnosed with cancer, and each one is in great pain.
Lin Feng immediately prescribed fluconazole, an antifungal drug that has a good effect on cryptococcus.
After prescribing the drug.
Lin Feng said to the patient: "Then you have to cooperate with the treatment and examination!" I'll arrange a skull MRI for you later, and also do a lumbar puncture! "
"Huh? Isn't it diagnosed? Why do you need a lumbar puncture? What's the use of this? Hearing this, the patient exclaimed.
For the patient's reaction, Lin Feng had long expected it.
There is no resistance to cranial MRI, so strong resistance to lumbar puncture.
He then explained: "You've been in a bad mental state lately, and you have some headaches from time to time, right? "
"Cryptococcus is a fungus, although it infects your lungs, it prefers to infect the central nervous system, and you also need to rule out the possibility of craniocerebral infection, so you need to withdraw your cerebrospinal fluid through a lumbar puncture for testing to see if there is Cryptococcus."
"There is no best! If there is, then the treatment will have to be strengthened, and the recovery will be worse. "
"Now we can't make mistakes, we have to understand the situation of cryptococcus."
Lin Feng finished speaking.
The patient's wife immediately said: "You have done the lung biopsy before, but it's nothing!" Then do this too, otherwise there will be any accidents at that time, and it will be you who will toss! "
"Okay, okay! Do do it! The patient answered immediately.
He really thinks so.
The lung biopsy was done, and it didn't hurt much!
That lumbar puncture is estimated to be similar, he can withstand it!
The diagnosis was not lung cancer, and he was in a much better mood.
The patient agrees.
Lin Feng was also relieved.
Arrangements for both examinations then began.
At first, when he looked at the patient's current condition, he was indeed worried that Cryptococcus had infected the patient's brain or central nervous system.
But when the results came out, it proved that his worries were superfluous.
Everything is normal.
This is followed by prolonged fluconazole treatment.
Almost two weeks passed.
The patient's symptoms have been significantly reduced.
The coughing up of blood is also gone.
On repeat examination, the lung mass seen on chest CT also shrank.
At this time, the patient's condition is really clear.
.....
Arrange the patient's treatment.
Lin Feng returned to the consultation room.
After a while, a little girl came.
Looking at the age, it is estimated that he is not yet 20 years old, which is very young.
As soon as he walked in, he said to Lin Feng: "Doctor, I'm coming to see the doctor!" "
"Sit down first and tell me where you're uncomfortable." Lin Feng nodded, seeing this little girl covering her stomach, her brows furrowed, it should be abdominal pain.
Seeing this, Xiaoru also went to pour a glass of water for the little girl.
"Doctor, I've been having abdominal pain and diarrhea lately. I also took a lot of medicine, but it didn't work! The little girl said.
"How long has it been?" Remember what medicine you took? What kind of pain is it? Colic, tingling, labor pain? Lin Feng immediately asked.
The little girl immediately said: "It's almost two months!" All I eat are medicines for diarrhea, and some medicines for the stomach! How it hurts, I can't say, anyway, it hurts very much! "
"Does it still hurt?" Lin Feng asked.
The little girl nodded hurriedly.
Subsequently.
Lin Feng asked the little girl to lie on the bed in the consultation room, ready to examine the little girl's body and understand the source of the pain.
While checking, he asked, "You haven't had any abnormalities during your recent holiday, right?" "
First of all, it is necessary to rule out pregnancy, if it is pregnant, Lin Feng must first suspect ectopic pregnancy, which will also cause diarrhea and abdominal pain, and severe points will lead to heavy bleeding.
Lin Feng pressed the little girl's right lower abdomen and learned that it was not painful.
Then rule out the possibility of appendicitis.
There is no plate abdomen.
There was nothing unusual on examination.
Then the problem is the deeper situation.
In that case, it is necessary to look for the situation from the blood test.
Arrange for Xiaoru to draw blood for the little girl and send it for testing.
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