NovelTags Chapter 490
Chapter 490
But
Rabies is also an idea.
At this time, the patient's wife is happy that she did not have a stroke.
Lin Feng: "I want to ask, in the past few months, or in the past year, have you been bitten by a dog?" "
The wife shook her head: "No..."
Lin Feng continued to ask: "That wolf, fox, cat, leopard, lion, bat... Wait, ever been bitten? "
Rabies, not necessarily a dog bite, can also be bitten by other animals.
What Lin Feng said is possible.
The wife continued to shake her head: "There is no ..."
Lin Feng nodded.
He asked Zhang Youfu himself.
"Didn't... Yes...... Been bitten..."
When the patient says this, there is really nothing.
But
At this time, Lin Feng also noticed a characteristic of the patient:
When the patient is speaking, he tries to open his mouth, but it is difficult to open it.
"Can you open your mouth a little?"
Zhang Youfu tried desperately to open his mouth, but it was difficult to open his mouth no matter what, and then at this time saliva couldn't help but flow down the ground.
Zhang Youfu was simply angry with his 'uselessness' and cried.
"It shouldn't be rabies... Although rabies will have throat muscles and respiratory muscle spasms, it will not have difficulty opening the mouth..."
The patient was asked to do other limb and neck movements.
"His limbs were spasming, his muscles were tight, and these were not symptoms of rabies."
"So, rule out rabies..."
The live broadcast room suddenly cleared up, and rabies was no longer discussed.
"I'll give him a personal examination..."
Lin Feng felt that he should have overlooked something.
soon
Lin Feng saw the side of the patient's left foot Zhang Youfu.
There is a crust, about 2 cm long.
Lin Feng's spirit moved: "When was this injury, and how was it injured?" "
The wife said on the side: "15 days ago, I stepped on an iron nail and injured it..."
I checked my whole body again.
There were no other wounds.
Only this wound.
"Did you go to the hospital to debride and disinfect this wound?"
"No, we simply clean up and disinfect..."
"Bandaged?"
"Yes, wrapped with cotton tape..."
This Lin Feng is probably determined.
"Tetanus"!
First of all, the patient's face is exactly the same as the typical "bitter smile" of tetanus. Due to the spasm of the facial muscles, the brows are furrowed and the corners of the mouth are drawn, which looks like a wry smile.
Secondly, the origin of tetanus is Clostridium tetanus. This bacterium is foreign, because of the 'murder weapon' and sticks to the wound, in an aerobic environment, it dies quickly (anaerobic bacteria), but if bandaged, the wound lacks oxygen, and it becomes an environment for the growth of Clostridium tetani.
The scar in front of the eyes, although it has been 'healed' and scabbed, if there is still Clostridium tetani inside, it is just an anaerobic environment, multiplying in large quantities, and then using the nerves inside as a springboard, it goes straight into the spinal motor neurons and spreads throughout the body, resulting in muscle tension and spasms in many parts of the body.
According to the course of the patient's disease: first yesterday's chewing muscles were tense, the patient could not swallow, and then today's facial muscles and neck muscles were tense, and a bitter smile appeared.
All this,
The inferences fit perfectly!!
The possibility of "tetanus" suddenly increased to 90%!
"Injured to the point of scabs, didn't go to the hospital, did you?"
"No... Doctor, is there a new discovery? "
Lin Feng nodded: "At present, it is "tetanus"..."
Then Lin Feng briefly explained to the patient what tetanus is.
Live Broadcast Room:
"Huh? Tetanus? "
"I'll go, it's really possible!"
"I just read the book about tetanus yesterday, and the patient may really be 'tetanus'."
"The patient did not pay attention when he was injured, if the wound is deep, try to go to the hospital to debride and disinfect, and also fight a tetanus anti-virus..."
Other viewers who did not understand tetanus were attracted to attention.
Although Lin Feng feels that the 90% probability is tetanus.
But!
Tetanus is a disease that cannot be tested in laboratories.
Tetanus wound: The tissue in the wound can be tested by Clostridium tetani culture or polymerase chain reaction (PCR), but the positive test rate is not high, and positive can only indicate that the wound is contaminated with Clostridium tetanus, and can not confirm tetanus, and negative can not exclude the diagnosis of tetanus.
Serum tetanus IgG antibody: such as the use of in vivo neutralization test or modified enzyme-linked immunosorbent test, it is generally believed that the antibody level exceeds 0.01IU/ml when it has a protective effect on the body, and the possibility of tetanus is small, such as the use of standard enzyme-linked immunosorbent test, antibody level of at least 0.1IU/ml is defined as protective, but tetanus antibodies to a protective level can not exclude tetanus diagnosis.
And! The above examination items cannot be implemented in most hospitals in China.
So!
The significance of laboratory testing for tetanus is not much!
No need!
Waste of money!
"Let's treat it according to tetanus... But rabies is not ruled out..."
Lin Feng transferred the patient to the ICU.
Because the condition is really serious.
Then there's the treatment plan:
Give patients larger doses of sedatives, analgesics, and muscle relaxants.
High-dose immunoglobulin to neutralize tetanus toxin that has not yet bound to nerves and minimize damage. (Toxins that have been bound to nerves cannot be isolated.) ）
Treatment of wounds and restoration of aerobic environment.
The next step is to wait.
As long as 5 days have passed, the patient has not died, it is definitely not "rabies".
If Lin Feng's treatment plan for "tetanus" has an effect and the patient's condition improves, it means that it is indeed "tetanus".
......
。