After a while, Zhao Sheng and Sun Li came to the ward.
As soon as he entered the ward, Zhao Sheng saw a six or seven-year-old boy lying on the bed. What was shocking was that all the exposed skin was on the boy's face, neck, chest, abdomen, hands and feet. , were covered with erythema, and the skin was eroded over large areas, and the epidermis was even loose, like pine bark about to fall off.
Bright red flesh and blood can still be seen in the already cracked skin.
Hiss~
Seeing this scene, Zhao Sheng couldn't help but take a breath of cold air.
Is this a burn or a scald?
Zhao Sheng couldn't help thinking when he saw this little boy whose skin on most of his body looked like burns.
Next to the hospital bed, a middle-aged couple stood, their faces full of anxiety and distress.
Li Mujia, at this time, was also carefully examining the little boy.
Seeing Zhao Sheng come in, Li Mujia said to Zhao Sheng with a serious face: "I have never seen such serious epidermal shedding."
"What do you say when the local hospital transfers me?"
Zhao Sheng nodded and then asked.
"The local hospital diagnosed varicella zoster infection and prescribed acyclovir and topical calamine lotion, but there was no improvement."
Li Mujia said in a very organized manner. She has always been very serious and meticulous, especially in consultation.
After receiving the patient, she contacted the attending doctor at the previous local hospital and learned about it in detail.
"okay, I get it."
Zhao Sheng nodded, indicating that he understood the situation.
"When did the child start to get bad?"
Zhao Sheng routinely asked the little boy’s mother.
Nowadays, many doctors are a little relaxed about consultation. Some doctors just give a few words to the outpatient clinic, and then ask the patient to undergo various examinations.
In fact, the causes of many diseases are hidden in consultation.
Questioning is an important means of diagnosing diseases. Through questioning, we can understand the occurrence and development of the disease, the diagnosis and treatment process, the past health status and the history of diseases. It is of extremely important significance for diagnosis and also provides a basis for the subsequent physical examination of the patient. And the arrangement of various diagnostic examinations provides the most important basic information.
"It's been a week, doctor."
The little boy's mother said quickly.
"What were the main symptoms when you first started feeling bad?"
Zhao Sheng asked again.
"One day the teacher said that Haohao had a cold and a slight fever, so we brought Haohao back from school. After that, he kept having a fever and complained that his whole body ached."
"The day after I got it back, my skin started peeling off."
The little boy’s mother replied.
"Doctor, what's wrong with Haohao? What kind of strange disease is this?"
After a pause, the little boy’s mother, Haohao’s mother, asked Zhao Sheng anxiously.
He is a good child, but I don’t know what happened. As soon as he was brought back from school, he started to shed his skin like a pine tree. They say that a tree cannot survive without its bark. If this person lost all his skin, he would definitely not be able to survive. .
"What kind of medicine have you given to your child before? Or did you accidentally touch something?"
Zhao Sheng thought for a while and asked.
Such severe skin loosening and shedding can generally only be seen in severe burns or scalds.
"I just took some cold and fever-reducing medicine."
The little boy's mother thought for a moment and said.
It’s impossible for a child to become like this just because he took some cold medicine!
"Which one is it specifically?"
Zhao Sheng then asked.
"It's the antipyretic medicine prescribed by the drugstore, the red water kind, the kind that tastes a bit sweet."
The little boy's mother thought about it carefully and then said.
"Ibuprofen suspension?"
Zhao Sheng asked.
"Well, this is it!"
"Doctor, we used to give this medicine to Haohao when he had a fever!"
The little boy's mother said very puzzled.
"Has the child been allergic to any medicines before?"
Zhao Sheng asked again.
Zhao Sheng felt reassured when he heard that the little boy had taken ibuprofen suspension, an antipyretic and analgesic drug.
"No, I haven't found any drug allergies."
The little boy’s mother said.
"This is exfoliative dermatitis caused by drug allergy, also called toxic epidermal necrolysis."
Zhao Sheng gave a clear diagnosis.
There is a clear history of taking antipyretic and analgesic drugs. After taking the drugs, oral mucosa, skin erythema, epidermolysis, and erosion appear. This can basically be diagnosed as severe drug eruption - toxic epidermal necrolysis (TEN).
This is a very rare disease. Normally, it only occurs in adults. It is still rare to occur in children as young as seven years old. No wonder the doctors at the local hospital did not think of it.
"allergy?"
"Doctor, what should we do now?"
The little boy's mother asked anxiously.
"The child's epidermal dislysis is very severe now, and it must be controlled immediately. After the dangerous period is over, we will see the subsequent skin recovery. If necessary, skin grafting will be needed."
Zhao Sheng thought for a while and said.
"Okay, okay, doctor, please!"
The little boy's mother was relieved when she heard Zhao Sheng's affirmative answer. As a parent, what worries you most is that your child is so sick and you don't even know what the disease is.
"Dr. Li, pay attention to maintaining the patient's water and electrolyte balance at all times, infusing immune globulin intravenously, applying a protective agent to the skin lesions, and applying cyclosporine first."
Zhao Sheng quickly formulated the current treatment plan and said to Li Mujia.
"good!"
Li Mujia nodded. At this time, she looked at Zhao Sheng with eyes full of admiration.
To be honest, exfoliative dermatitis caused by severe drug allergy is actually written in textbooks.
But it is different from being able to diagnose it in textbooks and seeing patients in reality.
As soon as Zhao Sheng saw this child, he was able to diagnose the child with the extremely rare toxic epidermal necrolysis in such a short period of time. This shows that the knowledge base in Zhao Sheng's mind, whether it is width or breadth, They are far superior to ordinary doctors.
Working with Zhao Sheng, Li Mujia felt very at ease, as if he had a solid backing.
In the past, Li Mujia thought that the gap between her and Zhao Sheng's levels was not very big, but now it seems that Zhao Sheng has unknowingly become the goal that Li Mujia needs to catch up with throughout his life.
Of course, this virtuous cycle is actually a good thing.
Just when Li Mujia breathed a sigh of relief and was about to give the little boy medical advice and then observe the condition, the head nurse Zhou Hong hurried in and said to Zhao Sheng: "Director Zhao, there has been a poisoning incident of many people, and the ambulance is already on the way. On the way!"
"Many people were poisoned?!"
When Zhao Sheng heard this, his scalp immediately went numb.
The last time we dealt with such a multi-person poisoning incident, it was the warrior who dared to use Caowu Wu to make wine. That time, four people were poisoned. If they hadn't arrived in time and diagnosed Caowu poisoning at the first time, who The session was a little slow, and the four people who drank Caowu Brewing Wine might all be dead.
Now that there's another acute multi-person poisoning incident, I'm afraid I won't have to sleep tonight.
(End of chapter)
