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Chapter 184 Opportunistic Parasites
Toxoplasma gondii is an opportunistic parasite. The three words "opportunistic" actually sum it up very well-they usually hide in the human body, until the horn of attack sounds, they will suddenly attack, and then take the life of the host in a vicious manner.

And the horn of this attack is the decline of the human immune system.

Toxoplasma infection is actually very rare in ordinary people.They generally appear in people with AIDS.Once the general doctor confirms that the patient is infected by Toxoplasma gondii, the first reaction is to check the HIV antibody first.Like Kaposi's sarcoma, the onset of Toxoplasma gondii is basically an exclusive disease of AIDS patients.

For Yang Jianqiang, he is both lucky and unfortunate.

A bout of leukemia forced him to undergo whole-body radiation, which ended up killing all the bone marrow in his body.Without the support and supplementation of hematopoietic bone marrow, the antibodies in his body that had been continuously suppressing Toxoplasma gondii were weak. It was recorded that after the memory T cells of Toxoplasma gondii antibodies died along with the normal apoptosis process, his body lost the resistance to Toxoplasma gondii. Insect recognition ability.The donor had apparently never been exposed to Toxoplasma gondii, nor did his bone marrow have the ability to make such antibodies.Therefore, Yang Jianqiang unfortunately lost the ability to suppress Toxoplasma in his body.This is his misfortune.

But luckily, the radiation that wiped out his bone marrow also took a toll on Toxoplasma.Toxoplasma gondii is a parasite that is relatively sensitive to radiation.A dose of more than [-] rads can cause parasites to lose their ability to reproduce.And low doses of radiation also have a strong inhibitory effect on Toxoplasma gondii.This is why although Yang Jianqiang lost his immunity, he became ill a year later.

"It's like writing a novel." Liu Pingchuan frowned and shook his head after listening to Sun Lien's report in his office, "This is too coincidental."

"However, the symptoms are correct." Sun Lien was quite confident in his diagnosis.Although through PCR testing, after all the three diseases have been checked, the results you want will definitely appear.But he still hopes to persuade Liu Pingchuan first to treat Yang Jianqiang earlier.Those eight edema areas gave Sun Lien some ominous premonition.

"If it is really a toxoplasma infection, combined treatment with sulfadiazine and pyrimethamine will do, and there is no need to hurry." Liu Pingchuan's opinion tends to be conservative, and he does not intend to take risks on the Yang Jianqiang carried out specific treatment.

Sun Li'en was silent for a while, Liu Pingchuan's opinion was a mature and prudent one.But he still has some inexplicable worries.Although he himself didn't know where this worry came from.

The opinions of superior doctors take precedence over their own opinions.This is a process that every training doctor will go through.For many regular training doctors who have just entered the industry, this hurdle must be experienced-it doesn’t matter what you think, what matters is what your superior doctor thinks.

Although it sounds like this approach is a bit excessive, for the sake of the patient's life, the training doctors always have to suffer some grievances first.After all, in comparison, the possibility of making mistakes by superior doctors is much lower than that of junior trainees.

Sun Li'en left Liu Pingchuan's office, and while walking towards the consulting room, he lowered his head and wondered where his doubts came from.Respecting one's superior doctor does not mean that one does not need to think.If he doesn't clarify this concern, Sun Li'en might not be able to sleep well tonight.

"Are you coming back to work so soon?" A voice behind Sun Lien interrupted his meditation. He turned his head and found that Zhou Ce was eating a sticky hot dog bun and walking towards him.

"Ah... yes." Sun Li'en nodded, the hot dog bun in Zhou Ce's hand looked sticky, and red ketchup and yellow mustard were all spread on the bun.I really don't know what Zhou Ce did to this bread. "Doctor Zhou is here for a consultation?"

Zhou Ce shook his head, "I just finished the outpatient clinic and had lunch by the way."

Sun Li'en glanced at the time on his phone, it was 10:[-] in the afternoon, and it was time to get off work in [-] minutes. "Lunch at this hour?"

"I don't want to say that I'm a poor ghost who can't even eat lunch." Zhou Ce smiled, finished the remaining hot dog in three bites, threw the packaging bag into the trash can next to him, clapped his hands and asked, "@#￥%@#@#!@#@#%...)&(*...#￥?"

"You..." Sun Lien's brows twitched, "Why don't you swallow what's in your mouth first? I still have some when you finish eating."

Zhou Ce waved his hands, rolled his eyes and swallowed what was in his mouth, "I see that you have walked five times in this corridor, and I want to ask if you are lost."

"Where do these inexplicable judgments of yours come from?" Sun Lien wiped the cold sweat that didn't exist on his head, "By the way, I heard you say something about stealing a nurse's panties when I was quarantined last time." Something..." He suddenly thought of Zhou Ce's first problem when he was quarantined. "Is there any story here?"

Zhou Ce opened his eyes wide and asked back, "You don't know this story?"

"I don't know." Sun Lien shook his head seriously, "If I knew, I wouldn't ask you."

Zhou Ce laughed and told the story.

It is said that seven or eight years ago, when Zhou Ce had just become a general resident doctor, there was an underwear thief in the Fourth Central Hospital.The thief's technique was not very clever, and he could even be said to be a model of recklessness—he swaggered into the female nurse's dormitory that was arranged in the inpatient department at the time when there were the most people.Then, in front of a whole corridor of nurses, he pushed open the door of a nurse's dormitory.A dozen pieces of underwear were stolen from it.

As a result of such a bold and straightforward action, the underwear thief was held in the elevator by Liang Baoan and a group of brothers before he even walked out of the inpatient department.

The security department caught these criminals as soon as it started operation, and originally planned to hand over the underwear thief directly to the nearby police station to enhance the friendship between the two parties, but unexpectedly, the teacher of the college who rushed over discovered that the underwear thief turned out to be a fifth-year intern student of the college .

With the attitude of curing diseases and saving lives, after obtaining the forgiveness of the stolen nurse, the security department handed over the offending buddy to the college teacher.Let's hope this incident was just a bad joke.Hopefully, under the criticism and education of his teachers, he can realize how inappropriate his behavior is.

Unexpectedly, a week later, the security department captured this little bastard again - some patients came to the security guard, saying that there was a pervert in the women's bathroom of the outpatient clinic who was watching them go to the bathroom.

Brother Liang from the security department rushed to the toilet with a group of brothers, only to find that the prisoner was the underwear thief who was caught only a week ago.

If it's just a pervert, then arrest it.But it's the first time I've seen someone so perverted, so straightforward and unrestrained.

Brother Liang became ruthless, and was about to send this unrepentant little bastard directly to the police station.And the college teacher who picked him up before also had an ugly expression on his face. He didn't want to understand how this taciturn and extremely introverted young man in school could do such a thing.

Coincidentally, the floor where the incident happened happened to be the site of hepatobiliary surgery.Director Zhao Chongxi, the director of the Department of Hepatobiliary Surgery, finished the outpatient clinic and came out to watch the fun.After hearing what happened, he pondered for a moment, and asked the nurse to draw a tube of blood from the boy and check his liver function.

It doesn't matter after a check, the kid's blood ammonia is as high as 974μmol/L.When he was sent to the imaging department for examination, he was diagnosed with stage III liver cancer.

"At that time, he was very restless, and he was not sure what was wrong with him at the time. There may be many symptoms that simply caused the blood ammonia to rise. I was afraid it was some severe infectious disease." Zhou Ce explained, "So, At that time, Dean Song made the decision, put the young man in restraint measures, and locked him in the newly renovated clean room."

It's a... not very funny story.Sun Li'en sighed, and asked a question like other people listening to the story, "What happened next?"

"Later...there was no later." Zhou Ce shook his head and sighed, "Hepatic encephalopathy was caused by the third-stage liver cancer, and the situation of the young man's family was relatively poor. Later, after the family took him away, there was no more news." He looked at Sun Lien, "So, what are you hanging around here?"

Sun Li'en glanced at Zhou Ce, wondering if this strange doctor thought he had a problem, and then replied, "A patient was picked up in the emergency department, and the situation is rather strange." Inference and Zhou Ce said it again.

"Your diagnosis... is a bit too jumpy." Like Liu Pingchuan, Zhou Ce's first reaction was "this is really a coincidence", but then he slowly noticed the difference. "But...it makes sense."

"If it doesn't make sense, I won't try to mention this to Dean Liu." Sun Lien sighed, "But after listening to Dean Liu, I vaguely feel that something is not quite right."

Sun Lien's worries are also Zhou Ce's worries.The Department of Nephrology often interacts with the Department of Rheumatology and Immunology. In some hospitals that do not have a separate Department of Rheumatology and Immunology, the treatment and diagnosis of this part are often handed over to the Department of Nephrology.Zhou Ce, who has the corresponding professional knowledge and vision, immediately found the crux of the problem.

"If the Toxoplasma outbreak was really caused by radiotherapy, how can the progress of the disease be explained?"

Sun Lien was stunned.Zhou Ce's question is very straightforward, and it is also the weakest link in the entire diagnosis process.His theory can explain why the patient developed the disease during the immunosuppressed period without contact with cats and dogs, but it cannot explain why his symptoms progressed so quickly after the onset.

"The specific reason... I don't know." Sun Lien admitted that he knew nothing about it.As a regular training doctor, it is not shameful not to have a comprehensive grasp of these professional knowledge. "However, based on the time and sequence of his disease changes, I think it may have something to do with the adjustment of his immunosuppressive regimen."

"The new immunosuppressive regimen has a weaker ability to suppress his immune system." Zhou Ce thought for a while, then was surprised, "So the reason why he developed symptoms so quickly was not because of the increase in Toxoplasma gondii infection, but because Because of increased immunity?"

Sun Li'en stood up abruptly, "I'm going to find Dean Liu!" Before he finished speaking, he ran out in a hurry.

　Thank you for your rewards, Yuan Bao is not in a very good condition today.Received monoclonal antibody, serum, interferon, cephradine, oseltamivir and roxithromycin combination therapy.Fortunately, it did not have diarrhea today.Dehydration has been somewhat corrected.When I opened my mouth to feed the water, I found that this little thing had grown a row of beautiful little deciduous teeth.Hope it sticks around and eats itself like a piglet in a few months.

　　The good news is that my mother is out of the hospital.The degree of vascular stenosis is still within an acceptable range, so it doesn't matter if you correct your eating habits and continue to take medication.

　　
　
(End of this chapter)