I can see the status bar

Chapter 515 Self-blame
This is a tick, and it is a tick that has already eaten and swelled dozens or hundreds of times in size.

It took Sun Li'en less than a second to recognize the identity of this thing.In the next second, he and Dr. Dong Xin diagnosed Todd's disease type in unison, "Lyme disease!"

Lyme disease is an infectious disease caused by Borrelia burgdorferi transmitted by ticks.Nervous system damage is its main clinical manifestation, while encephalitis and meningitis are its most important nervous system damage performance.It got its name because it was first discovered in Old Lyme, USA in 1975.my country's first discovery of such diseases was in 1986 in the forest area of ​​Heilongjiang Province.Due to the relatively small number of cases of tick bites found in the city, for a long time, Lyme disease and other related tick-borne diseases were actually regarded as special occupational diseases that forestry workers only faced.

Since ticks are often active in late spring to summer, Lyme disease often occurs in summer and early fall.But not everyone is able to find out that they have been bitten by a tick - nearly 50% of people diagnosed with Lyme disease cannot recall being bitten by a tick.Therefore, the diagnosis of Lyme disease mainly depends on its unique symptoms - chronic migratory erythema of the skin.

Skin lesions are a common first symptom, and some of these red macules or papules will expand into ring-shaped lesions among ethnic groups.It is occasionally mistaken for syphilis because of its resemblance to the horseshoe-shaped lesions caused by syphilis.Even searching on some search engines now, you can see questions like "Is Lyme disease actually syphilis?"

But disease is so difficult to diagnose precisely because of this wonderful misunderstanding.The standard treatment for Lyme disease is penicillin, which also happens to be the standard treatment for syphilis.Borrelia burgdorferi, which causes Lyme disease, and Treponema pallidum, which causes syphilis, are biological pathogens intermediate between bacteria (lower organisms) and protozoa (higher organisms).This will indeed lead to deep-rooted misunderstandings among many people who have little knowledge of medical knowledge.

However, Lyme disease progresses more quickly than syphilis, and its symptoms are also uncertain.As with documented recall of tick bites, not all patients present and find this chronic migratory erythema.Todd was apparently not found to have this symptom.This may be because he didn't pay attention to it himself, or it may be that Dr. Pascal regarded it as some kind of allergic reaction that was not very serious, or it may not even have occurred at all.

In short, Lyme disease manifested itself as meningitis in Todd, and the meningitis came with a vengeance.

Thinking of this, Sun Lien frowned suddenly.

"It may also be forest encephalitis." Since tick-borne diseases are thought of, forest encephalitis should also be placed on the same important angle for differential diagnosis.Dr. Dong Xin fully demonstrated the characteristics of being a fan. Before Sun Lien asked a question, he first raised his doubts, "His temperature is not very high, but it may be because..." He pointed to Todd Wet marks on the body, "caused by this cooling measure."

In fact, Sun Lien did not have any doubts about the diagnosis of Lyme disease. He believed that Todd suffered from Lyme disease instead of forest encephalitis for two reasons.

First of all, there is a symptom prompt of facial peripheral neuritis on the status bar.And this tip just became the most direct difference between Lyme disease and forest encephalitis.Although the arbovirus B encephalitis virus that causes forest encephalitis is a neurotropic virus, it has rarely been documented to attack the nervous system other than the central nervous system.Facial nerve palsy is a rare complication of forest encephalitis, and generally occurs in the late or even terminal stage of forest encephalitis.

Secondly, forest encephalitis has a relatively obvious first symptom, and patients will have obvious upper limb (especially neck) muscle weakness.When Sun Li'en saw Todd, he was holding his head tightly, writhing in pain on the hospital bed.If it was forest encephalitis, he shouldn't have twisted so... hard.

However, the second reason can still be put on the table, and the first reason owes a lot of credibility.Sun Li'en thought about it, and first explained the reason with what he saw with his own eyes.Then he continued to struggle - is it necessary to continue performing this ventriculocentesis when Lyme disease can be diagnosed?

"Okay, go ahead and finish shaving your hair. I'll get that tick later." The excellent actor Dr. Dong Xin waved his hand and asked Sun Lien to continue working. "High intracranial pressure leads to symptoms of brain herniation. This is not something that you can overcome with some antibiotics in your internal medicine department. This cranial valve should be removed."

Sun Li'en looked at Todd with some sympathy, and suddenly asked, "What are you going to do after that? Just use titanium mesh to make up for it?"

"It will definitely not work in a short period of time." Dr. Dong Xin stretched out his arms, "Children's skulls will grow slowly. The titanium mesh will not grow bigger with the development of the skull. The most common way is to wait for him. It will be added later with a titanium mesh."

That is to say, after that, Todd not only had to face the serious consequences of having his hair completely shaved, but also maintained the cruel status quo of missing a piece of his head throughout his adolescence.Sun Li'en felt a little uncomfortable when he thought of this, he was only nine years old.

A nine-year-old boy suddenly encountered such a huge change.He was devastated both physically and psychologically.What can we do in the days to come?
Although Sun Li'en himself understood that if this operation was not performed, Todd probably would not have any "future" to speak of in the future.But he still hesitated, a little... couldn't bear it.

The psychological hesitation and intolerance did not disappear, but Sun Lien's subordinates still moved very quickly.Three strokes, five strokes and two strokes, all the hair on Todd's head fell off.He ran the clipper back and forth a few more times, making sure every strand was cut to the shortest length possible.Try to keep these hairs from negatively affecting the procedure.Then he handed the clipper to the equipment nurse at the side, and quickly turned around and walked out of the operating room.

Just like Xu Yourong couldn't perform the operation himself, Sun Lien also couldn't watch the head of a child he knew very well in the operating room - this has nothing to do with professional quality, it's purely human A matter of habit.

After leaving the operating room, Sun Li'en took off his surgical gown in silence, and then saw Dr. Pascal sitting on a bench without saying a word in the lounge beside him.

Dr. Pascal obviously also saw Sun Lien, but he only moved his body slightly, and then returned to his previous appearance.

"Todd is in the operating room. His cranial pressure is too high, and a bone flap needs to be removed to relieve the pressure." Sun Lien sighed in his heart, but decided to speak directly, "We found a tick on his head, Probably Lyme disease."

Dr. Pascal froze for a moment, then opened his eyes wide.Then, he held his head with trembling hands.

"I shouldn't have prevented the property management staff from spraying insect repellent in the yard." His regretful voice came out through the gap between his hands, and there was a strong self-blame that couldn't be resolved, "Why did I just do this? Stupid?"

(End of this chapter)