I can see the status bar

Chapter 641 Sudden Positivity

In order to treat Kobayashi Kaoru, the doctors on Daishan Island specially organized a multidisciplinary consultation.In addition, doctors from the Bolivian medical team who just arrived on the hospital ship were invited to participate in the consultation.

For things like consultation, the higher the level of participating doctors and the more departments they consult, the easier it is to get a result closer to the truth.

The reason why Kobayashi Kaoru was able to obtain such a multidisciplinary consultation on the morning of the second day of admission was thanks to the medical history materials sent by Sun Lien-the patient had received imipenem injection treatment.

The reason why imipenem is a restricted-use antibiotic is not only because of its high price, but more importantly, its significant effect.

Not too many bacteria are not sensitive to imipenem.In addition to intestinal bacteria, there are occasional reports of several drug-resistant bacteria such as Pseudomonas aeruginosa and Proteus mirabilis.

During the consultation, the main focus of discussion among the doctors was "whether a single use of imipenem can be identified as drug resistance" and they were arguing endlessly.Generally speaking, the clinical judgment of drug resistance mainly relies on drug sensitivity tests and the experience of doctors.

Drug susceptibility testing is the gold standard for judging whether a patient's infected bacteria are resistant to drugs, but its initiation requires doctors to collect the pathogens that cause the patient's illness and pass corresponding inspection equipment.For patients like Kaoru Kobayashi, the only person who can judge drug resistance is the experience of doctors.

However, the doctors present here have huge differences on whether the pathogen infected by Kaoru Kobayashi is resistant to carbapenem antibiotics.

"Even if imipenem is used for sensitive bacteria, there are still a lot of cases where the patient's condition does not improve in a short period of time." The director of the infection department of the Daishan Island patted the table at Liu Tangchun who was sitting opposite him, " When giving antibiotics to a patient, it must be given in sufficient quantities and in sufficient duration to determine whether they are resistant to the drugs!"

"The patient changed from a healthy person to a patient with persistent high fever and a little unconsciousness after only five days of illness!" Liu Tangchun was not afraid of such things as quarreling. "It's enough, you're dogmatic! Let me ask you, it's enough, but what if the person before Zucheng died? Can you still carry the person out of the morgue and give him two days of antibiotics?!"

"The drug resistance can't be judged by the result of one medication!" The director of internal medicine and Liu Tangchun stared at Blowing Beard, "Five days is from the onset of symptoms to the serious progress of symptoms. If imipenem is useful, it is only because of his physical condition. What should I do if the progress of recovery has not been shown? You change an antibiotic every day to see if the patient died of liver and kidney failure first, or was killed by this unknown pathogen first?"

Sun Li'en sat shivering in the corner of the conference room. Usually, he had the impression that the General Clinic of the Fourth Hospital was not in such a style.At least the doctors in the fourth hospital would not slam the table in front of them when discussing it, and at the same time, they would not launch... personal attacks on another doctor.

Could it be that because of being in the military hospital, even the doctors have a smell of gunpowder?
"Don't mention any great achievements to me! You are empiricism!" Liu Tangchun tried to use Sun Lien's diagnostic talent to explain things, but he was pushed back directly by the director of internal medicine opposite him, "We are modern medicine. Do you understand medicine? Evidence-based medicine! If you insist that patients are resistant to carbapenems, show the evidence! Show the test results!"

Liu Tangchun threw the pen on the table in front of him, "Damn it, if it weren't for the backward equipment on your ship, I would still waste my mouth on you here?!"

The quarrel between the two big brothers became more and more angry, and the other doctors either held back their laughter and waited to see the two 120-year-old old men fight together, or they didn't dare to make a sound at all.Only Doctor Qian Yihong coughed, tapped the table lightly and said, "I said, two old comrades. We are discussing the patient's condition, not preparing a ring for you two to fight."

Only then did Liu Tangchun and the director of the internal medicine department change from being tense to glaring.However, the two of them seemed to be eager to try—after the other party said something wrong, they jumped up and sprayed each other's bodies.

"What's going on, Director Liu?" Hu Chunbo sat beside Sun Lien, and asked Sun Lien the inside story in a low voice, "What's the grudge between him and Director Huang?"

"Where do I go..." Sun Lien shook his head, logically speaking, after Liu Tangchun retired from the army, he went directly to Ningyuan Medical College to study.After graduation, he basically stayed in Ningyuan to practice medicine, and he had nothing to do with Yuanhai Hospital in Shanghai.It is even more impossible to have any personal grievances with the director of internal medicine at Yuanhai Hospital.

"It can't be because the army and the navy don't see each other right?" Hu Chunbo was still muttering, "I never heard that there is such a contradiction among us..."

"Don't make wild guesses, you old man." Sun Lien sighed, "Maybe it's just that you simply disagree with the other party's diagnosis?"

The consultation was carried out in a tense atmosphere.In order to prevent the two old men from suddenly jumping out and deciding to fight each other, the other doctors speeded up their discussions and quickly reached a consensus.

Sun Li'en looked at Consensus, and almost followed Liu Tangchun's example, jumping on the table and cursing.

The consultation opinion is, "Tuberculosis cannot be ruled out by perfecting the examination."

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"Combine tuberculosis, get your mother's tuberculosis!" Sun Lien complained to Dr. Jiang angrily, "What's the matter? Just because he coughed twice, you have to suspect tuberculosis?"

"He still has moderate anemia." Everyone is an internal medicine doctor. Of course, Dr. Jiang knew what Sun Lien was annoyed about.However, in front of Sun Li'en, Dr. Jiang still wanted to maintain the image of his team. "The urinalysis showed that he had proteinuria, but it was less than 24 hours after he was admitted to the hospital, and the statistics are not yet available."

Sun Li'en rolled his eyes and protested against Dr. Jiang's sudden change of subject.Then he asked, "What antibiotic is he on now?"

"Temporary stop." Dr. Jiang signaled Sun Lien not to get excited, "I asked the laboratory department to draw blood for tuberculosis antibody test. We will wait for the results to come out."

"You...don't really think it's tuberculosis, do you?" Sun Lien had no energy to confront Dr. Jiang, and he even wondered if he really made a mistake.Tuberculosis is variable and indeed insensitive to carbapenems.

"I'm not stupid." Dr. Jiang looked at Sun Li'en with the expression of looking at a fool, "Isn't this just to save face for the directors? When the antibody test report comes out and it is negative, you can continue to consider other options. Orientation?"

"Doctor Jiang, the test you want has been found." A nurse hurried in from the outside and handed the report to Dr. Jiang, "Do you want to isolate the patient now?"

"Why isolate him?" Dr. Jiang shook his head, and turned over the report, "Look, I said it was definitely not tuberculosis. It's written all over here, tuberculosis antibody positive...positive?!"

Sun Li'en poked his head over, looked at the examination report in Dr. Jiang's hand, and fell into a shocked silence with him.

Kobayashi Kaoru's test result is very clear - tuberculosis antibody (+), that is, antibody positive.

(End of this chapter)