This is a high school girl, 17 years old, for unknown reasons suddenly appeared fever, fatigue symptoms, at first the family suspected that it was a cold, but after buying cold medicine for her to take, found that the effect was not very good, the fever has not come down.
The family complained that Lili's highest body temperature could reach 39.0 °C, and it did not go away for several days, and the family was very puzzled.
In order to completely suppress the fever, Lili's father took the risk of adding a cold and fever medicine to her, hoping to exert a more powerful effect and not disturb Lili's Xi, however, even with the medicine, Lili's fever could not be completely alleviated, and her spirit was getting worse and worse.
In the evening, Lili directly had a jet of vomiting, which was also accompanied by yellow bile vomit, after vomiting, Lili's face was pale and abnormal, at this time the family understood that Lili was not an ordinary cold and fever, and immediately sent Lili to the hospital for treatment.
After the doctor learned all about the department in the emergency department, he said to his family: "If your child has a fever, don't use fever-reducing medicine casually, especially not use more than one, it is easy to have an accident." Immediately afterwards, the doctor observed the girl's condition: high fever that did not go away, severe vomiting.
The doctor immediately examined Lili's body, checked her skin and sclera, there was no jaundice, and the problem of acute hepatobiliary disease could be ruled out, and then the doctor asked Lili how her recent menstruation was, and Lili replied very tiredly: "Menstruation is normal, just ended", in fact, the doctor is considering gynecological diseases, after all, a young girl with sudden vomiting and fever needs to be vigilant against gynecological problems, such as ectopic pregnancy.
Now it is also possible to discharge gynecological diseases.
Doctors immediately took her temperature and found that the temperature under her armpit was close to 40°C, which seemed to be a dangerous infectious disease.
Lili's mental state is getting worse and worse, and the doctor can only explain to Lili's father that if it is a normal cold, it will generally not cause a high fever of about 40 °C, unless there is pneumonia, so the doctor recommends hospitalization.
Lili's father's expression was cloudy: "The child still has to learn to Xi."
"Stop, stop, here, it's to treat the child, not to talk about the Xi, do you want the child's life or learn Xi?" The doctor was impatient.
Lili's father had nothing to say.
In order to make a faster diagnosis, the doctor gave Lili a blood routine, urine routine, etc., and the blood routine examination found that Lili's white blood cell count was very high, and the infection must exist. The doctor immediately ordered a chest X-ray and blood gas analysis.
After a period of time, the examination results showed that Lili's lungs did have signs of infection, but it was not particularly typical pneumonia, and the blood gas analysis showed that Lili's oxygenation index was relatively low, which proved that Lili's respiratory function was impaired.
Just as the doctor was about to invite the respiratory medicine department to take a look, Lili's father walked into the office and said to the doctor: "Doctor, something is wrong, my daughter just ran into the toilet and didn't know who to talk to, she said a bunch of nonsense, and said that she was going to die, what's the matter?"
Hearing this, the doctor was also surprised, and immediately rushed to the ward to talk to Lili, and the doctor found that her mental state was much worse, and many questions were answered randomly, it seems that the patient has a mental problem, is it a high fever?
The doctor immediately ordered a CT scan to rule out encephalitis or meningitis immediately.
The doctor examined Lili again, and then said, "Her neck is hard, and meningeal irritation may be positive." ”
Under the command of the doctor, everyone put on an ECG monitor for Lili.
The CT scan was still very smooth, but Lili always cried and laughed for no reason, which made everyone feel a chill down the spine, and not long after, the CT results came out, Lili's thalamus and basal nucleus had some low-density lesions, but it was not clear what the problem was, so the doctor found a radiologist and asked him to help see, and the radiologist said that it was best to do MRI examination in this case.
The doctor said, "She's in terrible condition. MRI may not be done, and the patient may vomit and choke in the machine."
The radiologist was also out of her way, and at this time, Lili's mental state deteriorated further, and her limbs began to twitch uncontrollably for some reason, and her face was constantly twitching, and some white foam flowed out.
This frightened everyone present, and the doctor immediately tried to resuscitate him, but fortunately, the convulsions did not last long, but immediately Lili's face showed a look of extreme pain.
At the same time, Lili's father suddenly remembered something: "By the way, doctor, my daughter seems to have been bitten by a dog, is this rabies, isn't that dead"?
Meningeal irritation, muscle twitches······ , the doctor secretly scolded in his heart: "Damn, such an important thing is only said now".
If it is really rabies, there is no need to rescue, once the attack is certain death, the doctor immediately transferred Lili to the ICU, and reminded them to quickly draw the patient's cerebrospinal fluid for testing, to see if there is really rabies virus.
On the way to be sent for an examination, Lili's vital signs have been dropping, her blood oxygen saturation is only about 90%, and she has begun to lose consciousness.
Fortunately, the laboratory department gave a force, and the cerebrospinal fluid results came out quickly, and the rabies virus was not found, but another thing was found, and the antibody IgM against the Japanese encephalitis virus was positive!
It's really another village, and the patient is not rabies, but Japanese encephalitis!
The doctors breathed a sigh of relief, but immediately became nervous, this is a serious infectious disease! We must do a good job of adequate protection, this mode of transmission of JE is mainly transmitted by mosquito bites, it seems that she is indeed unlucky, and she has come into contact with mosquitoes carrying the virus.
After finding the cause, the treatment was much simpler, and Lili stayed in the ICU for 7 days and finally controlled Japanese encephalitis.
Japanese encephalitis is a viral encephalitis caused by the Japanese encephalitis virus, which is mainly transmitted by mosquito bites and is a mosquito-borne viral infection.
Japanese encephalitis is common in Asia, especially in rural areas. Symptoms usually appear within 5 to 15 days of infection and include fever, headache, vomiting, impaired consciousness, convulsions, and paralysis.
Currently, the most effective prevention and control measure against Japanese encephalitis is vaccination. In endemic or high-risk areas, Japanese encephalitis vaccination in children is recommended. In addition, protection against mosquito bites, such as the use of mosquito nets, mosquito coils and insect repellent, should also be noted.
How are Japanese encephalitis and rabies similar?
Similarities
First, pathogen transmission.
Japanese encephalitis and rabies are both diseases caused by viruses, and both are transmitted through animal-related routes. Japanese encephalitis is mainly transmitted through mosquito bites, while rabies is spread through bites from dogs, cats, or other mammals.
Second, the timing of the onset of symptoms.
Symptoms of Japanese encephalitis and rabies usually appear some time after infection. The incubation period for Japanese encephalitis ranges from 5 to 15 days, and for rabies, it can range from a few weeks to several months.
Differences
1. Type of pathogen.
Japanese encephalitis is caused by the Japanese encephalitis virus, whereas rabies is caused by the rabies virus. These two viruses belong to different viral families and have different genomic and biological properties.
2. Symptoms and clinical manifestations:
Japanese encephalitis and rabies also differ markedly in symptoms and clinical manifestations. Japanese encephalitis is characterized by neurological symptoms such as fever, headache, vomiting, impaired consciousness, convulsions, and paralysis.
Rabies, on the other hand, causes symptoms such as anxiety, fear, muscle cramps, difficulty swallowing, mania, and dementia.
3. Preventive and curative measures.
Prevention and treatment of Japanese encephalitis and rabies also differ. Japanese encephalitis can be effectively prevented by vaccination, whereas rabies requires prompt wound management, vaccination, and immunoglobulin therapy.
In short, the diagnosis and treatment of this disease is more complicated, everything is based on evidence, and all previous speculations may be overturned without evidence, which is also one of the charms of medicine.
#文章首发挑战赛#