radicalducati Chapter 725
Chapter 725
A call was received.
The patient's parents immediately became nervous.
Rushed to the hospital.
After listening to Lin Feng talk about his son's condition, he agreed to Lin Feng's arrangement without hesitation.
Hospitalized first, followed by ultrasound-guided cervical mass biopsy.
Soon.
The patient's hospitalized surgery was arranged.
Subsequently, B-ultrasound guided descending neck mass puncture biopsy was arranged, because the lump on the neck was so bulging that the color ultrasound could not be seen clearly, so the puncture biopsy was performed directly.
Antibiotics are given at the same time.
Two days later, the results of the puncture test came in.
'I saw more neutrophils and less powerful lymphocytes in the extracted tissue, but no cancer cells.
'Cancer can be ruled out directly.
The patient and his parents breathed a sigh of relief.
According to the results, the patient is an inflammation, but this inflammation should be cellulitis.
This is a purulent infection caused by bacteria, and the inflammation spreads around.
It's also a strange inflammation because antibiotics and prednisone turned out to be ineffective.
Prednisone is the most commonly used oral hormone drug, there is almost no inflammation that it can not suppress, many autoimmune disease patients have strong inflammation, you can use prednisone to suppress the inflammation.
As things stand now, prednisone is definitely going to stop.
Since it is not thyroiditis, but an ordinary bacterial infection is more likely, it makes no sense to use prednisone.
However, antibiotics still have to be used, but the previous antibiotics cannot be used, and they have to be changed.
And considering that Wu is infected in the skin of the neck, the infection near the skin is generally gram-positive coccus-based, the disease is mild, levofloxacin has no effect, maybe this pathogenic bacteria is more powerful, and may still be a drug-resistant bacteria, thinking of this, Lin Feng decided to use almost the highest level of antibiotics.
Vancomycin.
Vancomycin, which is still the main drug against gram-positive cocci, is extremely powerful, and there is almost no positive coccal infection that it cannot suppress.
A small infection of the neck, directly used vancomycin, seems to be a little too strong, but then again, the patient's symptoms are so obvious, ordinary antibiotics are not effective, at this time not vancomycin, so what to use?
Actually, it makes sense.
And as soon as vancomycin is taken, the infection is indeed under control.
Push it the other way around, indicating that he didn't use the wrong medicine.
I thought it was over.
Unexpectedly, 3 days later, the patient's neck swelling and pain recurred.
And it's just as powerful as the first attack, if not even more so.
This time, I found Lin Feng directly here.
This made Lin Feng even more confused, if it is just ordinary cellulitis, it will generally not recur.
But now the patient is indeed the left side of the neck skin is very red and swollen, the skin temperature is high, the tenderness is obvious, this is an inflammation.
And the patient swallows very painfully, not to mention eating, even swallowing saliva is uncomfortable.
After doing a neck ultrasound again, the thyroid gland still did not see obvious abnormalities, and the left cervical lymph node was swollen.
And it was found that there was a mixed echo mass under the left neck, similar to when it was first discovered.
Now I don't understand what this lump is!
The last puncture did not see cancer cells, only ordinary inflammatory cells, is it just an ordinary inflammation?
The point is, why does this area repeatedly become inflamed?
Is there anything tricky?
Can a knife solve the problem!
After pondering for a moment, Lin Feng said: "Let's go for a CT first!
The patient's neck hurts terribly, and now it is difficult to even turn his head, and he screams in trouble.
Of course.
Neck CT was done anyway.
The results are also out.
It suggests a mass on the medial side of the left neck sternocleidomastoid muscle, involving adjacent soft tissues and left lobes of the thyroid gland, and multiple equal earth lymph nodes around the left carotid artery.
"Teacher, shouldn't the patient be tuberculosis, such as cervical lymph node tuberculosis?" Xiao Ru leaned over to Lin Feng's side and asked in a low voice.
Lin Feng shook his head.
Not like!
At least it is not a typical combination, although Mycobacterium tuberculosis can also cause repeated inflammation, but generally not so obvious redness, swelling and heat pain, so obvious redness and swelling heat pain is basically caused by ordinary purulent bacteria, not Mycobacterium tuberculosis.
Moreover, if the patient is cervical lymph node tuberculosis, most patients will have pulmonary tuberculosis at the same time, after all, tuberculosis bacillus is not fixed, it will spread, at the beginning most of them are tuberculosis, because the patient inhales Mycobacterium tuberculosis through the respiratory tract, resulting in tuberculosis, and after the combination of bacillus settles, it begins to spread like the periphery, and there will be cervical lymph node tuberculosis!
And the patient has no obvious cough, sputum, chest pain, hemoptysis and other pulmonary tuberculosis manifestations.
Then, Lin Feng said softly: "It's hard to say, go for a chest CT at a glance!"
Soon.
Chest CT results are in.
The lungs are clean, there are no lesions, and naturally there is no tuberculosis.
Lymph node tuberculosis is almost impossible.
And the last puncture test did not show signs of similar tuberculosis.
It's still a common infection.
Because the blood white blood cell count seen on the frontal laboratory is significantly elevated, 17.2x10E9/L (normal 3-10x10E9/L), in which neutrophils are significantly elevated, neutrophils are known to specialize in common bacteria.
Moreover, the patient is relatively young, before and after 2 times neck redness, swelling, hot pain, lymph node swelling, fever, everyone is afraid of whether there will be AIDS and the like, but the patient repeatedly said, there is no unclean sexual behavior, no blood transfusion, no drug use, it is impossible to contract AIDS!
Of course, it is also necessary to rule out whether the patient deliberately concealed something.
Lin Feng still checked his immunization of four items, including HIV antibodies, and the results were all negative, and the patient did not have AIDS.
Nothing!
Then let's start with anti-infection treatment!
This time, ceftriaxone + azithromycin was used, which can almost cover common bacterial pathogens. Vancomycin is not used for the time being, and it really cannot be used casually.
Originally, this combination of antibiotics should be able to control inflammation.
But what everyone did not expect was that the patient still had fever every day during the hospitalization, the highest fever reached 40 °C, and the redness, swelling, heat and pain were not relieved at all.
At this moment, the patient's parents were already impatient, and asked Lin Feng: "Doctor, is this medicine effective?