"No way..." Dr. Gu pressed his temple.

Just listening to it makes you feel a headache... Does Dr. Xu face these complicated situations every day?

Shi Lian also rubbed his head: "The brain is wide and painful. But this will make progress."

She looked at it carefully for a few more times and was suddenly stunned.

The main clinical manifestation of herpes dermatitis is the body's multiple symmetrical blister rashes, and only a small number of people have gastrointestinal symptoms.

In other words, even if it is confirmed, it is enough to have a skin biopsy. What is the point of adding a small intestine biopsy?

Most herpetic dermatitis is not accompanied by gastrointestinal damage.

Even if Jiang Qiang has symptoms of diarrhea, it does not mean that intestinal biopsy can detect damage.

Unless…intestinal biopsy is not intended to diagnose herpes dermatitis at all!

"Yes, that should be the case!"

Shi Lian couldn't think of what the disease was for a while, but he realized that the teacher from home was definitely not for herpes dermatitis.

She speeded up and quickly handed over the report to Xu Qiu.

It also explains his own guess.

Xu Qiu looked up at Shi Lian and nodded, "You guessed that herpes dermatitis is not the point."

"So teacher, do you think the patient is not herpes dermatitis?"

"No, this is herpes dermatitis."

Shi Lian couldn't make a turn when she heard this.

Xu Qiu presented the report of the intestinal biopsy and said: "One of the difficulties in diagnosis of herpes dermatitis is that the cause is unknown. But the pathogenic mechanism of this patient is clear."

This sentence completely awakened Shi Lian. She immediately eliminated the disease that could induce herpes dermatitis, and thought of the patient's methhemoglobinemia...

A moment later, an unspeakable glow flashed in her eyes and she said in surprise: "Is it celiac disease?"

Xu Qiu nodded slowly.

Rash is not the focus, diarrhea is the one.

Herpetic dermatitis is not the main disease, and diarrhea is not caused by herpetic dermatitis. On the contrary, celiac disease causes diarrhea and causes herpetic dermatitis. This is the real logic of the disease!

Shi Lian felt a sudden realization: "It's just herpes dermatitis, and it's impossible to have abnormal symptoms of intestinal biopsy in the short term. But if it's celiac disease, everything can be explained!" ωωw..net

The direct manifestation of celiac disease is diarrhea, celiac diarrhea.

"No, if it is celiac disease, the patient will have to accept a gluten-free diet for the rest of his life. How about..."

As he spoke, Shi Lian suddenly became stunned and his expression became extremely shocked.

A gluten-free diet, that is, foods that do not contain gluten, such as common wheat, rye, barley and other products.

Celiac disease has another nickname, celiac enteropathy. Its attack is closely related to eating wheat flour. The patient is extremely sensitive to gluten, wheat flour, etc. Any food that can be decomposed into ethanol to gluten protein is a pathogenic factor for the disease...

Therefore, patients with celiac disease must maintain a gluten-free diet throughout their lives.

Shi Lian didn't pay attention to this at first, but after Xu Qiu woke up, she remembered that Jiang Qiang's food was not ordered in the hospital, but was brought from home by her husband...

They naturally thought this was a manifestation of the love of young couples, but they did not expect to find clues by asking more questions!

"Wait... Teacher, even if it is celiac disease, it seems that it cannot be associated with methorhemoglobinemia." Shi Lian thought about it carefully and realized something was wrong again.

From celiac disease to methoglobinosis, it has spanned several systems.

The various drugs that Xu Qiu suspected before, such as dapsone, were used in other departments, and it seems that they have nothing to do with celiac disease.

Xu Qiu said lightly: "Think about the indications of dapsone again."

Shi Lian thought, saying: "All types of leprosy, combined with trimethoprim, combined with pneumosporidium carnivorous, combined with pyrimethamine to prevent chloroquine-resistant malaria, and... "

She carefully recalled the knowledge she remembered in the pharmacology class.

Suddenly, Shi Lian was stunned and opened her mouth and said, "And...herpetic dermatitis!"

At this moment, the boring textbooks that recorded dapsone in the textbook became a living medical record, and the relationship between dapsone-herpetic dermatitis and medication was deeply engraved in Shi Lian's mind.

...

After Xu Qiu confirmed his illness, Wang Fan and others immediately started the rounds again.

The truth of this case was finally revealed.

Jiang Qiang had diarrhea before and also went to the clinic doctor to prescribe oleracycin.

It worked at first, but later the effect decreased, so Jiang Qiang privately increased the dosage.

In the end, the diarrhea was still not cured, so she went to the clinic again.

This time the doctor prescribed dapsone.

Since the medicines in the clinic were packaged in paper boxes, Jiang Qiang and her husband didn't know that they had changed the medicine this time. After taking them back, they still put them back in the bottle of tetracycline.

Because he was worried that it would not work, Jiang Qiang took the dosage of medicine according to the previously added amount.

It was fine for the first few days. Until this time, when I took over dapsone again, methhemoglobinemia finally broke out, and I started to dry out the blood oxygen to 39, almost dying halfway through...

Dapsone.

This is an infectious drug that is familiar to all clinicians and is also the main drug to fight leprosy.

But few people know that it can also be used for herpes dermatitis!

...

A few days later, Jiang Qiang was discharged from the hospital.

Her medical records have also become a teaching demonstration in the hospital, and are one of the classic cases when interns step into the medical gate.

Even Wang Fan and other experienced clinicians have ignored the rare indications of common medicines. If Xu Qiu had not insisted on figuring out the inducing factors after diagnosing methhemoglobinemia, no one would have thought of this.

Jiang Qiang is also very likely to take dapsone as oleracycin again.

However, if methhemoglobinemia is induced next time, the situation may be even more critical and may not be saved.

...

After seeing Jiang Qiang off, Xu Qiu had no time to relax his head, another emergency call came from the rescue room.

Generally speaking, Yunmei, Yang Yuen and others can handle it well. Those who can be called to Xu Qiu's office are basically acute and severe cases that Wang Ping and other directors are not safe.

"What's the situation?" Xu Qiu and Shi Lian, who were rushing from the emergency hall, were full of tears.

Shi Lian's little face was pale and said, "Teacher, a patient with acidosis, Director Wang Ping took a look and asked you to come!"

Xu Qiu felt awe-inspiring in his heart.

Wang Ping is an expert in the field of emergency respiratory disease, and he is ranked among the province. He doesn’t say whether most patients can be rescued, but he will never ask Xu Qiu at a glance...

"What's the situation?" Xu Qiu asked quickly.

Shi Lian said relaxedly: "The condition has stabilized temporarily. Director Wang Ping is checking in the emergency room and is waiting for you to go."
Chapter completed!