The Enhanced Doctor-Chapter 595: President Liu has found .

(Thanks to reader 20201019093109986350244 for the monthly ticket encouragement)

"Chao, things are a bit screwed up. It looks like you’ll be fighting alone this afternoon. The patient from last night still hasn’t tested positive," Liu Banxia said during lunch the next day.

Wang Chao gave a bitter smile and nodded. "I’ve already enlisted Miao Rui and Li Hao; it’s not appropriate to mislead other interns. Actually, I want to participate in this patient’s consultation. It’s a rare case."

Liu Banxia gave him a helpless look. "Shall we trade places then?"

"I don’t have a tendency for self-torture. Participating to learn is fine, but for me to manage this? No thanks." Wang Chao shook his head vigorously.

The patient had been sent to the ICU this morning after experiencing another bout of fever. This time, the temperature was climbing toward 39 degrees Celsius. This meant that whatever bacterial infection was causing the vasculitis in this patient had not yet been controlled. This certainly wasn’t a good sign, but for Liu Banxia and his team at the moment, there wasn’t any other option. Without a positive culture result, they couldn’t prescribe medication haphazardly. Broad-spectrum antibiotics clearly had no effect; using them now wouldn’t result in any improvement.

"Anyway, I’ve made up my mind. Once the director is done with his duties, I’ll join him for the consultation. If things get too dire, I’m really at a loss," Liu Banxia said.

"Ah... chances are slim, right? The director also has to wait for the culture result, doesn’t he?" Xu Hui replied.

"You’re supposed to be resting. Why aren’t you heading home to sleep? You’re just hanging around the break room. Your wife is going to blame me when she sees me again," Liu Banxia said.

"What else can I do? I’m also very interested in this case. And I have a premonition: if we still don’t have a positive culture result by tonight, we might lose the optimal treatment window," Xu Hui said. "The patient’s inflammatory response has progressed quickly, but it hasn’t reached sepsis yet. This bacterium is very peculiar; it doesn’t seem like one of those so-called superbugs."

"That’s exactly what’s troubling. If anyone could shorten the culture time for the instruments, I’d treat them to pig’s trotters," Liu Banxia muttered.

He was really anxious, but bacterial cultures simply required time.

Normally, over 80% of positive results would be reported within 48 hours. It hadn’t even been twenty-four hours yet, so they had to wait.

But Liu Banxia and Xu Hui had a similar feeling: this strain of bacteria was very peculiar. They could afford to wait, but they feared the patient could not.

Otherwise, Liu Banxia wouldn’t have transferred him directly to the ICU. The situation could no longer be managed by mere observation in the ward. In case something happened, the patient could receive emergency treatment in the ICU, which was equipped with more devices and could provide greater support.

After lunch, Liu Banxia arranged for someone to keep an eye out and waited for Zhou Shuwen’s surgery to end. Wang Chao glanced at him sympathetically, then left with Miao Rui and Li Hao to attend to his own very important patient. That patient was currently only being controlled with medication, with all hopes pinned on a fecal transplant. Selecting a high-quality donor was the most critical task Wang Chao could undertake at the moment. What’s next? To put it bluntly, it was up to fate. Even in Western countries, where institutions had extensive experience with fecal transplants, the subsequent events were often left to their equivalent of ’God.’ This was because the sheer number of microbial species in the intestines was overwhelming, and current technology couldn’t yet determine which specific bacterium, or combination thereof, would be effective.

"Oh, Boss is back? Hurry and change your clothes so you can cover for me later," Liu Banxia said, quickly running over to Shi Lei as he walked in from outside.

"Why didn’t you go out with Wang Chao?" Shi Lei asked.

"It’s that patient of mine from yesterday. He didn’t improve at all this morning, so I’m waiting for the director for a consultation. How did your blind date go? It went well, right?" Liu Banxia asked.

"Um... I think it was alright. Anyway, we added each other on WeChat. We didn’t go to any of the restaurants you and Qiaoqiao recommended for lunch, just had a normal Chinese meal. It didn’t cost much," Shi Lei said, a bit shyly.

"That’s great then! Keep it up! Go get changed quickly and be ready to cover for me anytime," Liu Banxia said, giving him a firm pat on the shoulder.

He was genuinely happy for Shi Lei; it seemed this major, long-standing problem of his was finally about to be resolved. But his own difficult-to-diagnose patient was truly a headache.

After waiting nearly another half hour, around 1:00 p.m., Liu Banxia finally saw Zhou Shuwen.

"Director, are you tired?" Liu Banxia hurried over to ask.

"What are you up to now? Why didn’t you go out with Wang Chao?" Zhou Shuwen asked.

"We’ve encountered an extremely complicated case. If you’re not too tired, could you help us with a consultation? I’ve already asked Huang Bo to get your lunch, and I specifically requested a bowl of hot and sour soup," Liu Banxia said.

Zhou Shuwen looked at him helplessly. "You’ve already arranged everything, so why are you still asking me? Let’s just go straight to the meeting room."

Only Liu Banxia would dare to make such arrangements on Zhou Shuwen’s behalf. Besides, the surgery Director Zhou had just finished today was quite exhausting.

Once they arrived at the meeting room, Liu Banxia gathered everyone else. Zhou Shuwen ate his meal while listening to Liu Banxia explain the situation.

"The patient’s condition is indeed somewhat unusual. My judgment is similar to yours: it’s likely a type of bacterial infection causing vascular inflammation," Zhou Shuwen said after listening. "It’s precisely because of this inflammation that the patient has suffered multiple infarctions in such a short period. The current lesions are in the lungs and head, correct? Are there any other affected areas?"

Liu Banxia shook his head. "So far, I haven’t received any related reports. I’ve instructed the ICU to notify me immediately if there are any changes."

"Have you checked the effects of the thrombolysis yet?" Zhou Shuwen asked.

"Thrombolysis was effective. The patient’s primary symptoms remain high fever and coughing," Liu Banxia replied.

"My guidance is twofold," Zhou Shuwen continued. "First, wait for the bacterial culture results. After all, this is the most reliable basis for diagnosis; everything else is just guesswork. However, related diagnostic procedures and tests cannot stop. That result might come in an hour, or it might take dozens of hours. We need to re-evaluate the patient’s lung and sinus infections, as there may be a correlation. And don’t forget the condition of his finger. Lastly, if it truly becomes necessary, we’ll have to perform a biopsy. But that should be our absolute last resort, especially considering the patient has diabetes."

"Director, don’t you have a general idea? Last time, you immediately identified it as IgG4-related disease," Liu Banxia pressed.

Zhou Shuwen shot him a look. "If I were that clairvoyant, would I still be sitting here? You all figure it out. I’m going to finish my meal and get some rest. If there isn’t too much going on this afternoon, come assist me in the operating room. I’m a bit tired."

After speaking, Zhou Shuwen picked up his tray and walked out.

Everyone looked at Liu Banxia with admiration. The director’s words clearly showed that he didn’t consider Liu Banxia an outsider and fully recognized his abilities. He even wanted Liu Banxia to take the lead in surgery so he could rest.

"Stop staring at me like that. So, a biopsy then?" Liu Banxia asked the group.

"We should be cautious with a biopsy. Why not observe the sinus situation a bit longer?" Chen Xuehai suggested. "Could the sinuses be the initial source of infection, which then spread to the lungs and subsequently infected the cerebral blood vessels? Yesterday’s nasal endoscopy didn’t reveal anything specific. Should we take another look today?"

"That’s reasonable," Liu Banxia nodded. "Let’s do another nasal endoscopy. If that still doesn’t give us answers, we’ll have to consider a puncture biopsy. Otherwise, this is truly difficult."

Invasive tests on diabetic patients must be approached with extreme caution; it’s best to avoid them if possible. Otherwise, given the patient’s current condition, there’s a high risk of inducing further complications. His body temperature currently required both Physical Cooling methods and medication to control. If the high fever persisted, the strain on his body would be immense. The white blood cell count from this morning’s blood panel was already significantly higher than yesterday’s.

"Su, how’s the patient’s finger wound?" Liu Banxia asked.

"Currently, it doesn’t seem to be a major issue. There’s some inflammation, but it’s not severe," Su Wenhao replied. "I’ve been keeping a close eye on him since he was transferred to the ICU today. The frequency of his coughing spells has increased slightly compared to when he first arrived. I’ll perform another limb examination later to check for any new symptoms."

Liu Banxia nodded. "Keep observing him closely for me. I still feel that the wound on his finger is somehow connected. After all, it’s a visible potential source of infection, and that would be the fastest route for bacteria to enter the bloodstream."

Su Wenhao nodded. He was determined to carry out this order, even though he had already examined the patient once that morning.

Another nasal endoscopy was performed on the patient. When the new results came back, Liu Banxia’s eyebrows furrowed into a deep knot.

It seemed the sinus infection was the most severe. Yesterday, there was only some mucosal damage, but today, there were already signs of tissue necrosis. If it continued to develop at this rate, the patient would be in real danger. Although they still couldn’t determine the specific bacterium, the current situation was clearly perilous. What kind of bacteria could cause such a rapid onset and be capable of invading the blood vessel walls? The tissue necrosis in the sinuses had to be an external manifestation of this vascular invasion.

He grabbed the patient’s hand again, carefully observing the wound on the finger, then began examining both hands meticulously. As he observed, Liu Banxia’s eyes gradually lit up, and then he abruptly ran out.

He could have asked the patient directly, but the man was currently too tormented by high fever and coughing to give a coherent response.

The others exchanged glances. It looked like Liu Banxia had found something. They needed to follow him, quickly!