The Enhanced Doctor-Chapter 632 Completely clueless

Looking at the bronchoscopy diagnostic report, Liu Banxia and the other two exchanged glances.

"Call someone. Even if it’s a bit late, I haven’t encountered such a situation before," Xu Hui said, frowning.

"Xu Yino, call Dr. Wu from Cardiology," Liu Banxia nodded.

It was already after one in the morning. Even though the patient could have waited until morning for the consultation, the three of them really couldn’t wait.

Wu Xiaoyue, who was called in for the consultation, also frowned after reading the results of the bronchoscopy. "There’s erythema, edema, inflammation, and tracheal wall collapse; it’s quite dangerous. How long has this situation been developing?"

"There seem to be no further changes at present; the child’s blood oxygen is okay after oxygen was supplied. But looking at the current situation, it might affect the entire bronchial tree, right?" Liu Banxia asked.

Wu Xiaoyue nodded. "Considering the lung inflammation, let’s start with medicine. Has the pus been sent for culture?"

Liu Banxia nodded. "We’ve sent it for culture. Right now, we’re not sure whether to start airway protection in advance."

"The child also has some abdominal distension. From the ultrasound results, it’s likely due to some intestinal edema. However, a colonoscopy has not yet been done; we plan to do it tomorrow morning."

"The proportion of eosinophils is also a bit high. We temporarily can’t connect the digestive tract condition with the respiratory tract condition."

"For a child of this age, long-term intubation will definitely impact tolerance. If not handled well, it could injure her trachea," Wu Xiaoyue said.

"My personal opinion is to start with levofloxacin and acetaminophen tonight, but blood oxygen levels must be monitored constantly. If we find the blood oxygen dropping, we must intubate for airway protection," Wu Xiaoyue said.

"Teacher Wu, I’ll stay on top of this," Xu Yino said.

"Dr. Wu, have you encountered such symptoms before? Something that can connect all of these conditions? We suspect that it might be due to some kind of fungal infection causing a hematogenous inflammatory response," Wei Yuan said.

"That’s also possible. Have you examined the child’s skin? Usually, such conditions would also have some reaction on the skin, right?" Wu Xiaoyue asked.

"Xu Yino did the check and found no swelling or rash. As it looks now, the symptoms are only affecting the lungs and intestines, but we can’t link the intestinal situation," Liu Banxia said.

"We can perform a colonoscopy tomorrow morning. The child has just been examined for so long; we were also concerned that a colonoscopy now wouldn’t be effective."

Their earlier discussion had also reached the same conclusion; they just wanted to see if Wu Xiaoyue had any more useful suggestions in this regard.

If this were an adult, a series of checks would be underway, and airway protection would be done at the very least. Perhaps even now a nasogastric tube would be inserted to relieve the pressure in the gastrointestinal tract.

But this is a minor; she doesn’t have the same level of tolerance. If the tube is inserted now, under the effects of anesthesia, there might be no problem at that moment. But what happens when the effect of the anesthesia wears off? The child might pull it out herself, which would damage the trachea.

The colonoscopy examination is similar; it’s not a pleasant feeling when the endoscope advances along the intestine. If the child isn’t well prepared and moves around, it could even damage the intestine.

"We can only proceed this way for now and see if there’s a positive result from the rapid pus examination. But, not to discourage you, it’s difficult to get results in such a short time," Wu Xiaoyue said.

"Could it be an allergic reaction caused by some kind of parasite? Otherwise... we should also investigate hematological causes."

Liu Banxia nodded. For now, this was the only way to handle it.

He would have to explain the situation to the patient’s parents, which wasn’t an easy task.

"Doctor, are you saying that after all these checks, we still don’t know what illness Yanyan has? Isn’t it a common cold?" After listening to Liu Banxia, the patient’s father asked anxiously.

Liu Banxia nodded. "Our current diagnosis is some lung inflammation, very likely caused by some kind of fungus or virus."

"Another possibility is that it’s blood-related, involves the lymphatic system, or is a malignant transformation in the lungs, which resulted in this rapidly developing condition. The common cold might have weakened her immunity, allowing the pathogen to take advantage."

"But that’s just one of our speculations for now. When we performed the bronchoscopy, we also extracted a pus sample. We will have a doctor closely monitoring her tonight."

"By the way, I wanted to ask, have you traveled anywhere recently? Even if it was a long time ago? We also suspect these current conditions might be due to some parasite."

"We don’t have money to travel. I work for others, and her dad drives for a ride-hailing service. We’re just trying to save more money for Yanyan, so we can afford tutoring classes for her in the future to help her sprint ahead," the patient’s mother said.

"Yanyan hasn’t been well for a while. She catches a cold now and then, and we planned to buy some health supplements for her."

"Doctor, are you saying it might be pneumonia?" the patient’s father asked.

"There is indeed evidence of lung inflammation, so we have taken a sample," Liu Banxia said after a moment’s thought.

"But many factors can cause lung inflammation and infection, so for now, all we can do is treat with broad-spectrum antibiotics. We still need to see the culture results of the pus, but the child’s body temperature should be controllable, which will make things a bit easier for her."

Upon hearing Liu Banxia’s words, the couple’s expressions fell considerably. They understood that the current treatment was merely conservative.

"Doctor, please put in a bit more effort," the patient’s father said.

"Don’t worry, we will definitely diagnose her carefully," Liu Banxia assured.

DING! Task released: Strange Pneumonia

Open-ended task: After admitting the patient, it was found that the symptoms of pneumonia are very peculiar, and further diagnosis is required by the host. The task reward will be issued depending on the diagnostic result.

"This is becoming a bit of a headache. You guys go rest first; I need to think about it more," Liu Banxia said after returning.

"You just spoke with the family, right? Is there any other information they might have overlooked?" Xu Hui asked.

Liu Banxia shook his head. "There is, but it’s not much use. The child is a bit weak, has low resistance, and has a history of common colds, but she got better after taking medication."

"I also asked them if they have any travel history. They’ve been living locally and have never been elsewhere. But what on earth could have infected her to cause her bronchus to end up like this?"

"The only thing I can think of is that the child’s declining resistance allowed this pathogen to invade. Another possibility is that this pathogen isn’t very common, which is why it caused these unusual symptoms."

"Xu Yino, it’s going to be a tough night for you. Airway protection should only be done when absolutely necessary. No matter what the disease is, since it has already affected the lungs, we need to be extra vigilant."

"Teacher Liu, don’t worry, I’ll stay awake all night," Xu Yino nodded firmly.

"Can’t you all contribute any more constructive guesses? Think outside the box, be bold with your ideas," Liu Banxia said, looking back at Wei Yuan and the others.

"What can we guess? No underlying diseases, no travel history, and we haven’t seen such a case locally in Binhai City. The only other possibility is blood-related factors, but right now, the only sign is swelling in the child’s cervical lymph nodes," Xu Hui said.

"Let’s wait. That’s all we can do now. We need to see what the examination results look like tomorrow and what the colonoscopy shows. If the intestines exhibit conditions similar to the bronchus, this disease will be very serious."

"Yes, it might even be infectious. Currently, the child’s parents have shown no discomfort, which actually makes me feel a bit relieved," Wei Yuan nodded.

"By the way, are there any external injuries on the child? Could it be that some bacteria infected a wound and then lay dormant in her body, only flaring up now?" Wu Xiaoyue asked.

"I forgot to ask about that. Let’s wait until tomorrow morning; Xu Yino can ask," Liu Banxia said.

"See, this is good. Everyone is starting to think divergently. Maybe we can spark even brighter ideas. Any other suggestions?"

The three of them shook their heads simultaneously. This was already the limit of their current thinking.

More thoughts were leaning towards lung cancer, which would also depend on the results of tumor marker screening. Even if the nodule’s margin is distinct and smooth, malignancy still can’t be completely ruled out.

"Alright, you guys can rest now. I have some more thinking to do," Liu Banxia said.

Wei Yuan and the others didn’t say anything else. Based on the current situation, this was the only course of action they could offer. Even though they knew in their hearts that levofloxacin might not be effective, they could only proceed with this conservative approach to medication.

Returning to his seat, Liu Banxia was wide awake, his mind entirely consumed by the young patient’s condition.

"Teacher Liu, why don’t you take a break? Even a short lie-down would help." Huang Bo approached him.

"I can’t sleep. My gut feeling about this young patient’s situation is that it’s very dangerous. The longer we delay, the less time we have to save her," Liu Banxia said.

"You still need to rest. It’s already the middle of the night; who knows what kind of workload we’ll have tomorrow?" Huang Bo said.

"Don’t worry, we can handle anything that comes into the Emergency Department at night. Unless a patient is severely injured, we won’t call you or Teacher Wei."

"Alright then, I’ll try to get some rest too," Liu Banxia nodded.

He was well aware that just staying up wouldn’t help; a diagnosis couldn’t be forced by sheer wakefulness. But even when he lay down on the bed, he didn’t fall asleep as soon as his head hit the pillow, like he usually did.

A doctor’s intuition can sometimes be alarmingly accurate, and his current premonition was extremely dire. Considering the current extent of the bronchial edema, it would be far too dangerous if it were to progress further.