The Enhanced Doctor-Chapter 634 New Ideas Provided by Xu Yino

The situation is quite serious. There’s edema present in the intestines, but we also have some good news: the tumor markers for lung cancer are negative.

Liu Banxia brought Wei Yuan and Xu Hui together.

"After discovering the patient’s intestinal edema had worsened, I ordered immediate intubation. This was to protect her airway and prevent the bronchial situation from deteriorating to a point where intubation would become impossible."

"This is getting complicated," Xu Hui frowned.

"Exactly. Should we perform a lumbar puncture and analyze the cerebrospinal fluid to see what’s going on?" Liu Banxia asked.

"Currently, our considerations can’t be limited to just pulmonary diseases; we must consider a systemic illness. Regardless of which pathogen is causing it, it’s already manifesting as a systemic condition."

"If the liver and spleen also become affected, it could lead to liver failure, kidney failure, or even heart failure. Should we also test immunoglobulins and investigate the rheumatologic system?"

"Banxia, don’t rush. We need to be cautious," Xu Hui advised.

"If we continue down this path, the list of potential tests will be too long. There are countless types of autoimmune diseases, each requiring specific diagnostics. How many would we even need to run?"

Liu Banxia nodded in agreement. He had indeed panicked a bit. Regardless of what this child was suffering from, the current situation was that her symptoms were worsening, and levofloxacin was useless.

"Teacher Liu, when I was performing the colonoscopy, I noticed several rashes on the patient’s back," Xu Yino said, entering the room.

"Rashes? What color, what shape?" Liu Banxia hastily asked.

"They’re plaque-like, red," Xu Yino replied.

"Are there any skin flakes?" Liu Banxia followed up.

Xu Yino thought for a second before shaking his head.

"Could it be lupus? No, I have to go see for myself," Liu Banxia said and rushed out.

Lupus is an autoimmune disease, the exact cause of which is still unclear in medical science; all we have are conjectures.

Although the young patient didn’t present with a rash upon admission, the clinical course of lupus isn’t always identical. What if this is a type where the rash appears later?

However, after rushing out, he slowed his pace. He remembered that lupus typically presents with anemia or leukopenia in blood tests. But this young patient had an elevated white blood cell count and no anemia.

Could the increased white cell count be due to the lung inflammation? Could it be a combined effect of pneumonia and lupus?

After all, the enlarged lymph nodes on the child’s neck couldn’t be ignored.

With this thought, he quickened his pace again, heading towards the ICU.

When he arrived at the ICU, the intubation had just been completed. Seeing Liu Banxia enter, the young patient blinked her eyes.

"It’ll be a little uncomfortable, but you need to hang in there. Once this tube is in, your breathing will be much easier," Liu Banxia comforted her.

"We’re treating your illness right now. Just bear with it a little longer, and we’ll get you better. Tell Uncle, do you feel any pain anywhere? If you do, just point to it or blink your eyes."

The child gently shook her head.

Liu Banxia frowned. Another characteristic symptom of lupus is pain. Many patients continue to experience pain even after their lupus is treated, requiring ongoing management.

Actually, the term ’lupus erythematosus’ is a bit of a mouthful. In common parlance, it’s often just called ’Herpes Zoster.’ However, Herpes Zoster is merely one way lupus manifests.

Liu Banxia went around and carefully examined the child’s back. There were three plaque-like rashes on her waist, their surfaces smooth and without any scaling.

"Should we test for lupus?" Zhang Zhiyuan asked.

"I’m hesitant now. The symptoms don’t quite fit. We did suspect an autoimmune disease, but currently, there are no clear indications, so we can’t perform targeted tests," Liu Banxia said.

"Any guiding insights?" Zhang Zhiyuan pressed.

Liu Banxia shook his head. "We’re completely in the dark right now. However, having preemptively protected her airway gives us some peace of mind. Was the intubation very difficult for you all?"

Zhang Zhiyuan nodded. "The tracheal edema is quite severe. Have the cultures come back positive yet? If the tracheal edema worsens and compresses the tube, the child will really suffer."

Liu Banxia frowned. This was something he had considered. If it were an adult patient, he might have intubated last night.

"Let’s continue to observe for now. We can only conduct targeted tests once more symptoms manifest," Zhang Zhiyuan said.

"Sigh... She had a bowel movement last night, and we collected a sample for a stool test. No parasites were detected. However, I’m still worried it might be caused by parasites that weren’t visible in the chest imaging," Liu Banxia said.

"Let’s wait until this afternoon. We’ll see if any new symptoms appear by then. If her condition deteriorates further, how about a lumbar puncture?" Liu Banxia continued, "I’m completely baffled right now. I don’t know if this lung inflammation is just another manifestation of the same underlying disease."

"Don’t worry. She’s in good hands here with me," Zhang Zhiyuan reassured him.

Liu Banxia nodded and walked out of the ICU, feeling dejected.

"Dr. Liu, how’s Yanyan?" the child’s father rushed over.

"Her condition is stable for now. We’ve explained about the intubation, haven’t we? It’s a precautionary measure. The ICU will be administering medication soon to see if we can get her symptoms under control," Liu Banxia said.

"Our recommendation is to continue observing. We can only conduct targeted examinations once more symptoms appear. Otherwise, performing random tests will only cause the child more suffering."

"Dr. Liu, no matter what method we use or how much it costs, we must cure Yanyan," the child’s mother pleaded.

"Rest assured, I will invite doctors from other departments for a consultation later," Liu Banxia replied seriously.

"Dr. Liu, we... we are relying on you," the child’s mother said.

Liu Banxia nodded but didn’t stay longer. He didn’t know what else he could say to comfort the parents.

"Did you run the tests?" Wei Yuan asked when Liu Banxia returned.

Liu Banxia shook his head. "Let’s continue the consultation. I looked, and it doesn’t seem to be lupus. The child isn’t experiencing any pain. I expect Zhang Zhiyuan will just order another complete blood count and a blood chemistry panel to see if there are any changes in her levels."

"This is such a headache. It’s the first time I’ve encountered a case with simultaneous edema in both the respiratory and digestive tracts. It’s somewhat similar to that hereditary angioedema case you diagnosed before, Banxia, but other indicators are different," Xu Hui mumbled.

"Even if the symptom presentation is somewhat unusual, there are still signs of pneumonia, aren’t there? We used levofloxacin, and it had no effect," Liu Banxia said.

"Right now, I’m thinking it’s either a pathogen we haven’t encountered before or a parasite. Those seem to be the two most likely possibilities. That general direction feels correct, doesn’t it?"

Wei Yuan nodded. "Although I don’t have a deep understanding of pathology, I’m inclined to agree with that assessment. For a bacterial cause, we can only wait for the culture results. As for parasites, what if they’re in her brain?"

"If they were in the brain, there should be some neurological manifestations, right? Like dizziness, seizures, or a high fever?" Liu Banxia said.

"Her current symptoms are fatigue, similar to a common cold, followed by respiratory distress due to bronchial edema, and abdominal distension from intestinal edema."

"Although it resembles an allergic reaction, with such severe edema in her bronchi and intestines, there should be more pronounced external signs on her body. And it shouldn’t have taken this long for just these few rashes to appear, should it?"

"I’ve also been thinking about the pathogen. They haven’t traveled recently. If such a pathogen existed here in Binhai, she likely wouldn’t be the only case," Liu Banxia added.

Wei Yuan and Xu Hui fell silent upon hearing this. That was indeed a valid point. For such a rare condition, if it were caused by a pathogen endemic to Binhai, there would likely be more patients.

"Teacher Liu, do you think the pathogen could have been brought in by someone from outside the area, and she somehow came into contact with it?" Xu Yino quietly suggested from the side.

"Hmm... let me think," Liu Banxia frowned. That’s a possibility. But what outsiders would a child normally come into contact with? She usually just goes to school. If she were exposed there and carrying the pathogen, wouldn’t her classmates show similar symptoms?

Or perhaps this pathogen isn’t transmitted person-to-person, but object-to-person? That would mean an object from outside carried the pathogen.

From outside the region?

It’s plausible. As far as he knew, no similar cases had been reported domestically. Or perhaps there were, but they were extremely rare and hadn’t caught his attention?

"If it were transmitted by an outsider, it would be difficult for them to enter the child’s daily life, wouldn’t it?" Wei Yuan voiced his doubt.

"Actually, Brother Wei, it’s quite possible," Liu Banxia said, rubbing his chin.

"Xu Yino’s suggestion is excellent! The child’s father is a ride-hail driver. Could he have come into contact with a certain pathogen while working? And then, could the pathogen have been transmitted to the child when he returned home?"

"The child’s parents are healthy, but she recently had a cold, so her immunity was weaker, and she accidentally contracted it?"

"I’ll go ask them. This could really be it! Xu Yino, come on, let’s go ask them together. This might be our lead! Don’t walk, run!"

Liu Banxia took off running as soon as he finished speaking.

This was a new line of inquiry, and a reasonably plausible one. If it turned out to be true, Xu Yino would be the hero of the hour.