The Enhanced Doctor-Chapter 637 actual related cases

Having had a decent lunch, Liu Banxia briefly reunited with Qiaoqiao. After returning to the emergency center, he started diagnosing and treating patients himself.

His mind was a mess, and he needed to do something to distract himself.

However, this didn’t work well. After diagnosing a few patients, he went to the ICU. "Brother Zhang, how is the child’s condition?"

"The situation isn’t good. There’s some fluid accumulating in the lungs, but it’s not severely impacting her yet. We’ve done a new blood test and serological examination, and the test for standard immunoglobulin came back negative," Zhang Zhiyuan said.

"Considering this, I think we can rule out autoimmune diseases. We should focus our energy on examining parasites and bacteria. This approach is more reliable."

"Another symptom is the increase in rashes on the child’s body—on her arms and thighs. After repeatedly questioning her, we confirmed that the rashes are somewhat painful."

"We’ve sampled the rashes and performed an allergy test, which came back negative. There have been no changes in her body temperature."

"Didn’t you say that you were also looking for related diseases in other hospitals? Still no results? Personally, I’m inclined towards bacteria. If it were parasites, we would’ve seen other symptoms after such a long time."

Liu Banxia nodded. "But the cultures still tested negative, and we still haven’t found any related cases. This is so frustrating."

"Teacher Liu, Teacher Liu, we’ve found one!" Xu Yino exclaimed, running over.

"Found one? What’s the situation?" Liu Banxia asked quickly.

"Look at your phone! Someone in the group chat posted about a similar patient at a hospital in Binhu District. The patient has had pneumonia for two weeks and still isn’t cured," Xu Yino said hurriedly.

"Contact the hospital immediately and confirm the patient’s travel history. Did they come from abroad?" Liu Banxia asked.

Xu Yino nodded. "Yes, they returned from abroad. The doctor who treated them remembers, so that’s confirmed. They’re also trying to contact the patient to see if their travel routes overlap with ours."

"Good, good. Actually, I’ll go there myself, and you’ll come with me. If we locate the patient, we can go to where they are now," Liu Banxia said excitedly.

Finally, there was a glimmer of hope. Now they needed to verify the travel routes. If this patient had indeed taken that bus, they could directly link the two cases.

Zhou Shuwen had no surgeries scheduled that afternoon, so after Liu Banxia requested leave, he and Xu Yino rushed to Binhu District Hospital.

"We’ve only been focusing on major hospitals and completely forgot to check with the district ones. How did you think of it?" Liu Banxia asked curiously.

"Hehe, I can’t just keep benefiting from your kindness, Teacher Liu. I have to work hard too! So, I expanded the search range a bit," Xu Yino said with a grin.

"Actually, I wasn’t thinking of anything specific. I just contacted a few hospitals at random, and it turns out one of my seniors works at Binhu District Hospital. What a coincidence, right?"

"Teacher Liu, what kind of bacteria could a patient bring back from abroad? It doesn’t seem to be highly contagious. So far, it’s just the two of them, right?"

Liu Banxia shook his head. "It’s hard to say now; it depends on which country the patient returned from. If it were some countries in Africa, this could become a serious problem."

"We can’t link the two cases at the moment. Let’s meet the patient first and see. You did a great job today."

He believed in giving credit where it was due. Although the two cases weren’t definitively linked yet, Liu Banxia felt they were very close. This was the only suspicious case found so far; even if it turned out to be a wild goose chase, they had to investigate.

"Xu Yino, over here."

As soon as they got out of the car, they saw a female doctor waving at them from the hospital entrance.

"Teacher Liu, this is my senior, Shen Bingqian. She’s the one who diagnosed the patient," Xu Yino said.

"Hello, Doctor Shen. Has the patient arrived?" Liu Banxia asked.

"Hello, Dr. Liu. The patient is already here; he lives nearby. After a brief chat, I found out he returned from the United States," Shen Bingqian said quickly.

"After hearing Nuonuo’s explanation, he’s currently undergoing a bronchoscopy. You can review the diagnostic records we’ve compiled so far first."

"Thank you. If we can connect the dots, perhaps both patients can be successfully treated," Liu Banxia nodded.

When he arrived at the office, after exchanging a few pleasantries, Liu Banxia began to carefully examine the patient’s medical record.

The blood test results were similar to Yanyan’s, with a rise in white blood cells and the proportion of eosinophils. However, this patient’s condition wasn’t as severe as Yanyan’s, with an eosinophil level of only 7%.

Moreover, the only symptom this patient currently showed was lung involvement. There were no rashes or abdominal swelling.

Based on this alone, there was no way to link the two cases. Ordinary pneumonia could also lead to the current results.

"Dr. Liu, the patient has completed the bronchoscopy. There is indeed slight edema in the bronchi, matching the symptoms Nuonuo described," Shen Bingqian said after receiving a phone call.

"Teacher Liu, Teacher Liu, are we close?" Xu Yino asked, her voice filled with excitement.

"Almost. But we still need to confirm if their paths crossed. Doctor Shen, would it be convenient for us to see the patient directly?" Liu Banxia asked.

"Yes, I’ll take you there right away," Shen Bingqian nodded.

Arriving at the internal medicine consultation room, they found the patient sitting on an examination table, looking very weak.

"Hello, I’m Liu Banxia from the Emergency Center of the Second Affiliated Hospital. We’re treating a patient with symptoms somewhat similar to yours. Could you try to recall if you rode in this car after returning to the country?" Liu Banxia introduced himself and handed his phone to the patient.

"Let me think... COUGH, COUGH... I remember. I did take that car," the patient said, nodding after looking at the phone for a moment.

"It was the day after I returned to the country. I was delivering something I’d bought for a friend. Doctor, are you saying the driver also has this cold and pneumonia, just like me, and isn’t getting any better?"

Liu Banxia’s heart pounded. He could link the cases now! "You returned from the United States? Which region? Has there been any prevalent illness there recently?"

The patient frowned. "I went to California. I didn’t notice any particular illnesses there. But there were earthquakes; they’re pretty common. California is on a fault line, so earthquakes happen frequently."

"California... earthquakes," Liu Banxia muttered, frowning.

He racked his brain. It seemed there hadn’t been any massive outbreaks there. But for now, even if this patient’s symptoms weren’t as severe as Yanyan’s, the cases could be connected.

"Try to recall again, did any of your friends there exhibit symptoms similar to yours before you returned?" Liu Banxia pressed.

The patient shook his head. "I just went there for a vacation. I caught a cold soon after coming back. Medicine I took at home didn’t work, and the IV drips here haven’t helped either."

Liu Banxia frowned. These sparse clues weren’t enough to point to anything specific. So what exactly was going on?

What illnesses, besides those related to earthquakes, were common in California? He had a vague impression but couldn’t quite recall where he’d heard about it.

"Ah, I remember now! There’s coccidioidomycosis in California and Arizona State in the United States!" After thinking hard for a while, Liu Banxia snapped his fingers.

"Ah, is that valley fever?" Xu Yino also remembered. "Huang Bo even joked back then that Americans have their share of hardships too."

The interaction between the two confused both Shen Bingqian and the patient.

"That should be it," Liu Banxia continued. "This patient’s condition is consistent with pulmonary coccidioidomycosis, while our patient, Yanyan, seems to have disseminated coccidioidomycosis."

"Generally, Coccidioides rarely affects the digestive tract, but that’s just a statistical probability. Doctor Shen, this fungus is dimorphic; it’s tricky."

"Perform serological tests on the patient, including a latex agglutination test; it’s very sensitive. Also, screen for IgG antibodies; the positive rate for that is very high too."

"Furthermore, obtain a biopsy sample; there should be swollen lymph nodes. If spherules of the fungus are found, it can basically be confirmed."

"But your patient’s symptoms are relatively mild. If medication is needed, oral ketoconazole should be sufficient. Xu Yino, contact the ICU again. Tell them to proceed with the biopsy for Yanyan. And... have them consider using amphotericin B. Just tell Zhang Zhiyuan; he’ll understand."

"Alright, I’ll contact them right away," Xu Yino quickly nodded.

Shen Bingqian was somewhat bewildered. She had never even heard of valley fever. Yet, these two had quickly discussed it, reached a diagnosis, and Liu Banxia had even outlined a treatment plan.

"Director Qu, you’re here just in time!" Just as Shen Bingqian was wondering how to proceed, she saw Qu Yihong, the director of internal medicine, and quickly called out. "This is Dr. Liu, the chief resident from the Emergency Center of the Second Affiliated Hospital. It seems one of our patients and one of theirs are linked cases of valley fever."

"The chief resident of the Emergency Center? Oh, I remember now. Liu Banxia, right?" Qu Yihong asked with a smile.

"Hello, Director Qu. This patient and ours are indeed related cases. He visited California and likely contracted the Coccidioides fungus from the soil there," Liu Banxia said quickly.

"I’ve heard your name mentioned a few times in meetings, so I remembered it. Is Chief Director Zhou still as busy as ever?" Qu Yihong asked.

"She was in surgery this morning. She finally got a bit of a break this afternoon, but there’s still a mountain of paperwork for her to approve," Liu Banxia said.

Honestly, he was itching to head back immediately. But this was a director, and he apparently knew Zhou Shuwen. As anxious as Liu Banxia was, he couldn’t just leave now.