The Enhanced Doctor-Chapter 638: Running around recklessly is risky

"Dr. Liu, does your patient also need to undergo diagnostic tests?" Qu Yihong asked.

Liu Banxia nodded. "Yes, it’s based on the deduction we made from your patient here, so we still need to perform serological and biopsy confirmation tests."

"In that case, take our patient with you as well. Shen, you should also go along. This is valuable experience; we can’t miss this learning opportunity," Qu Yihong said.

"Director Qu, would that be convenient?" Liu Banxia asked hesitantly.

Transferring a patient from the inpatient department of the Second Hospital wasn’t a major issue. After all, they were all part of the Second Hospital, and with the right connections, no department would mind one less patient.

However, this was Binhu District Hospital. Even though it was a related case, it was still very important for Binhu District Hospital. Within China, cases of Coccidioides infection are few; it’s quite rare.

"It’s no problem. If he stayed here, the relevant tests would still be sent to the city hospital for processing. Instead of wasting time like that, it’s faster to hand him over to you directly," Qu Yihong said with a smile.

"Besides, our patient’s condition doesn’t seem very serious at the moment. But what if it worsens while waiting for the test results? At your facility, he can receive earlier intervention."

"As a district hospital, our patient volume and medical resources are limited. Also, our Binhu District Hospital is somewhat different from county-level hospitals like those in Jinshui District."

Liu Banxia nodded. "Alright then, Doctor Shen can bring the patient with us. We can also learn more about our patient; the manifestations of Coccidioidomycosis indeed vary."

"Doctor, is my illness very serious? Is it contagious?" the patient asked at this point.

"Actually, if it really is Coccidioides, it’s not a huge problem. This fungus is mostly transmitted from contaminated objects or soil to people; there don’t seem to be any documented cases of human-to-human transmission yet. Like our other patient’s parents, and your friends and family, they should all be fine," Liu Banxia said.

"By the way, who did you give the items you brought back from abroad to? It would be best if you could provide their contact information so they can also come to our hospital for a precautionary check-up.

"After all, we currently can’t determine whether you were infected through contaminated clothing or a specific item you purchased, so it’s better to be cautious."

The patient nodded, feeling somewhat more at ease, and quickly took out his phone to call the friends for whom he had brought back items.

This was unavoidable unless they meticulously inspected the items and clothes he brought back to determine what served as the carrier for the fungus.

"Teacher Liu, isn’t it a bit inappropriate that we just ’poached’ this patient like this?" Xu Yino asked curiously on their way back.

"Sigh..." Liu Banxia sighed. "As the old saying from the martial world goes, ’The older the ginger, the spicier it is.’"

At first, I thought so too. But after we left, it dawned on me that we’ve somehow ended up owing him a favor.

Considering the current situation, do you think the patient could have realistically stayed at Binhu District Hospital for continued treatment? They couldn’t have kept him anyway, so Director Qu might as well do us a favor by transferring him to us.

And we have to be grateful for it. In the future, if any issues arise, we’ll have to give them preferential treatment whenever possible. But it doesn’t really matter. Being able to find the linked case and diagnose this disease is a success in itself.

During my initial diagnosis, I missed a step. If we had performed a lymph node biopsy on the child earlier, we might have found the dimorphic fungus to be positive, and perhaps we could have deduced it then.

"Teacher Liu, it wouldn’t have been that easy to deduce, would it?" Xu Yino asked with a smile.

Liu Banxia nodded again. "Indeed, this fungus is genuinely difficult to diagnose in China. However, if we had a preliminary diagnosis, and now with the information provided by this new patient, we can confirm it directly and start treatment immediately."

"So, you see, sometimes it’s better not to wander around too much in unfamiliar places; you never know what kind of pathogens you might bring back. When we get to the hospital, we also need to calm the child’s parents’ emotions. We can’t let them get into a conflict with this patient over this."

"That’s a very good point. They’re victims of an unwarranted disaster. Their child has suffered for so many days, and they’ve spent so much money. What if we choose to keep it confidential for now? Don’t tell them we’ve brought this patient back," Xu Yino suggested.

That’s probably the only way for now, otherwise, it could get really awkward. Anyone would be upset if they found out, Liu Banxia thought.

He had nearly forgotten about this issue and knew he needed to be careful when explaining the situation back at the hospital.

「Back at the Emergency Center」

Xu Yino arranged for the new patient’s admission paperwork. Liu Banxia, with Doctor Shen, headed straight to the ICU.

"Dr. Liu, they just said you’re close to a definitive diagnosis?"

As soon as Liu Banxia reached the doorway, the child’s parents stopped him.

Liu Banxia nodded. "We found a related case at another hospital. It’s confirmed that he rode in your car, which might have caused the cross-infection."

"Currently, we are conducting the final confirmatory tests. As soon as we confirm the diagnosis, we can start administering medication. The nature of this disease is somewhat unusual. Fortunately, we discovered it in time, and it hasn’t become too severe yet."

"Dr. Liu, what exactly is this illness?" the child’s mother asked anxiously.

"Hmm... If our assessment is correct, it’s a fungus called Coccidioides, which usually lives in the soil," Liu Banxia said after a moment’s thought.

"However, recent earthquakes in susceptible regions may have caused this fungus to spread. Additionally, Yanyan’s health hasn’t been good lately, and her immunity is very low, which is why she developed these symptoms."

"You’ve been told what tests are needed, right? For the final pathological examination, a biopsy sample is required. To ensure accuracy, a sample will also be taken from the lymph nodes in her neck."

The child’s father nodded. "They’ve already told us, and it seems the procedures are complete. Dr. Liu, will this disease leave any permanent after-effects?"

Liu Banxia pondered for a moment and shook his head. "Under normal circumstances, no, but it also depends on her response to the medication."

"After all, Yanyan is showing signs of respiratory compromise, so we can’t remove her breathing tube yet. We’ll have to use oral medication for treatment."

"Later, we’ll need to perform a lumbar puncture to check if the fungus has spread to her brain. Although the chances are low, we still need to be thorough. I’ll go in and check on her now. I’ll let you know if there are any updates."

The couple nodded. All they hoped for now was for the medication to be administered quickly and take effect, so their daughter wouldn’t have to suffer so much.

"Brother Zhang, this is Doctor Shen from Binhu District Hospital. How is our patient doing?" Liu Banxia asked.

"I just consulted some literature, and it really does seem to be Coccidioides. All samples for testing have been collected. I plan to do a lumbar puncture after the diagnosis is confirmed to see if the brain is involved," Zhang Zhiyuan said.

Listening to their conversation, Shen Bingqian sighed inwardly. This was the difference, and it was enormous. They both considered the possibility of brain infection, while she hadn’t even heard of this disease. She had been wondering why they didn’t just do the lumbar puncture immediately. Now she understood; it was a matter of protocol. If it wasn’t Coccidioides, performing a lumbar puncture would indeed be rather speculative.

"Our patient here, her presentation is indeed quite unusual. She likely has what’s called disseminated Coccidioidomycosis, which is more complex to treat than the primary form," Liu Banxia continued.

"So, the body’s resistance is crucial. If her immunity were a bit stronger, she might have been fine. Many illnesses strike when the body is vulnerable. Fortunately, we caught this in time."

"Dr. Liu, can this disease cause permanent damage to internal tissues?" Shen Bingqian asked.

Liu Banxia nodded. "It’s certainly possible. Fortunately, both our patients are relatively stable for now. The disease has a long incubation period, and it’s often misdiagnosed and treated as pneumonia."

"In fact, even in the United States, without specific tests, many cases are treated as pneumonia. The presenting symptoms are so similar that it’s hard to suspect otherwise."

"For instance, your patient only has a pulmonary Coccidioides infection. Our patient here is more severe; it has already affected her lungs, intestinal tract, and lymphatic tissue. It could potentially spread to her liver, kidneys, bones, and eventually, the brain."

"This fungus is cunning due to its dimorphic nature. It usually exists in a mycelial form, which facilitates its spread within the body. When the temperature is suitable, it converts to a yeast-like form and continues to proliferate."

"Diagnostic tests can often be negative. Many people are infected in endemic areas. For our little patient to also get infected like this is truly unfortunate and rare."

I personally suspect it might have been dust on clothing. You could just call it bad luck. One moment everything’s fine, and the next you’re caught up in something like this, having to endure such suffering.

"Teacher Liu, that patient has been settled in," Xu Yino said, walking in at that moment.

"Alright. Xu Yino, why don’t you show Doctor Shen around? Dinner’s on me," Liu Banxia said.

"Dr. Liu, that’s really not necessary," Shen Bingqian quickly replied.

"Oh, it’s fine," Xu Yino interjected.

"They’re always extorting meals from me, so one more won’t hurt. Besides, I should at least fulfill my duties as a host," Liu Banxia said with a smile, then walked out.

He also needed to check on the young man. He just hadn’t mentioned it to the child’s parents, but he couldn’t pretend the young man wasn’t there. The young man’s treatment, for now, was straightforward: just medication.