The Enhanced Doctor-Chapter 703 Sudden Neck Rigidity

"Just as I feared, this complicated scenario has arisen, and I cannot handle it alone," Wang Huan said.

"Alright, leave it to me for now, and continue seeing your patients. However, based on the current results, there should be no problem proceeding with anticoagulant thrombolytic treatment," Liu Banxia nodded.

"This is Dr. Liu, the chief resident at our emergency center. He will be responsible for the subsequent diagnosis and treatment," Wang Huan informed the patient and his girlfriend.

"The current diagnosis aligns with my initial assessment. However, there are still some underlying causes that need clarification. Our primary concern at the moment is to determine the cause of these symptoms."

The patient’s girlfriend turned her gaze towards Liu Banxia. The patient also wanted to observe him but was in considerable discomfort.

"Come help him onto the examination bed with me. Lying down might offer some relief as we continue to investigate," Liu Banxia suggested.

"Miao Rui, go to cardiology and see if anyone is free to assist in the consultation. This young man’s condition is quite complex and requires careful study."

"Dr. Liu, is it a serious illness?" the patient’s girlfriend asked.

"As Dr. Wang mentioned earlier, all we see now are symptoms. I will slowly explain everything to you; don’t worry prematurely," Liu Banxia reassured her.

"Have him lie down first; it will make him more comfortable. His swollen legs and difficulty breathing are caused by these blood clots."

"This is not too serious—the blood clot is not completely blocking anything. If we conduct thrombolytic treatment, the swelling and difficulty breathing will be alleviated."

"Dr. Wang mentioned that his symptoms appeared about eight or nine days ago. Were there any anomalies before that? Besides the fever, were there any issues with his leg or lung function?"

The patient’s girlfriend shook her head. "Jiaming has always been well. We’re even planning to get married this year, and he just got a new job in the development zone."

"He started to have a fever initially but didn’t cough or sneeze. We thought he wasn’t adapting well to our local climate, so we gave him some acetaminophen."

"We didn’t expect that although it worked on the first day, by the third day it was ineffective, and his temperature started to rise. Then we went to the hospital in the development zone and had an intravenous drip."

"His condition improved a little, but by evening, his temperature would rise again. Then his legs began to swell badly, his energy levels dropped, and his breathing became uncomfortable. Even with a simple diet of congee and milk, he struggled, so we came here."

"Doctor, please give me an IV," the patient lying on the examination table spoke up. "I can’t stand the fever. I’m finding it hard to breathe. You can treat me however you like."

"Don’t worry yet; the anticoagulant thrombolytic treatment has certain risks and requires careful dosage adjustment. But rest assured, we’ll at least make sure you can breathe easily," Liu Banxia comforted him.

The young man nodded, his face strained with discomfort.

High fever and difficulty breathing are incredibly distressing. The fact that he had endured these symptoms for so many days, despite being able to tolerate them initially, was a testament to his impressive endurance.

"President Liu, pulmonary embolism?" At this moment, Xu Guosheng, an attending physician from cardiology, walked over.

Liu Banxia nodded. "Take a look. These are the blood tests and related examination results. There’s no problem with the anticoagulant thrombolytic treatment, right?"

Xu Guosheng took the inspection report and examined it carefully.

"Okay, conventional thrombolysis will do. Just keep a close eye on him and hook him up to an EKG." After Xu Guosheng finished speaking, he gave Liu Banxia a knowing look.

"Miao Rui, conventional thrombolysis and connect an EKG. After you write the doctor’s orders, I’ll sign them," Liu Banxia said before going outside with Xu Guosheng.

"Just treating the symptoms won’t address the root cause. The patient’s high fever is clearly a major contributing factor," Xu Guosheng commented once they were alone.

"Moreover, the patient mentioned previous IV treatments at the hospital, which was likely anti-infective therapy. Since his white blood cell count isn’t elevated, does that largely rule out the possibility of a bacterial infection?"

Liu Banxia nodded. "Indeed, the fever and enlarged spleen are significant symptoms. I have a bad feeling about this. What if the pulmonary embolism wasn’t caused by a leg clot breaking loose?"

Upon hearing this, Xu Guosheng was taken aback. If that were the case, the patient’s situation would certainly become more serious.

"So, I plan to order a stool test for the patient to verify the presence of parasites," Liu Banxia continued.

"Could the presence of parasites also cause similar reactions? If larvae were to drift in the blood and trigger some reaction, could that lead to a blood clot?"

"Your theory is a possibility, but the issue is that the patient’s white blood cell count is not high," Xu Guosheng pointed out.

"Well, since Miao Rui is here, let’s conduct a stool examination for the patient as we proposed. For the fever, we can apply a cold compress for Physical Cooling."

Liu Banxia nodded and instructed Miao Rui to add a stool test to the orders.

"Can you think of any other possible causes?" Liu Banxia asked Xu Guosheng after Miao Rui left.

Xu Guosheng shook his head. "We still have too little information. We can only start by looking at the enlarged spleen and lymph nodes; it’s likely related to the lymphatic system."

"How about running further tests on blood biochemistry and checking liver and kidney function? More data will give us a clearer direction. The symptoms only surfaced after the fever started. But what’s causing this? The high fever, thrombosis, enlarged spleen, and lymph nodes could all be the result of the same underlying medical condition, right?"

"That’s what I’ve been thinking too. Therefore, I guessed there may be no direct correlation between the emboli in his leg and lung," said Liu Banxia.

"It’s tricky, indeed. We’ll have to wait for the results of the blood biochemistry and fecal examination first. After all, checking the lymphatic system can be somewhat complex," said Xu Guosheng.

"We’ve run so many tests, and yet the patient’s condition is still poor. Anticoagulation and thrombolysis are necessary now, so I suggest pushing back the other tests."

"Alright. So, we can conclude now. Start with anticoagulation, thrombolysis, and Physical Cooling, then wait for the latest test results. This seems to be the most suitable course of action right now," Liu Banxia nodded.

Even though it felt a bit perfunctory, it was the reality.

The process of identifying the cause of an illness would not always be smooth sailing. When setbacks hit, one must first figure out how to navigate around them.

If you rush blindly, you might fall into a pit. For a doctor, the worst that could happen is an incorrect diagnosis, but for a patient? It could be a matter of life and death.

Liu Banxia returned to the bedside, where the treatment had already begun.

"After the cold compress, are you feeling a bit better? Currently, we can’t directly administer antipyretics to you yet. We have to figure out the cause first," Liu Banxia said.

"The anticoagulant treatment also takes some time to become effective. But since your clot isn’t very severe, it will work faster."

"It’s fortunate you didn’t delay any longer. If it had worsened and caused a complete blockage, it would have become difficult to treat. Think back, have there been any other unusual symptoms recently?"

"Doctor, we’ve racked our brains. Whether it’s food or drink, everything has been the same for both of us. I haven’t had any problems. Could it be an issue with acclimatization?" the patient’s girlfriend asked.

"Where was his hometown originally? By his accent, it seems like somewhere from the Northeast. It’s not too far from here, is it?" Liu Banxia inquired.

The patient’s girlfriend gave a nod. "Not far, but it’s still a different place, right?"

"Generally, issues with acclimatization would cause symptoms like abdominal pain and diarrhea. I’ve checked the records; you haven’t reported these," Liu Banxia answered.

"The reason we ordered a stool examination was to check for any parasitic infection. What about diet? Have you eaten any undercooked meat recently?"

The patient’s girlfriend shook her head. "No, we usually stew our meat. Even the meat used in stir-fry is cooked before the vegetables are added."

Liu Banxia cast a glance at the young man lying there. He had asked so many questions, yet all the answers came from his girlfriend. It was clear that the young man was genuinely suffering a great deal from his prolonged illness.

"Doctor, please don’t mind him. Jiaming is usually cheerful and loves to joke around. He’s just been too demoralized by this illness, and we’re unsure how it will affect his work," noticing Liu Banxia’s expression, the patient’s girlfriend hurriedly explained.

Liu Banxia laughed and nodded. "I’m a doctor; I understand. Having a high fever alone can be unbearable, and he’s also suffering from pulmonary embolism, which affects his breathing."

"You both don’t need to worry too much. As the old saying goes, ’Illness comes like a landslide but goes like pulling silk.’ And for some conditions, the acute phase is actually easier to treat."

"Even though he has an eight or nine-day case history, it still seems like an acute case to me. The more test results we gather, the stronger our theoretical basis will be."

"Once the thrombolytic therapy takes effect and his spirits improve, any hidden conditions might emerge, making treatment easier."

"In the meantime, try recalling more details. Look for any symptoms that you might’ve overlooked. Anything you remember, no matter if it’s useful or not, share it with us for evaluation."

"After the anticoagulation is complete, we’ll admit him to a ward. You can start processing his admission form now. This is Dr. Miao; I’ll assign him to keep a close eye on your boyfriend here."

"Thank you, Doctor. This has been an extremely stressful time for us," hearing Liu Banxia’s patient explanation, the patient’s girlfriend seemed to relax slightly.

"Doctor, my neck feels a bit odd," said the patient lying on the bed.

"What kind of oddness?" Liu Banxia asked. 𝘧𝓇𝑒𝑒𝑤ℯ𝑏𝓃𝘰𝑣ℯ𝘭.𝘤ℴ𝘮

"It feels tense, a bit rigid," answered the patient.

Liu Banxia moved closer to the bed to examine the patient’s neck, and his heart skipped a beat.

The patient had no trouble turning his head from side to side, but when Liu Banxia tried lifting his head slightly, he felt significant stiffness. This was nuchal rigidity.

How did it become like this?