The attenuated measles vaccine is a free and compulsory vaccination program in China, and most citizens have been vaccinated in childhood.
Universal vaccination has significantly reduced the number of people suffering from measles in the country. Unfortunately, some groups have individual differences and will still get the disease after being vaccinated, but the symptoms are milder than those who have not been vaccinated, and they are basically moderate to mild symptoms.
Even so, it is definitely in the patient's best interest to detect and accurately diagnose the disease early. A prudent doctor will screen the patient for all common key diseases.
Measles patients will have specific signs of measles mucosal plaques, so the doctor will check the buccal mucosa in the patient's mouth.
The so-called measles mucosal spots are small gray-white spots that appear on the buccal mucosa of the patient's mouth 1 to 2 days before the rash. The diameter is about 0.5 to 1.0mm, and there will be some redness around it. It is said to be a specific sign of measles because of this symptom.
Only measles has it, and it can be diagnosed to a great extent different from other diseases. Once measles mucosal spots are detected, the probability of measles is almost certain.
Xie Wanying carefully looked at the buccal mucosa and found no measles mucosal spots. After that, she continued to carefully press the child's tongue with two cotton swabs to check the throat. The cotton swabs replaced the tongue depressor for the patient's examination, and the precautions for using the tongue depressor were the same.
, it should be placed in the anatomical position of the V-shaped groove called the boundary sulcus at the junction of the front 1/3 and middle 1/3 of the tongue. If it is too far forward, the tongue base and back pressure will not be in place. Too high will hinder the doctor's view, which will not affect the doctor's vision.
It is difficult to clearly see the tonsils and pharyngeal mucosa. If it is too far back, it will easily cause nausea and vomiting in the patient.
"Ah."
The doctor sister said this, and the boy said "ah" obediently.
The child opened his throat wide, and with the use of the tongue depressor, the doctor soon saw two small pink masses on both sides of the throat, which were palatine tonsils, commonly known as tonsils.
The light of the flashlight revealed that the child's tonsils were congested and edematous. It seemed that there were thick white spots on the surface, indicating that the acute tonsillitis had not gone away.
"My grandson has a cold, right, doctor? Give him some cold medicine." The grandmother of the patient was beside her anxiously urging the doctor to prescribe medicine, and she had to rush to get the medicine and go home to cook.
Xie Wanying was not in a hurry, put down the cotton swab, and then asked about the child's diet, stool and urine, whether there were any body pains, etc., and then looked at the child's skin for any traces of wounds or rashes.
"He can eat. He has some stools and his urine is a little yellow."
Based on the information provided by the patient's family, the overall initial diagnosis trend is acute tonsillitis in children. Xie Wanying said to the child's grandmother: "His condition requires blood tests, intravenous infusions, and intravenous drips."
"Aren't you going to give him some cold medicine?" the child's grandmother was surprised and asked.
"He doesn't have a cold, he has acute tonsillitis in children. There are signs of suppuration. He must get an injection, not just taking oral medicine." Xie Wanying emphasized that the child's condition is relatively serious.
"Injection? Oops, I don't have that much money. I need to call his parents." The patient's grandmother patted her thigh.
As a doctor, Xie Wanying did not dare to say that she might hospitalize the child, mainly because the family's financial situation was probably not very good based on their dress.
Clinically, most doctors will try their best to consider the patient and the patient's family, and will consider their financial situation. If the economy really does not allow it, the patient can be treated in the outpatient and emergency department without hospitalization as much as possible.