Toxoplasma gondii is an opportunistic parasite. The three words "opportunistic" actually sum up it very well. They usually hide in the human body until the horn of attack sounds, and then they suddenly attack, and then attack with vicious attacks.
The situation takes away the life of the host.
And this clarion call for attack is the decline of the human immune system.
Toxoplasma gondii infections are actually very rare in ordinary people. They usually appear in AIDS patients. Once doctors confirm that a patient is infected with Toxoplasma gondii, their first reaction is to check for HIV antibodies. It is the same as Kaposi's sarcoma.
, the outbreak of Toxoplasma gondii is basically a disease exclusive to AIDS patients.
For Yang Jianqiang, he is lucky and unfortunate at the same time.
The attack of leukemia forced him to undergo systemic radiation therapy, and the result of systemic radiation therapy was to kill all the bone marrow in his body. Without the support and supplement of hematopoietic bone marrow, the antibodies in his body that continued to suppress Toxoplasma gondii continued to weaken.
, recorded that after the memory T cells of Toxoplasma antibodies died along with the normal apoptosis program, his body lost the ability to recognize Toxoplasma gondii. The donor had obviously never been exposed to Toxoplasma gondii, and his bone marrow
There is no ability to produce such antibodies. Therefore, Yang Jianqiang unfortunately lost the ability to suppress Toxoplasma gondii in his body. This is his misfortune.
But fortunately, the radiotherapy that cleared his bone marrow also caused huge damage to Toxoplasma gondii. Toxoplasma gondii is a parasite that is relatively sensitive to radiation. A dose of more than 20,000 rads of radiation can cause parasites.
The body loses its ability to reproduce. And low-dose radiation also has a strong inhibitory ability against Toxoplasma gondii. This is why although Yang Jianqiang lost his immunity, he became ill a year later.
"It's like writing a novel." After listening to Sun Lien's report in his office, Liu Pingchuan frowned and shook his head, "What a coincidence."
"However, the symptoms are correct." Sun Lien is quite confident in his diagnosis. Although through PCR testing, after all three diseases have been tested, the results he wants will definitely appear. But he still hopes to convince Liu first
Pingchuan, carried out targeted treatment on Yang Jianqiang one step ahead. Those eight edema areas gave Sun Lien some ominous premonitions.
"If it is really Toxoplasma gondii infection, just use a combination of sulfadiazine and pyrimethamine for treatment. There is no need to rush for such a short time." Liu Pingchuan's opinion is conservative, and he does not intend to take risks before getting conclusive evidence.
Yang Jianqiang underwent specific treatment.
Sun Lien was silent for a while. Liu Pingchuan's opinions were mature and prudent. But he still felt a little inexplicable. Although he himself didn't understand where this worry came from.
The opinions of superior doctors take priority over your own views. This is a process that every trained doctor will go through. For many trained doctors who have just entered the industry, this level is a must. What you think doesn’t matter.
What matters is what your superior doctor thinks.
Although this approach sounds a bit excessive, for the sake of the patient's life, doctors with regular training always have to suffer some injustice first. After all, in comparison, the possibility of mistakes by senior doctors is much lower than that of junior doctors.
Sun Lien left Liu Pingchuan's office, and while walking towards the consulting room, he lowered his head and wondered where his doubts came from. Respecting his superior doctor did not mean that he did not need to think about it. If he did not deal with this concern
Clearly, Sun Lien is afraid that he won't be able to sleep well tonight.
"Are you back to work so soon?" A voice behind him interrupted Sun Lien's contemplation. He turned around and found Zhou Ce walking towards him while chewing a sticky hot dog bun.
"Ah...right." Sun Lien nodded. The hot dog bun in Zhou Ce's hand looked sticky, with red ketchup and yellow mustard spread on the bun. I really don't know what Zhou Ce thinks of this bun.
What did you do? "Dr. Zhou, are you going for a consultation?"
Zhou Ce shook his head, "I just finished watching the outpatient clinic and had lunch by the way."
Sun Lien glanced at the time on his phone. It was now 5:40 pm, and he would have to get off work in 20 minutes. "Do you want to have lunch at this time?"
"I don't want to say that I am a poor guy who can't even eat lunch." Zhou Ce smiled, finished the remaining hot dogs in three mouthfuls, threw the bag into the trash can next to him, clapped his hands and asked,
“#￥%##!##%……)&(*……#￥?”
"You..." Sun Lien's brows twitched, "Why don't you swallow the food in your mouth first? I still have time to wait for you to finish eating."
Zhou Ce waved his hand, rolled his eyes and swallowed what was in his mouth, "I see that you have walked around this corridor five times, and I wanted to ask if you are lost."
"Where did your inexplicable judgments come from?" Sun Lien wiped the non-existent cold sweat on his head, "By the way, I think I heard you say something about stealing the underwear of a young nurse when I was quarantined last time.
Things..." He suddenly thought of Zhou Ce's first question when he was quarantined. "Is there any story in this?"
Zhou Ce opened his eyes wide and asked, "You don't know this story?"
"I don't know." Sun Lien shook his head seriously, "If I knew, I wouldn't ask you."
Zhou Ce laughed and told a story.
It is said that seven or eight years ago, when Zhou Ce first became an ordinary resident doctor, there was an underwear thief in the Fourth Central Hospital. The thief's methods were not very clever, and he could even be said to be a model of ruthlessness. He was the most crowded at noon.
At that time, he arrogantly broke into the dormitory of female nurses who were arranged in the inpatient department at that time. Then in front of the entire hallway of young nurses, he pushed open the door of a nurse dormitory and stole more than a dozen pieces of underwear from inside.
The result of such a bold and straightforward action was that the underwear thief was pinned down in the elevator by Security Guard Liang and a group of brothers before he even left the inpatient unit.
The security department caught such criminals right after they started operating. They originally planned to hand over the underwear thief directly to the nearby police station to enhance the friendship between the two parties, but unexpectedly, the college teacher who rushed over found out that the underwear thief turned out to be a fifth-year intern student of the college.
.
In line with the attitude of treating illnesses and saving lives, after obtaining the forgiveness of the stolen nurse, the Security Department handed over the offending buddy to the college teachers. I hope this incident is just a not-so-fun joke. I hope that under the criticism and education of the teachers
Next, he can realize how inappropriate his behavior is.
Unexpectedly, a week later, the security department arrested this little bastard again. Some patients came to the security guard and said that there was a pervert in the women's restroom of the outpatient clinic who was peeping on them when they went to the toilet.
Brother Liang from the security department rushed to the toilet with a group of brothers, only to find that the prisoner turned out to be the underwear thief who was caught just a week ago.
If he was just a pervert, he would have been arrested. But this was the first time the security department had seen a pervert so upright, so frank and unrestrained.
Brother Liang became furious and prepared to send this impenitent little bastard directly to the police station. The college teacher who picked him up before also had an ugly expression on his face. He didn't even think about understanding this young man who was usually taciturn and extremely introverted in school.
How could such a thing be done?
Coincidentally, the floor where the incident happened happened to be the territory of the Hepatobiliary Surgery Department. Director Zhao Chongxi, the director of the Hepatobiliary Surgery Department, came out to watch the fun after watching the outpatient clinic. After hearing what happened, he pondered for a moment and asked the nurse to give the guy a cigarette.
I took a tube of blood and checked my liver function.
It didn't matter after a check-up, the boy's blood ammonia was as high as 974 μmol/l. When he was sent to the imaging department for examination, he was diagnosed with stage III liver cancer.
"He was very agitated at the time, and I wasn't sure what was wrong with him at the time. There may be many symptoms that simply caused the increase in blood ammonia. I was afraid it was some serious infectious disease." Zhou Ce explained, "So,
At that time, Dean Song made the decision and put the young man in restraints and locked him in a newly renovated clean room."
This is... not a very interesting story. Sun Lien sighed and asked the same question as other people listening to the story, "What happened next?"
"Then... there was no later." Zhou Ce shook his head and sighed, "The third-stage liver cancer caused hepatic encephalopathy, and the young man's family condition was also relatively poor. Later, after his family took him away, there was no news again."
He looked at Sun Lien, "So, what are you hanging around here for?"
Sun Lien glanced at Zhou Ce, wondering if this strange doctor thought he had a problem, and then replied, "We received a patient in the emergency room, and the situation was quite strange." He told him what he knew about the patient's condition, and his own
Infer and talk to Zhou Ce again.
"Your diagnosis... is a little too jumpy." Like Liu Pingchuan, Zhou Ce's first reaction was "This is such a coincidence," but then, he slowly tasted the difference. "
But...it makes sense."
"If it doesn't make sense, I won't try to mention this to Dean Liu." Sun Lien sighed, "But after listening to what Dean Liu said, I vaguely felt that something was not right."
Sun Lien's worries are also Zhou Ce's worries. The Department of Nephrology often interacts with the Department of Rheumatology and Immunology. In some hospitals that do not have a separate Department of Rheumatology and Immunology, this part of the treatment and diagnosis is often left to the Department of Nephrology. With corresponding professional knowledge and
Zhou Ce, who had a clear vision, immediately found the crux of the problem.
"If it is really an outbreak of Toxoplasma gondii caused by radiotherapy, how can we explain the progression of the disease?"
Sun Lien was stunned. Zhou Ce's question was very direct, and it was also the weakest link in the entire diagnosis process. His theory could explain why the patient became ill during the immunosuppression period when he had not been exposed to cats and dogs, but it could not explain why.
Why did his symptoms progress so quickly after the onset of the disease?
"The specific reason... I don't know." Sun Lien admitted that he knew nothing about it. As a trained doctor, there is no shame in not having a comprehensive grasp of these professional knowledge. "But based on the time and sequence of changes in his condition, it is speculated that
I think it may have something to do with adjusting his immunosuppressive regimen."
"The new immunosuppressive regimen has a weaker ability to suppress his immune system." Zhou Ce thought thoughtfully, then was surprised, "So the reason why he quickly developed symptoms was not because of the increase in Toxoplasma gondii infection, but because
Because immunity is improved?”
Sun Lien stood up suddenly, "I'm going to find Dean Liu!" Before he finished speaking, he ran out.