"You can't say that. We've at least ruled out a few possibilities." Zheng Ren's expression was as serious as when Su Yun and Zhou Litao were teaching.
"What are you considering now?"
"The most common one that can be applied should be formaldehyde poisoning," Zheng Ren said. "Mild poisoning has blurred vision, dizziness, headache, fatigue, and other systemic symptoms. Severe poisoning can cause the patient to have pulmonary edema, hypoxia, and other symptoms. "
"It doesn't seem like it." Su Yun shook his finger. "First of all, formaldehyde poisoning is difficult to continue after leaving the toxic environment. Let's not talk about immediate relief and becoming like a normal person, but it's unlikely for the sense of smell to develop into convulsions. "
Zheng Ren also felt that this diagnosis was a little far-fetched. Su Yun's judgment was right.
He continued to ponder, his fingers tapping on the table. Su Yun felt that if this guy was old, he would also be like Old Chief Physician Pan.
Or perhaps he was intentionally or unintentionally imitating Old Chief Physician Pan.
"It's not formaldehyde poisoning or sulfur dioxide poisoning. Intracranial tumor? This possibility … "Zheng Ren said softly as he thought about it.
"Do you even recite it during exams? How annoying, "Su Yun said disdainfully. Su Yun said disdainfully, "Do you want to bring your fifth edition of surgery with you during the hospital consultation in the future and recite it paragraph by paragraph?"
"Hmm …" Zheng Ren continued to ponder as if he did not hear Su Yun's mockery. "Also, it's an illusion. You feel like you can't smell anything and then you have a seizure. "
"You can go write fantasy novels. If there's such a situation, why did it not appear earlier or later, but in the CT room? Isn't this nonsense? "Su Yun said.
"If it's a seizure, would it be better if we treat it as epilepsy? For example, reflex epilepsy syndrome.
Almost all seizures are induced by specific feelings or complex cognitive activities, such as reading epilepsy, panic epilepsy, visual reflex epilepsy, hot bath epilepsy, card epilepsy, and so on. Remove the triggering factors, and the seizures will disappear. "
"You mean …" Su Yun was also puzzled.
"Claustrophobia is usually more obvious during nuclear MRI. However, there are also patients who have seizures during CT, in SCI … "
"Stop showing off your data. Epilepsy is possible, but can it explain the sense of smell failure?" Su Yun continued to nitpick.
Indeed, Su Yun was right.
This was like pressing the gourd and the ladle would float. The failure of the sense of smell and epilepsy could not be put together.
Besides, claustrophobia was rare.
Zheng Ren let out a long sigh and continued to think.
"Hehe, do you want me to ask about other medical histories?" Su Yun said with a smile.
"Are we going to find Zhou Litao?"
"Who knows? Let's ask the nurses first. Maybe they can provide useful information."
"If you want to go and have fun, just go. Don't use medical history as an excuse," Zheng Ren said. "Actually, epilepsy and the failure of the sense of smell can also be put together."
"For example?"
"Antihypertensive drugs can improve heart function, but they can also occasionally damage the olfactory nerve."
"It's too far-fetched."
"Abnormal discharge of brain neurons … Nerve damage …" Zheng Ren began to mutter again.
"Don't think that you can be more professional by saying that epilepsy is an abnormal discharge of brain cells and neurons," Su Yun said.
"It's not like that …" Zheng Ren raised his hand and said, "Nerve damage doesn't necessarily have to be caused by external injuries. Other factors can also cause nerve damage."
"Tumor invasion, chemical elements in the air, what else do you want to say? I've just diagnosed these. "
"Parasites, such as amoeba, first enter the human nasal cavity and are ingested by the supporting cells of the olfactory nerve epithelium by phagocytosis. Then, they travel along the unmyelinated mesentery of the olfactory nerve terminus, pass through the cribriform plate, and reach …"
As Zheng Ren spoke, he was stunned.
Su Yun's gaze was also a little puzzled. He looked at Zheng Ren in surprise.
At first, he wanted to refute, but primary amoeba meningoencephalitis was indeed a disease that caused loss of smell and symptoms of epilepsy. Su Yun swallowed the words that were on the tip of his tongue.
Uh …
"It's primary amoeba meningoencephalitis!" Zheng Ren said, then added, "This diagnosis is more reliable. There's an 80% probability!"
"Primary amoeba meningoencephalitis? How did it get in? "
"Ask Chief Zhou if there are any wounds near the patient's nose. By the way, how old is the patient? It's possible that his acne was squeezed and he was infected with amoeba. "
The more Zheng Ren spoke, the more confident he became.
Because the flaws in the previous diagnosis were too obvious, as long as there was basic logic, it could be ruled out. They belonged to a type of differential diagnosis, a sacrificial diagnosis to find a reason to be denied.
"At first, there was an abnormal sense of smell, but then there was dizziness, headache, nausea, spurting vomiting, and then epilepsy." Su Yun frowned, giving a reason that he was not quite sure himself.
"Depending on the location of the infection, the progression of the disease may be staggered," Zheng Ren said. "The disease is very complicated. The steps in the textbook are only one of the ones that have a high probability of appearing."
As expected, Su Yun's words were immediately refuted by Zheng Ren.
Zheng Ren then picked up his phone and made a call.
The phone rang at the door. Zhou Litao then pushed the door open with his phone.
"Chief Zheng, Brother Yun, I'm sorry. The patient had an emergency and came back late," Zhou Litao said apologetically.
"Is there any trauma in the triangular area of the patient's mouth and nose?" Zheng Ren asked directly.
"Uh … No," Zhou Litao said, "No trauma."
Zheng Ren was a little disappointed, but he immediately asked, "How old is the patient?"
"An old man in his sixties," Zhou Litao answered subconsciously.
Was he wrong?
"Chief Zheng, what disease are you considering?" Zhou Litao asked carefully when he saw Zheng Ren's unfriendly expression.
"No trauma? What about rosacea? "
"Uh …" Zhou Litao was stunned. What was wrong with Chief Zheng?
"There's rosacea. The patient drinks a lot all year round. For the time being, we're considering alcohol-induced convulsions," Zhou Litao said immediately to save Chief Zheng from asking more questions.
"No! It's primary amoebic meningoencephalitis, "Zheng Ren said." Put the patient in a state of sedation and hurry up with a CT scan. Oh, and do a cerebrospinal fluid examination. "
"…"
Zhou Litao had just been busy, sweating profusely. When he returned, he was once again stunned by Zheng Ren's words. He was even more confused than when Su Yun had explained his doubts.
"Rosacea. When in contact with raw water, there's a very small probability of amoeba infection. The incubation period is short and the onset is sudden, "Zheng Ren said with certainty. Zheng Ren said with certainty, "Let the inpatient department doctor check the cerebrospinal fluid immediately and do a CT scan."
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