Since joining the Fourth Hospital, Yuan Ping'an has been used by Sun Lien as a particularly convenient document search engine. Yuan Ping'an's performance is indeed worthy of Sun Lien's "expectations". After receiving Sun Lien's request, Deputy Chief Physician Yuan gave a list within ten minutes. He also added a very proud sentence at the end of the document, "I have made a lot of lists, all of which are the lists that Dr. Sun may need to use. I am still studying how to use databases recently. Maybe I can organize relevant information through fuzzy searches."

Sun Lien felt a little embarrassed to force an excellent emergency department doctor into a programmer. However, this embarrassment was quickly swept away by the excitement of seeing the list.

I won’t mention the common parasites in the list for now, but the situation in various places is actually not much worse. However, when there are many parasites, Sun Lien saw some uncommon content.

Schistosoma, liver flukesomiae, and lung flukesomiae. These three are the most important flukesomiae in the local area. Moreover, there is only one flukesomiae in Sichuan that has a relatively high incidence rate across the country - lung flukesomiae.

Malaria and black fever in the protozoa disease classification are obviously incompatible with Qian Ziwen's symptoms. Since 2011, malaria itself has no local disease reports in Sichuan. Several sporadic occurrences were infected outside the province, and then they started to develop after returning to Sichuan. Black fever was mainly concentrated in the southwest region, including Wenchuan, Lixian, Maoxian and other places in Aba Prefecture, as well as Hepingwu County, Beichuan County, Mianyang City. There are basically only sporadic occurrence reports in other areas.

Qian Ziwen's symptoms and his previous residence are not comparable to protozoa disease. The more common nematode disease is not even more suitable for his symptoms. Then, the only type of disease that can be suspected is flukesmosis.

Currently, there are not many patients in Sichuan Province. There are about 1,700 advanced patients. Moreover, no acute cases of local infection have been found for ten consecutive years, and no local infections or sick animals have been infected for five years. Since 2015, all 63 endemic counties (cities, districts) have reached the standard for blocking schistosomiasis. Although Qian Ziwen is still likely to suffer from schistosomiasis, the possibility is not high.

In terms of symptoms, the suspicion of schistosomiasis cannot be ruled out. Fever is the main symptom of acute schistosomiasis, and it is also accompanied by gastrointestinal symptoms, liver and spleen atrophy and lung symptoms. At present, Qian Ziwen only has fever. Therefore, schistosomiasis cannot be ruled out, but the risk is not too great.

The incidence rate of hepatic flukes is not high. The survey report in 2004 first showed that the infection rate and standardized infection rate of Sichuan population were 0.21% and 0.18%, respectively, and the infection rate in the province was at a low level. However, the main geographical range of hepatic flukes is located in the area north of the Yangtze River, which happened to be the area where Qian Ziwen and his grandmother lived.

From the geographical analysis of living, Qian Ziwen also has the risk of being infected with liver flukesomiasis. However, his symptoms are not up to par.

There are seven main types of liver flukes, but almost all of them are symptoms related to digestion and nutrition. Hepatitis type, cholangitis type, gastroenteritis type, and cirrhosis type are symptoms related to the digestive system. Children with severe infections may be divided into dwarf type. The hidden type and mixed type are obviously not suitable for Qian Ziwen's recurrent fever without cause.

Sun Lien used a pen to draw a picture on the printed list, saying that Qian Ziwen was less likely to be infected with liver flukesomia than he was.

From this perspective... the most likely thing is that pulmonary flukesomiasis is the only one left.

Sun Lien scratched his head with a pen and decided to skip the narrative directly and take a look at the diagnostic plan first.

"Ask the child whether he has a history of living or traveling in popular areas such as Jiangsu, Zhejiang, Sichuan, Yunnan, etc.? Do he often go to Xigou to play, and catch creek crabs, crayfish, etc.; do he drink stream water, eat raw, pickled or half-baked crabs or crayfish." The first article in the diagnostic guide made Sun Lien's eyes lit up.

According to Grandma Qian Ziwen, there is a stream behind her house. This is a place where nearby residents often play in the water to cool off. Building an umbrella in the shallow stream water, and then placing tables and chairs in the stream to play mahjong is one of the main entertainment activities in the local summer.

Then, if a four-year-old child doesn't play in water and catch shrimps and crabs in this environment, it will be a little wrong. After catching these little things, it seems to be a very reasonable entertainment act to use them for a tooth sacrificial sacrifice.

Sun Lien raised his eyebrows, then simply found the diagnostic guide for pulmonary flukesiasis from the computer, and then began to study it carefully.

In fact, if you really need to look at it carefully, the assumption of pulmonary stimuli is still a bit unrestrained. After all, Qian Ziwen has not had symptoms such as coughing and blood coughing. However, during the examination of the hospital, he was not found to have active mass under his skin.

But pulmonary flukesomiasis seems to be at least more likely than schistosomiasis and liver flukesomiasis. Sun Lien thought for a while, and then decided to do a check-up.

I'll do an ELISA right away? It seems that I don't take my father's wallet seriously. Then do an imaging test? But there is only fever, which may indicate that the pulmonary twitch is not serious enough to cause invasive lesions and hollows in the lungs. Even if I do a test, I may not be able to find valuable results.

Sun Lien was having a headache. Yuan Ping'an ran to the office. He pushed the door open and asked, "Doctor Sun, what's going on? Do you have any clues?"

"It's a little bit." Sun Lien nodded, and then said, "I feel that pulmonary stimuli is a bit like, but there is no evidence to support this idea yet. And schistosomiasis cannot be ruled out."

"He doesn't have many symptoms... why don't you do a B-ultrasound?" Yuan Ping'an came over and suggested, "Pulmonary flukesomiasis generally does not cause hemolysis or bleeding, right? His low hemoglobin is likely to be a kind of hematopoietic disorder related to the liver - Pulmonary flukesomiasis will invade the liver."

Sun Lien slapped his thigh, "Yes! He just had fever! Anemia is also a symptom!"

Pulmonary flukes are not just picky parasites in their lungs. They are actually not picky about food at all - the liver, lungs, and even the nervous system. They drill everywhere whenever they have the chance.

The most common pulmonary flukesomiasis is of course the chest and lung type. This is the most common type. Patients often show symptoms such as cough, sputum, shortness of breath and chest pain. Moreover, cough occurs the earliest and there are very obvious signs of "the heaviest in the morning".

Abdominal pulmonary flukesomiasis accounts for about 30% of the total incidence. Patients will show dull pain in the whole abdomen or the right lower abdomen. When the insect body migrates to the liver, liver abscess will form. The main manifestation of this abscess is the increase in the liver volume.

This is why Yuan Ping'an suggested a B-ultrasound. Pulmonary flukes have a considerable possibility of invading the liver, and this invasion may lead to repeated fever and anemia in the patient. It is also very simple to determine whether there is a Pulmonary fluke invading the liver - after the Pulmonary flukes moves into the liver, an abscess will definitely form. As long as the abscess is found, there are enough reasons for further diagnosis of Pulmonary flukes.
Chapter completed!