As a clinician with "rich experience in dealing with infectious diseases", Sun Lien's own vigilance is definitely the highest among ordinary clinicians. After roughly asking about the patient named Wei Aihua in front of him, the alarm ringtone in Sun Lien's mind finally stopped - she and Ji Xiuying had no activity trajectory or intersection in location, and her symptoms were different from Ji Xiuying.

Wei Aihua's main symptom is cough, but it is not accompanied by fever. What really makes the doctors in the affiliated hospital helpless is Wei Aihua's lung tablets.

From CT, Wei Aihua's lungs had multiple patches and nodules negative two years ago. The doctor at the time thought that this should be pneumonia, so she used antibiotics for treatment. During the hospitalization, Wei Aihua felt that her symptoms had improved. However, the CT test showed that her lung lesions showed no signs of absorption.

The most recent CT scan was half a month ago. The respiratory department of the affiliated hospital admitted Wei Aihua and diagnosed it again according to pneumonia. However, this time, not only did the CT scan result not change, but even made more serious progress. Wei Aihua himself did not feel the cough decrease-the frequency and frequency seemed to be no different from before treatment.

This result surprised the doctors in the affiliated hospitals, and the progress...the doctors felt a chill.

Wei Aihua's lungs showed multiple patchy ground glass shadows, accompanied by thickening of lobular spaces. These ground glass shadows also showed patchy "paving stone signs" on the border.

Paving stone sign is a very distinctive imaging lung lesion result. This may also be one of the most unfriendly imaging features for "intensive phobia". It is an imaging feature similar to irregular paving stones that appear when the thickening of the lung lobular septal thickening and the shadow of the lobular spacer superimposed on the opaque background of ground glass.

Many years ago, paving stone sign was a classic lesion of alveolar protein deposition. It was also one of the earliest imaging changes used to describe alveolar protein deposition. However, as imaging gradually developed, the imaging department's understanding of this feature is getting better and better. In addition to alveolar protein deposition, pulmonary edema, pneumosporidium carnivora infection, diffuse alveolar hemorrhage and invasive mucous adenocarcinoma are all likely to show this feature.

This is why the doctors in the respiratory department of the affiliated hospital felt a little cold after seeing this change - Wei Aihua had never had five infectious diseases when she was admitted to the hospital. She must not be HIV...

Fortunately, the five infectious diseases that were urgently supplemented later proved that Wei Aihua was not a patient with acquired immunodeficiency syndrome. This also helped the doctors in the affiliated hospital rule out that she was suspected of Pneumosporidium Caris.

However, this elimination method cannot help Wei Aihua relieve her illness. She was still coughing frequently. In the following half month, except for not continuing antibacterial treatment in the last week, Wei Aihua continued to undergo various tests including routine hematuria and feces, blood biochemistry, coagulation function, autoantibodies, ESR and respiratory etiology tests. All results were negative.

Because of concern that it might be tuberculosis, the affiliated hospital also conducted three sputum smear tests for Wei Aihua. Blood anti-tuberculosis antibodies and serum tuberculosis infection T cells were also negative. Even the common bacteria and fungal cultures of the sputum were negative.

The doctors in the affiliated hospital had a headache when they achieved this step. The half-month hospital stay had already arrived, so continue to be hospitalized... The social security side may think that this patient is over-medical. Therefore, the doctors in the affiliated hospital recommended Zhou Xiufang Comprehensive Diagnostic Center of the Fourth Central Hospital to Wei Aihua, and also specifically pointed out Sun Lien's name.

Wei Aihua, who had been tortured for almost three years, came to the Fourth Hospital with the last glimmer of hope, and was very "lucky" to meet Sun Lien's medical treatment afternoon. She originally thought she needed to spend some effort to grab an expert account, but she did not expect that when she mentioned Sun Lien's name, she gave the first account in the afternoon to the charging window.

Moreover, the registration fee was only ten yuan. Wei Aihua could hardly remember when she last used ten yuan to go to the expert clinic - twenty years ago? As soon as she entered the clinic, Wei Aihua was surprised to find that this "expert" was actually a young man about the same age as her son. If it weren't for the fact that the other party was indeed serious about the treatment and the deputy director of the affiliated hospital had recommended it to her, she would have really turned around and left.

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"Um..." Although he was complaining in his heart that he had fallen into the respiratory disease trap recently, Sun Lien vaguely felt that... the aunt in front of him might not be a problem with respiratory disease.

Although the lesion is indeed in the lungs, the prompt given by the status bar allows him to see an interesting place.

"Lipid granuloma 20865.39.57" and "Pulmonary Tuberculosis 12436.21.45".

Tuberculosis is very easy to understand, which means that the status bar has clearly defined a diagnosis - Wei Aihua is infected with Mycobacterium tuberculosis. If she does not have a fever and does not support all examinations. This means that she is likely to be a occult infected person.

Mycobacterium tuberculosis is a very elusive pathogen. It exhibits a variety of symptoms and has many types of impacts on patients. Among them, the most stunning one is "occult tuberculosis infection".

This type of patient does not have the symptoms of fever, night sweats, morning coughs, etc. that tuberculosis patients often have. They often hide in the human body for many years and eventually develop into bone tuberculosis and other diseases that require long-term treatment.

As for the negative test... Anyway, it was tuberculosis, Sun Lien was not surprised at all. He no longer wanted to see the diagnosis plan for tuberculosis again - in short, it was "unable to rule out tuberculosis". Any disease may be related to tuberculosis, and tuberculosis can show almost all types of symptoms.

But...what is the case with this lipid granuloma? Sun Lien has not treated many respiratory patients, and he has never seen such a diagnosis description before. Even the various diagnostic information collected by Wu Youqian has not described it like this.

If analyzed simply in a literal sense, this may be a lesion caused by oil, but it may also be an abnormal immune result.

The essence of granuloma is an inflammation caused by delayed hypersensitivity reactions. It is the aggregation of macrophages and their derived cells, which may appear with other inflammatory cells. When macrophages and their evolved cells are locally infiltrated and proliferated, these cells will form nodular lesions with clear boundaries - this is granuloma.

Macrophages are phagocytocytes in the human body that are specially used to deal with large foreign bodies and cell fragments. They consist of two tissue forms: "fixed cells" and "free cells". In addition to being present in the blood, they also exist in loose connective tissues - such as in alveoli.

If the three words "lipidity" are combined, then it seems that the culprit of the disease has been portrayed with an accurate portrait - this should be a kind of oil that is inhaled into the lungs by the patient for a long time.

Sun Lien was very satisfied with his inference. He seemed to have seen hope of solving the diagnosis in the outpatient clinic. However, he immediately felt disappointed.

"I don't cook normally..." Wei Aihua was a little surprised that Sun Lien would ask her this question, but she still answered with some embarrassment, "I don't know much about cooking, and my husband usually cooks."

It was not the oil smoke caused by cooking... Then what oil is often inhaled by a middle-aged woman who can't cook? Sun Lien frowned. This oil of unknown origin and tuberculosis that cannot be diagnosed through immunology... It is really troublesome to add up.
Chapter completed!