Practicing Medical Skills in a Small Clinic novel Chapter 574

Chapter 574: Chapter 262: Eliminating Possibilities, Diagnosis from a New Perspective (2)

Getting caught up in a dead end is the easiest thing to happen when diagnosing complex cases.

After all, every doctor naturally feels confident in their own diagnosis and knowledge.

Even if this confidence may be misplaced, they tend to self-recommend and find it hard to extricate themselves.

Doctors running their own clinics are different.

Especially when they are both the boss and the doctor, striving to their utmost when diagnosing various cases.

They go to great lengths to identify the cause of the illness.

Because determining the cause can prevent accidents and also result in hefty treatment fees. If it’s a complex case, it can enhance the clinic’s reputation and prestige.

With so many incentives, clinic owners work hard to improve their diagnosis efficiency for all kinds of diseases.

"The patient initially presented with headache, sore throat, and fever, symptoms very similar to influenza. Could this be a viral infection?"

Li Jingsheng decided to look into the patient’s symptoms.

He carefully examined and enlarged the patient’s skin photos to see the details.

The backs of the hands and legs were covered with purple bruises of varying sizes.

Previously, he focused on the larger bruises; now, changing his approach, he was inspecting the smaller bruises.

"This may not be subcutaneous bleeding, but rather disseminated intravascular coagulation."

At that moment, his experience in cardiovascular disease diagnosis came in handy.

"If it really is disseminated intravascular coagulation, it must be acute."

His line of thinking was continually breaking new ground.

The day after the patient took medication, purple purpura began appearing subcutaneously on the face and limbs, varying in size.

This indicated the onset was very acute.

"Sudden purpura, acute disseminated intravascular coagulation, upper respiratory tract infection, sore throat with congestion, pre-onset use of antibiotics and antipyretics, headache, fever, mild tenderness around the navel, mild thrombocytopenia, significant increase in white blood cells and neutrophils..."

He combined all the information with the initial diagnosis results and began searching for diseases that matched these symptoms.

This method was indeed very practical.

It’s similar to a computer’s intelligent search: the more comprehensive the information provided, the more accurate the results.

"Sepsis caused by meningitis seems to have quite a few similar symptoms."

The most familiar is meningococcal septicemia.

Li Jingsheng’s eyes gradually brightened.

"Additionally, the patient has mild tenderness around the navel, joint and muscle aches, symptoms very consistent with allergic purpura."

However, based on his medical knowledge and clinical experience, such widespread mucocutaneous bleeding typically results in very low platelet counts, usually not exceeding 50 × 10⁹/L.

In most cases of widespread bleeding, platelet counts are below 30.

"Should I get a chest X-ray?"

If possible, an ECG could also be checked.

But each additional test deducted one or two points, making him very cautious.

He still suspected that viral meningitis was more likely.

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