rotation was in the rotation, I encountered a case. At first I thought it was a common tonsillitis , but later I found that it was a more terrifying disease.
To this day, I still remember that the intern nurse was frightened and trembled all over. had no appetite for many days, and even couldn't help but vomit when I saw meat.
It was a Thursday afternoon. I had just finished my free time and a middle-aged woman knocked on the clinic door.
The woman is 38 years old this year and comes from the township below. Because the journey is long, she needs to transfer cars continuously, so even if the woman goes out early in the morning, she doesn’t come to our hospital until three o’clock in the afternoon.
When I saw me, the woman had symptoms such as fever, headache and aggravated throat. Because it is a special period, I dare not be careless. I finally felt relieved after reading the 48-hour nucleic acid report of women.
I started to ask about the specific situation. Although the possibility of new crown has been ruled out now, understanding the medical history will be more conducive to my next work.
It turned out that as early as a week ago, she had acute tonsillitis caused by sore throat due to a cold. She tried to withstand it, but after a few days of endurance, she still worsened. She had no choice but to get an intravenous cephalosporin antibiotic at the local health center.
Unexpectedly, the symptoms not only did not relieve but were aggravated after taking the medicine. In addition to fever, headache, sore throat, she didn't even dare to swallow, and her voice became hoarse.
Because she dared not swallow, I suspect it is esophageal cancer . Although chronic pharyngitis also has a foreign body sensation in the throat, this feeling is more obvious when it is quiet, and the symptoms will be relieved or even disappear when eating. Esophageal cancer is different, which manifests itself in the difficulty of swallowing large pieces of solid, semi-solid, fluid and water.
Since it was getting late that day, considering that her condition might not be simple, she suggested that she find a place nearby to live first and arrange a checkup for her the next morning.
Maybe she thought she could prescribe medicine and go home that day, but she didn't expect it to be so troublesome, so she complained when she heard that the next day she could check: "I just feel uncomfortable in my throat. Do you have to wait for the next day?"
"You don't rule out the possibility of esophageal cancer at this moment, and I will improve the relevant examination tomorrow."
She didn't say anything when I heard me say this, but she was obviously at a loss and could clearly feel her body trembling.
"Now I'm just suspicious. The examination is just to rule out this possibility, so that the right medicine can be prescribed later." I comforted.
The next morning, the woman came on time. What surprised me was that as soon as she entered the clinic, she hurriedly prepared to take off her mask.
"You put on the mask, now is a special period..." Before I finished speaking, she had already taken off the mask over there.
"Doctor, I can't breathe, and the back of my ears and face hurts too much."
Only then did I realize that yesterday was fine, but today her neck and face were already very red and swollen. I wanted to palpate the test, but when her hand was approaching the red and swollen place, she avoided it because of severe pain.
's neck was swollen like that, and it didn't look like esophageal cancer, but her condition is urgent now, so she quickly arranged for her to do laryngoscopy and neck CT. The result of laryngoscopy was found, showing that there were a large amount of purulent secretions in the oropharynx and the lateral wall of one side of the pharynx was swollen. At the same time, a cervical CT suggests multiple abscesses can be seen on the right cervical chest.
In other words, the situation was already very serious, so she was immediately arranged to be hospitalized and convened colleagues in the respiratory department and the infectious department to discuss it. Finally, an agreement was reached: tracheotomy was performed first, and then treatment was performed with sufficient antibiotics.
In the afternoon of the same day, a colleague from the respiratory department performed a tracheotomy and abscess of the pharyngeal wall for her, aspirating a large amount of purulent secretions, and the woman's condition began to improve.
I thought everything was going in a good direction, but just the day after the operation, I found that her body temperature was still rising, and her face and neck were swollen, her skin was red and tight, and there was gas accumulation under the skin. There was also a volatility when touched, which meant that purulent substances were produced under the red and swollen area.
Assign the operation again. Later, the nurse who participated in the operation recalled the scene at that time and was still scared:
"You can't imagine what kind of odor it was. It smelled like a rotten corpse. We usually just wear a layer of masks, but at that time we wanted to wear the whole bag of masks on our faces."
"The meat in the affected area was like being eaten by wild animals. I really can't imagine that such a patient can survive..."
So what is this disease? Later, after pathology and bacterial culture, it was finally confirmed that the woman was infected with a "carnivorous fungus", that is, necrotizing fasciitis . After two more surgeries were confirmed, the necrotic tissue was basically removed and the lesions were basically controlled. The woman was transferred to the critical care medicine department negative pressure ward for monitoring and treatment.
Then why did she get such a terrible disease? At the end of the third operation, I asked her in detail and found that she had had experience in contact with seafood before her body became abnormal.
Sea products are very common, why is it that she is targeted by necrotizing fasciitis? This starts with carnivorous fungus !
terrifying necrotizing fasciitis!
Necrotizing fasciitis, also known as "carnivorous fungus" infection, to put it bluntly, our skin, subcutaneous and fascia tissues are invaded by bacteria and then acute necrotizing soft tissue infection occurs.
Once infected, the disease will develop very rapidly. "Carnivorous fungi" will continue to eat away our fat and fascia. If it is not removed in time, the bacteria will "eat" the patient from the inside.
is actually very scary. Imagine that when you checked in in the morning, the patient was still lying on the hospital bed. When you came back in the afternoon, I found that there were only some strange residues and liquids left. How could not be scary?
It should be noted that necrotizing fasciitis begins rapidly, develops rapidly, and is in a dangerous condition. Extensive necrosis of local tissues is also very easy to spread. Once there is no timely surgery, the mortality rate is as high as 33-72% .
What you need to be more vigilant is that necrotizing fasciitis is often not easy to detect, which is also the most dangerous.
For example, we are accidentally injured when cutting vegetables, accidentally pierced when dealing with seafood such as fish and shrimps, accidentally stabbed by sharp objects, scratched by pets, etc. These all provide conditions for bacterial invasion.
For example, the reason why the woman in the above article suffers from necrotizing fasciitis is because when she was dealing with shrimp, the shrimp head splashed on her neck, which happened to be bitten by a mosquito on her neck. After scratching, she left a wound, which caused a tragedy. There are many examples of
. There was a 27-year-old man who had a 5mm cut on his ankle. Unexpectedly, two days later, he started to have a fever and the wound also had large-scale ulceration and was once critically ill.
and An old man from Dongguan stabbed his left hand while dealing with shrimp. Two days later, the left upper limb began to swell and pain. When he was sent to the hospital, the left upper limb had already died. In the end, because of shock, moved into icu, and he saved his life after amputation of the left upper limb.
One is an infection caused by the skin being punctured and damaged, and the other is an intestinal infection, such as eating it without cooked, or even eating seafood raw (sea urchin, crab, shrimp , oysters and oysters , etc.). If it is an infection caused by trauma, local debridement surgery can be performed to solve it. Once it is an intestinal infection, the problem will be really big!
Some suggestions:
If you are stabbed by seafood, first rinse the wound with running water, and then disinfect with alcohol or iodine.Remember not to stick band-aids directly, because a closed environment may be more conducive to the reproduction of anaerobic bacteria . Try to avoid touching water before the skin wound has not healed. If the wound is swelling and pain, go to the hospital in time.
When bitten by an animal, in addition to considering necrotizing fasciitis, you should also be alert to rabies , etc. It is recommended to go to the hospital in time.
