The experience of this 21-year-old college student made me unable to calm down for a long time. When I thought of him kneeling on the hospital bed, sometimes holding the bed sheets and tearing them up, sometimes I calmed down and looked at my parents sadly, with fear and uneasiness in my eyes. After his parents came from another city for 4 hours, he stopped breathing completely with the company of his family, teachers and classmates... Every time I think about it, I can't help but feel sorry.
The male, 20 years old, is a student from a local university. He broke up with his girlfriend a week ago.
After breaking up, the patient did not go to class for several consecutive days, and the teacher told the counselor about this situation. The counselor found the patient's roommate and asked about the situation, thinking that he was depressed after breaking up and was unwilling to go to class, so he came to the dormitory to find him.
When I arrived at the dormitory, I found that the patient was lying in bed and was in a very depressed mood. However, according to the boy himself, he did not go to class because of dizziness, headache and fatigue.
In addition, the counselor also found a cat in the patient's dormitory. It turned out that this was raised by the patient and his girlfriend before, but now they have broken up, and the cat has been here. According to school regulations, pets are not allowed in dormitories, but now is not the time to say this, so seeing a doctor is important.
At that time, the patient's condition was already very bad, and the counselor did not dare to delay and took him to the school hospital.
The counselor and the doctor briefly explained the situation. The doctor performed corresponding examinations on the patient, but found no abnormalities. The school doctor said that these young people now have too poor psychological qualities and cannot bear the slightest setback. Just go back and rest more and strengthen nutrition.
The next evening, the patient's roommate called the counselor and said that his symptoms had not only not relieved, but had worsened, so he asked him to come and take a look.
I have to say that this counselor is very conscientious and is already off work time, and after receiving the call, he still rushed over.
That night, the patient was sent to the hospital emergency room.
When he saw him, the symptoms were already very serious. In addition to local muscle pain, the patient also had symptoms such as difficulty opening the mouth and , stiff neck and unable to move freely .
The first reaction is meningitis, because neck stiffness , headache, and consciousness disorders, all of which are highly consistent with the symptoms of meningitis. But surprisingly, no abnormalities were found after the head MRI examination.
At this time, a terrifying situation occurred.
"Water...water!water!" Looking at the tea cup on my table, the patient showed a very frightened expression and his face was also very painful. What makes me nervous is that he is not only afraid of water, but also light and sound. Even a slight stimulation can induce spasm .
Before these symptoms, I never considered it in a bad direction until he had these symptoms. I realized that the situation was not good. Anyone with some common sense knows that at this time, is a typical symptom of rabies .
Maybe the counselor also realized the problem and asked tremblingly:
"Can it...can it be rabies?"
"This possibility is not ruled out! Does the patient have a related history of exposure before?"
"He has a cat in his dormitory, and I don't know if it has anything to do with it." It can be seen that the counselor's expression changed from anxiety at the beginning to fear and despair.
After hearing this, I quickly checked the patient's body and found a wound on his right thigh. The wound is very deep and has not been completely scarred at this time.
When I saw these, I was desperate. If it was really rabies, it means that everything I do now is futile.
At this time, the patient recovered a little more consciousness, and I had the opportunity to learn more about the situation from him.
"Have you been bitten by a cat?"
" Last week I turned over while I was sleeping and accidentally pressed it down and got bitten...but I went to get the rabies vaccine."
" has the immunoglobulin been injected? "Although I was relieved to hear him say he had received the rabies vaccine, the wound was a bit deep after all, so it was still safest to use immunoglobulin .
" I was also given. "
Here, the possibility of rabies can be basically ruled out. Because he was injected with rabies vaccine and immunoglobulin after being bitten, the probability of the disease is very small. I don't believe he is so unlucky.
What is the reason? In an instant, a word flashed through my mind. I tried my best to deny this situation, but everything in front of me forced me to doubt it.
He was bitten by an animal and was vaccinated in a standardized manner throughout the process, but he still had rabies-related symptoms. There was only one possibility: Tetanus !
Animal or insect bites; wounds are contaminated by soil and feces; burns and scalds, squeezes and ; puncture injuries caused by nails or needles, and open fractures , etc. are all triggering factors.
After being bitten by cats and dogs, many people know that they need to get rabies vaccine, but most people ignore the importance of preventing tetanus. Related literature reports that among severe cases of tetanus caused by animal injuries, stabbings, iron saw injuries, falls, etc., animal injuries account for 17% .
Symptoms of tetanus and rabies The disease is extremely similar. Although it is not the same disease, the mortality rate of both is surprisingly terrifying.
, especially when tetanus has already occurred, the prognosis effect is often very poor. According to statistics from WHO , about 1 million people are infected with tetanus every year, and the death toll is about 4.4 million . If there is no timely treatment, the mortality rate of the elderly and infants is close to 100%!
As expected, he did not think about tetanus prevention after being bitten. I explained the situation to him, asked the counselor to notify the patient's parents, and contacted colleagues in ICU to prepare for rescue.
l0 That night, the patient had severe systemic spasms and interfered with his breathing. After consultation in multiple departments, he decided to perform tracheostomy on him to assist breathing.Maybe the patient had checked the relevant information on his mobile phone, and knew that there was little hope, so he refused the tracheotomy. He had been waiting for his family, and he said he just wanted to see his parents for the last time.
The next morning, parents from other places rushed to the ward. When they saw the child for the first time, two simple and honest middle-aged people cried.
They hugged their son tightly and kept saying: "Don't be afraid, mom and dad are here, it can be cured. "
I can clearly feel that the patient is trying to restrain himself and not let himself be hyperactive and irritable.
At noon that day, the patient left with the company of his parents, teachers, classmates, doctors and nurses.
Here I also want to tell you a few facts:
First, Tetanus is not a literal broken wound that is exposed to wind. It is an acute characteristic caused by Clostridium tetanus invading our wounds and growing and reproduction, which then produces toxins. Contagious opposite sex.
Second, Tetanus is also called "7-day wind", and the course of the disease has three main periods. The incubation period is the incubation period, which varies, mainly related to whether the injured person has received a vaccination, the trauma site and treatment method. During the prodromal period, fatigue, dizziness, headache, irritability, local pain and even stiffness.
attack period, at this time, the muscles will continue to contract, from the chewing muscles to the face, back, abdomen and limbs, and then dyspnea and suffocation. It is also during this period that it shows great sensitivity to sound, light, vibration and touch and induces strong convulsions.
3, open fractures and squeeze injuries; deep puncture injuries; trauma and septic symptoms at the same time; burns, scalds, frostbite, etc., and the wound has foreign bodies or necrotic tissue, especially mammals' saliva, feces or soil, etc.; burns, scalds and frostbite, and must undergo surgical treatment, but have not been treated and the time has exceeded 6 hours; warhead injuries and other types of wounds must be intervened in a timely manner.
