Chapter 241: Chapter 241

"Dr. Liu, do you think it could be heavy metal poisoning?" Wang Huan asked.

Liu Banxia shook his head. "It shouldn't be. Heavy metal poisoning usually presents with neurological responses. Besides, the patient's current abdominal pain, muscle soreness, edema, and high fever don't quite match that profile."

"We've just run stool, urine, and blood tests, checked liver function, and performed a CT scan. If it were heavy metal poisoning, whether acute or chronic, there should have been some indication."

"But symptoms vary greatly, manifesting differently depending on each individual's constitution. Brother Wang, why don't we try some antibiotics first, then perform a heavy metal screening?"

Wang Huan nodded. "Alright, let's see how he responds. I'm a bit unsure about this patient myself. Keep a close eye on him. I'll give it more thought after I finish with my current patient."

"Doctor, do I have some incurable disease or something?" the patient asked again after the IV drip had started.

"Don't worry just yet. There must be something we're overlooking. I'm clearing my schedule for today; I'll focus solely on you," Liu Banxia said, pulling a chair over to sit right beside the bed.

The patient glanced at him but said nothing.

Anyone would be worried if they were this ill. So many tests, and still no diagnosis. How could he not be anxious?

As for Liu Banxia, he was mulling over which conditions could explain the patient's current symptoms.

The patient had initially reported diarrhea, with persistent abdominal pain and fever. Over time, these symptoms evolved to include abdominal pain, chest pain, high fever, and swelling of the eyelids and face.

The abdominal pain might be due to intestinal inflammation. The blood test showed an elevated white blood cell count, so antibiotics might elicit some response.

Chest pain and muscle soreness? This could be heart-related. We can add an EKG and an echocardiogram later.

And the swelling of the eyelids and face? Edema can have many causes, but it's often due to organ failure, such as the liver, kidneys, or heart.

However, the recent ultrasound didn't reveal any ascites. The kidneys and liver appeared normal, and their respective tests showed no unusual findings.

Could it really be a cardiac issue? That's the only overlapping factor and the only organ that hasn't been thoroughly examined yet.

"Teacher Liu, should we run more tests?" Xu Yino asked quietly.

Liu Banxia nodded. "Let's start with a twelve-lead EKG. It's possible his abdominal pain and these later symptoms are caused by different conditions."

"Doctor, do you actually have any idea what's going on? I don't mind the tests, but you need to find something. If you really can't figure it out, just tell me, and I'll go to another hospital."

The patient, feeling slightly better after the infusion, had overheard the conversation between Liu Banxia and Xu Yino and voiced his dissatisfaction.

"Please, don't get agitated. Even if you went to another hospital, they would conduct the same investigations we are," Liu Banxia said.

"Abdominal pain and diarrhea can indicate gastrointestinal issues. However, when I listened to your abdomen, your bowel sounds were normal. And you haven't had any more diarrhea since then."

"There are many other tests we can perform, but I first need to determine the general direction for your diagnosis. I don't want you to waste money and time on unnecessary tests."

"When you first came in, I suspected your abdominal pain and diarrhea might have been caused by something you ate. Now that your symptoms have changed, I've temporarily ruled that out."

"During the CT scan, we focused on your chest and abdomen because you reported chest pain and muscle soreness. But you saw the results; everything appeared normal."

"I'm not saying this to shirk responsibility; there's nothing to shirk. You came to us for treatment, and it's our duty to find out what's wrong."

"If I were just guessing, I could order a gastrointestinal endoscopy, but that's not necessary. We worry about patients who resist tests, but for cooperative patients like you, we can't just order random scans either."

"But you have to find *something* wrong with me. Right now, my whole body aches, almost like when I have a bad cold. Could it be stomach flu?" the patient asked.

"I've considered that too, but so far, you haven't shown any nausea, vomiting, or bloating. Instead, you've developed chest pain and swelling," Liu Banxia replied.

"Trust me, let's do an EKG first to rule out any heart-related issues. If there are still no clear indicators after the infusion, I'll ask the director of our hospital's Internal Medicine Department to examine you. How does that sound?"

The patient nodded. What other choice did I have?

I knew the process would be the same wherever I went. Binhai Second Hospital isn't a small clinic; there shouldn't be issues with insufficient medical skills or inability to interpret test data.

"Oh... Teacher Liu, look! There are some rashes on the patient's chest. It seems like they just appeared," Xu Yino said hurriedly as she lifted the patient's gown.

Liu Banxia leaned in to examine them carefully. For more chapters visit novelFirｅ.net

I'm certain these rashes weren't there when I performed the physical examination and auscultation. These are new symptoms that just appeared.

The rashes startled Liu Banxia; his first thought was a drug allergy. However, after carefully examining the IV site and finding no irregularities, he breathed a sigh of relief.

"First, let's get an EKG. These rashes might be a further manifestation of his condition. Now that his symptoms have changed, let's also get a complete blood count. Tell them to rush it," Liu Banxia instructed.

The EKG results came back. Based on Liu Banxia's knowledge, it was normal. However, still uneasy, he showed it to Wang Huan.

"Are those rashes you mentioned severe?" Wang Huan asked after looking at the EKG.

Liu Banxia shook his head. "Not very. We checked the patient, and the rashes are only on his chest. It's not a drug allergy either. If it were, many would have appeared instantly, and the patient would have other adverse reactions."

"This is really puzzling. The EKG is normal too. Even if we did an echocardiogram, I suspect the result would be the same," Wang Huan said.

"Have you considered asking the directors for a consultation? In all the patients I've treated, I've never seen a case with this progression of symptoms. The patient might not have a common illness."

"Sigh... I'm not avoiding a consultation because I'm afraid of losing face," Liu Banxia said. "But the patient is already losing faith in us. If we still can't figure it out, I'm afraid of delaying his treatment."

"I initially thought these recent symptoms and those at admission were caused by two different diseases, but the EKG is normal. We need to consider these symptoms collectively."

"I still think the patient's current set of symptoms might be caused by something he ate. I'll go ask him more about what he's eaten."

Wang Huan nodded. He, too, honestly couldn't make any accurate judgment based on the symptoms the patient was currently exhibiting.

"Please tell me again what you've eaten in the past few days," Liu Banxia asked when he returned to the patient. "And also, did anyone who ate with you have any adverse reactions?"

"I rent a place by myself," the patient replied after a moment's thought. "For breakfast, I usually grab something quick, like pancake wraps or rolled wraps. For lunch, I always get takeout, and it varies."

"For dinner, I mostly cook a couple of simple dishes to go with a drink. Last night, I had pork head, stir-fried garlic sprouts with meat, and boiled skirt meat. I drank two bottles of beer but didn't have any rice."

"Do you eat every night?" Liu Banxia asked.

The patient nodded. "Pretty much. It's hot these days, and I don't have much of an appetite. Two cold beers are refreshing. I just enjoy this kind of meal. My girlfriend isn't in Binhai City, so I don't have many other expenses."

"In that case, your girlfriend can rest easy. You certainly know how to enjoy your food," Liu Banxia said casually, his mind still racing.

"That's exactly it," the patient's spirits seemed to lift a bit. "She thinks spending money on food is fine, at least it's going into my own stomach. She knows I love to eat, so if I spend my money on food, I won't have any left for getting into trouble."

"Speaking of food, there's a lot to it. Restaurant food is good, but it's often not as clean or as substantial as home cooking."

"Take that skirt meat, for example. It's part of an authentic meat stew. I couldn't bring myself to eat it all at once, so I froze it. When I was really craving it, I boiled it and ate it with mashed garlic. The flavor wasn't bad either. Pork from pigs that aren't fed commercial feed—everything from them tastes good."

"Is there a place in Binhai City that sells free-range pork?" Liu Banxia asked in surprise.

The patient shook his head. "No, you have to go to the surrounding villages to scrounge for it. Fewer people raise pigs these days; it's not that common even in the countryside. Although it costs a bit more to buy, the meat is delicious."

"Last time, we bought two pork legs and a whole set of offal. When we roasted it, people were fighting over it. It didn't need oil or too many seasonings, still eaten with garlic paste."

The patient finished speaking and smacked his lips, savoring the memory.

Liu Banxia's brow furrowed. "When did you eat this?"

"About ten days ago, right? We wanted to buy more at the time, but they wouldn't sell us more," the patient said.

"Teacher Liu, have you discovered something?" asked Xu Yino, who had been observing Liu Banxia attentively.

Liu Banxia nodded. "Let's wait for the complete blood count results. And let's also request a peripheral blood smear, focusing on eosinophils."

"Doctor, have you figured out what disease I have?" the patient asked.

"It might be parasites—trichinella worms, to be precise," Liu Banxia said. "I considered many possibilities but completely overlooked this one. This kind of trichinellosis is really uncommon these days. Let's wait for the test results first."

"If it's as I suspect, then this is truly a case of 'illness entering through the mouth.' You'll have to be careful in the future. There's nothing wrong with enjoying good food, but we need to eat safely."

He felt much more relieved now, as the patient's current symptoms were highly consistent with trichinellosis.