Chapter 2424: line with translation of chapter title

Title: "2340 Small wound, big trouble" - not needed for glossary (title). Not a named entity.

"Do I still need a CT?" the patient was somewhat unhappy, but his opinion no longer mattered at this point. The patient's family seemed to realize something and repeatedly agreed.

Named: CT (possibly referring to the CT room, but CT is just an abbreviation; here it's just "CT". Not a named entity? It's a test. Could be considered but not in the glossary. We'll ignore.)

Zhou Litao did not attempt to express all the pus from inside the patient's wrist skin this time; instead, he gently disinfected the surface and covered it with sterile gauze.

Named: Zhou Litao (person). Also maybe wrist common. No.

He went to issue a CT order, and the patient and family went to get the examination.

CT order (CT order). Not named.

As soon as they left, Zhou Litao immediately pulled Zheng Ren into the duty room, opening the computer on one side and calling the CT room on the other. He gave the patient's name and instructed that the results be uploaded right away after the scan.

Named: Zhou Litao, Zheng Ren, duty room, CT room. Also maybe computer common.

"Boss Zheng, what disease do you suspect the patient has?"

Named: Zheng Lao Ban.

"Marine Mycobacterium?" Su Yun was also uncertain, looking at Zheng Ren and asking in a questioning tone.

Named: Su Yun, Zheng Ren, Marine Mycobacterium.

"Yeah, it's an infection caused by Marine Mycobacterium."

Named: Marine Mycobacterium.

Zhou Litao struggled to recall Marine Mycobacterium.

Named: Zhou Litao, Marine Mycobacterium.

He was quite familiar with disjunctive mycobacterium; non-tuberculous mycobacteria are all mycobacteria other than tuberculosis and leprosy mycobacteria, also known as environmental mycobacteria. Non-tuberculous mycobacterium disease refers to the pathological changes in related tissues or organs resulting from human infection with these bacteria.

Named: Disjunctive Mycobacterium.

Also non-tuberculous mycobacterium. Environmental mycobacterium. Also non-tuberculous mycobacterium disease.

"Boss Zheng, how did you determine it was Marine Mycobacterium?" Zhou Litao asked.

Named: Boss Zheng, Zhou Litao, Marine Mycobacterium.

"Generally, non-tuberculous disjunctive mycobacterium grows over a wide temperature range; the patient only has a wrist problem, so the greatest possibility is Marine Mycobacterium that grows between 28 and 30 degrees Celsius." Zheng Ren said.

Named: non-tuberculous disjunctive mycobacterium, Marine Mycobacterium, Zheng Ren.

Although Zhou Litao understood the logical connection, he dismissed other issues at a glance, which he could not accept.

Named: Zhou Litao.

"That's right. First, the patient's family said they need to change the gauze six or seven times a day." Zheng Ren said, "This indicates there is a lot of pus at the wound site. At the wrist, about 20 ml of pus needs to be drained each day, and there is likely even more; a sinus tract may already have formed."

Named: Zheng Ren.

Zhou Litao listened quietly, but the first point did not fully answer his question.

Named: Zhou Litao.

"Second, despite such a severe 'wound,' the patient has no history of external trauma, and the purulent cavity is limited to the left wrist. At the time, I thought that position had been injured, but the patient didn't notice."

Named: Zheng Ren.

"If that's the case, our considerations would be narrowed considerably."

No named.

"But we also cannot rule out something like a fine needle..." Zhou Litao still didn't understand.

Named: Zhou Litao.

"Stupid!" Su Yun had figured it all out, looking down on Zhou Litao: "What did the patient say before coming? Rheumatism, rheumatoid arthritis!"

Named: Su Yun, Zhou Litao.

"Huh?" Zhou Litao looked blankly at Su Yun.

Named: Zhou Litao, Su Yun.

"What does that mean? A Staphylococcus aureus infection could be misdiagnosed as rheumatism or rheumatoid arthritis?" Su Yun's sneering smile already overflowed.

Named: Su Yun, Staphylococcus aureus.

"Oh oh oh." Zhou Litao finally understood.

Named: Zhou Litao.

"Well, so we estimate the patient was injured while playing in the sea, stabbed by some marine organism on the left wrist, but the wound was so tiny he didn't notice. Marine Mycobacterium lingered under the skin, multiplied, and eventually led to this situation."

Named: Marine Mycobacterium.

Zhou Litao remained silent; he still didn't understand but didn't ask.

Named: Zhou Litao.

"Manager Zhou, do you also need to review diagnostics?" Su Yun patted his shoulder, saying, "Avian intracellular complex mycobacterium can cause non-tuberculous disjunctive mycobacterium pneumonia. Avian intracellular complex mycobacterium and scrofula mycobacterium can induce non-tuberculous disjunctive mycobacterium lymphadenitis."

Named: Manager Zhou, Su Yun, avian intracellular complex mycobacterium, non-tuberculous disjunctive mycobacterium, scrofula mycobacterium.

"Too much, it's complicated. Temperature is the final basis for determining Marine Disjunctive Mycobacterium; it only appears under the skin without affecting internal organs, so it's likely Marine Disjunctive Mycobacterium."

Named: Marine Mycobacterium.

Zhou Litao sighed lightly, glanced at the computer. His paper isn't finished yet; does he have to study diagnostics now?

Named: Zhou Litao.

Modern medicine is vast and complex; really wanting to become a general practitioner like before? Probably even if his hair turned white, he couldn't achieve that.

No named.

In the past, general practitioners were rough; there's nothing like today's specialization.

No named.

"No need." Zheng Ren laughed, saying, "In the emergency department, the main focus should be on resuscitation; other things just need proper triage. For example, this patient should be sent to hand surgery; they should be able to diagnose correctly."

Named: Zheng Ren, Emergency Department, Hand Surgery Department.

"You're just talking nonsense." Su Yun said dismissively.

Named: Su Yun.

"It's not nonsense; few people can remember something after reading it once. If Manager Zhou follows your advice to study, delaying emergency resuscitation, what then?" Zheng Ren said seriously.

Named: Manager Zhou, Zheng Ren, Emergency Department.

Zhou Litao burst into tears.

Named: Zhou Litao.

It turns out Boss Zheng scolds people without using dirty words; this is his disdain for his own stupidity.

Named: Zheng Lao Ban.

But he soon freed himself from a discouraging mood and asked, "Boss Zheng, what do you think of the patient's condition?"

Named: Zhou Litao, Zheng Lao Ban.

"Not optimistic. A CT scan alone doesn't explain much; I estimate an MRI is needed. Tendons and such should already be corroded and rotten; hand surgery this time has encountered a big problem."

Named: Zheng Ren, CT scan, Nuclear Magnetic Resonance, Hand Surgery Department.

Zheng Ren sighed.

Named: Zheng Ren.

So heavy?! Zhou Litao was stunned.

Named: Zhou Litao.

However, since the images haven't returned yet, any speculation is just guessing; they chatted casually until Zhou Litao's phone rang, and the CT room doctor said the images had been uploaded.

Named: Zhou Litao, CT room.

Zheng Ren sat at the computer, searched the patient's name, and opened the CT images.

Named: Zheng Ren, CT (CT image).

The patient's left wrist subcutaneous area has a 3×4 cm abscess; the tendons have been invaded, and even the ulna and radius bones have been affected.

No named.

Indeed, it's a big problem; Zhou Litao was once again impressed by Zheng Ren's diagnosis.

Named: Zhou Litao, Zheng Lao Ban.

"Let's go back for now; when the patient returns, you explain it to them." Zheng Ren said, "Send them to hand surgery, first consult infection control to manage inflammation..."

Named: Zheng Ren, Hand Surgery Department, Infection Department.

"Normal medical procedure, do you really need to say that? Do you really think you're the head of hand surgery?" Su Yun interrupted Zheng Ren's words, saying dismissively.

Named: Su Yun, Zheng Ren, Hand Surgery Department (Hand Surgery Department head).

Also, Zheng Ren laughed.

Named: Zheng Ren.

"Boss Zheng, do you think the patient will recover?" Zhou Litao asked.

Named: Zheng Lao Ban, Zhou Litao.

"After four or five surgeries, we'll see. Chronic ulcer repair, tendon anastomosis, median nerve release, local skin flap repair, negative pressure sealed drainage—only then can we see the effect."

Named: Zheng Ren (speaker). Also techniques: chronic ulcer repair, tendon anastomosis, median nerve release, local skin flap repair, negative pressure sealed drainage.

Um... an invisible wound could actually cause such a serious illness! Zhou Litao felt a chill.

Named: Zhou Litao.

"This isn't much; do you know the most common route of infection for Marine Disjunctive Mycobacterium?" Su Yun asked.

Named: Su Yun, Marine Mycobacterium.

Zhou Litao shook his head.

Named: Zhou Litao.

"Cutting vegetables in the kitchen, or changing the water in one's own fish tank. The boss first asked whether the family kept fish, then asked if they had traveled."

Named: Su Yun, Boss.

"Why not cutting vegetables then?" Zhou Litao was still immersed in Zheng Ren's list of procedures, unable to extricate himself, asking dazedly.

Named: Zhou Litao, Zheng Lao Ban.

Afterwards, he saw Su Yun's gaze behind the black hair on his forehead, and he cursed himself inwardly. Having said there was no wound, he directly ruled out this infection route.

Named: Zhou Litao, Su Yun.

How did this happen? Being absent-minded, Zhou Litao first did self-reflection.

Named: Zhou Litao.

"Have him go to surgery immediately; the two most serious outcomes of this disease are amputation and skin cancer." Zheng Ren stood up and left, leaving behind a final remark.

Named: Zheng Ren, amputation, skin cancer.

Zhou Litao nodded repeatedly; these two points are extremely important and cannot be delayed.