It was Feng Runguang's turn to speak. He cleared his throat and said:

“The patient’s course of disease showed obvious liver damage, but the bilirubin level was not significantly elevated, so I think acute liver failure should not be diagnosed. Disseminated intravascular coagulation and multiple organ failure can be confirmed.

The patient has thrombocytopenia, a hemorrhagic rash, and disseminated intravascular coagulation, so hemorrhagic fever should be considered. Also, has the patient used Chinese herbal medicine, been exposed to special chemicals, or consumed any unusual foods? Given her young age and the severity of her illness, we must carefully rule out poisoning.

After hearing several senior directors babble on and on, Chen Xia felt that these diagnoses were definitely not comprehensive and they must have missed something.

Seeing Chen Xia scratching his head, Ren Yuanfei quietly stepped on his foot and whispered a reminder:

"Sit still. Your father-in-law hates people who sit or stand inappropriately, especially when they're discussing a serious matter."

Chen Xia glanced at his master, his eyes suddenly lit up, and he blurted out: Yes, infectious disease department, chickenpox, everyone forgot about chickenpox.

Dean Gu had already seen the way his son-in-law sat, and when he suddenly heard him mumbling to himself, he felt quite dissatisfied and asked with a stern face:

"Chen Xia, you are the attending physician and the person primarily responsible. What do you think of this patient?"

Yang Jingye sat in his seat and gave a thumbs up to the dean next to him. This was a case of putting justice above personal responsibility, as he directly appointed his son-in-law as the directly responsible doctor.

Chen Xia stood up and said, "Director, directors, I think we have all overlooked a problem. The patient suddenly developed chickenpox yesterday."

"chicken pox?"

Everyone was confused, and then fell into deep thought, immediately searching for relevant information about chickenpox in their minds.

Ren Yuanfei leaned back in his chair and nodded slightly, feeling somewhat proud: "This disciple is indeed talented."

In fact, even if Chen Xia didn't mention it, he would have mentioned this issue.

"Yes, everyone has overlooked the chickenpox issue. On the contrary, I believe the patient's current condition is due to acute liver failure and disseminated intravascular coagulation caused by the varicella-zoster virus. This can explain almost all of the patient's clinical manifestations."

Dean Gu was a little skeptical, but since his son-in-law said he was sure, he decided to listen to his opinion.

Chen Xia turned around and saw his master smiling. "Master, it seems this is a professional issue in our infectious disease department. Do you want to explain it or should I?"

"Little rascal, since you were the one who brought it up first, of course you should report it to everyone. I'll also take the opportunity to check on your recent academic performance."

Everyone pricked up their ears, wanting to see what medical insights the head of the General Affairs Department had. To be honest, no one took it seriously.

Chen Xia stood up, coughed a few times, and said:

"I suggest that varicella-zoster virus infection could explain the patient's symptoms for several reasons:

1. Visceral varicella-zoster virus infection includes liver damage, lung damage, and brain damage. Among them, liver damage related to varicella-zoster virus infection often manifests as a triad: papules, abdominal pain or back pain, and fever.

2. Liver damage is characterized by coagulative necrosis, surrounded by mixed inflammatory cell infiltration, including macrophages. Laboratory findings often reveal mild elevations in transaminases for several days, followed by rapid progression to fulminant liver failure, disseminated intravascular coagulation, and shock.

3. Bilirubin gradually increases while aspartate decreases. 80% of aspartate is present in the cytoplasm of liver cells. When liver cells are damaged, the permeability of the cell membrane changes, allowing aspartate to escape into the blood. Early on, aspartate may increase.

As the condition worsens, the enzyme is depleted over time, and its short half-life leads to a decrease in serum bilirubin. However, this patient's bilirubin level was not elevated, which explained to Director Du that this patient's liver failure was somewhat different from what he usually sees.

To sum up, I personally tend to believe that this patient was infected with visceral varicella-zoster virus.

At the same time, the patient had taken paracetamol before admission, which can also cause drug-induced liver injury and is the most common cause of severe acute liver injury and acute liver failure."

As soon as Chen Xia finished speaking, Ren Yuanfei was the first to applaud, followed by several old directors.

Regardless of whether you agree with his point of view or not, based on the several well-reasoned arguments he just put forward, he has achieved scientific rigor and also shows that he has worked hard in the field of infectious diseases and has a very solid foundation.

Old Man Gu tried his best to maintain a serious expression, but the corners of his mouth unconsciously curled up.

Yang Jingye sighed inwardly, "This kid is too ambitious, and he's protected by the dean and several senior directors. He's like a hedgehog, hard to bite."

Although the cause of the disease was not determined during this hospital-wide consultation, at the suggestion of Ren Yuanfei and Chen Xia, the patient was treated according to the criteria of severe hepatitis, disseminated intravascular coagulation, multiple organ failure syndrome, and septic shock.

Du Guobiao and Chen Xia returned to the emergency room and immediately directed the rescue.

Active fluid resuscitation combined with vasoactive drugs to fight shock, liver protection, transfusion of fresh frozen plasma, correction of coagulation dysfunction, maintenance of water, electrolyte and acid-base balance, etc.

Chen Xia even took out the best antibiotics from the space hospital, including carbapenem injections of apenem and moxifloxacin, and used acyclovir injections for antiviral treatment.

Saving lives was the most important thing at this time, and he didn't bother asking the patient's family for money. Although Chen Xia was very heartbroken, he still did not hesitate to give the patient an IV drip.

All necessary treatments have been given, but the patient's condition is still not optimistic. Unfortunately, Yuezhou Fourth Hospital does not have a ventilator. Several emergency blood gas analyses have shown that the patient's blood oxygen saturation has not increased.

Wu Shaochen, with two panda eyes, asked quietly: "Mr. Chen, what do you think of this patient?"

"What else can we do? He's probably not going to be able to save her. Hurry up and issue a critical illness notice and explain everything to the family."

A seriously ill patient came to the emergency department, and the Fourth Hospital did not have an intensive care unit, so everyone ended their usual leisurely work and went into a state of readiness for battle.

As Chen Xia expected, at 2:09 pm, the patient's heart and breathing suddenly stopped, and his blood pressure and oxygen saturation could not be measured.

Chen Xia immediately performed cardiopulmonary resuscitation and repeatedly injected epinephrine.

At 14:18, the heart rate recovered to 74, then gradually rose to 140, the blood pressure was measured at 95/54, spontaneous breathing recovered to 17 times, and the blood oxygen saturation finally came up.

The patient was in a deep coma, and his blood pressure and heart rate required large doses of epinephrine to maintain. His blood gas continued to metabolize acid, with high lactate and potassium.

All the doctors and nurses were busy and sweating, and the patient was in a critical condition.