The patient's X-rays showed that there was no abnormality in the lungs, except for some pulmonary fibrosis. The county hospital suspected that the pneumonia had not been cured, but it was based on some evidence, but it needed to be identified more carefully. Without a CT machine, it could only make this judgment. Now, if conditions permit, clinicians can make further judgments based on CT scans. The texture of the lung tissue is thickened and blurred, the bronchial wall is thickened, and fibrosis is visible in some parts. There is bronchitis, which is consistent with Chang Jiawei's previous judgment.
Seeing this, Xie Wanying couldn't help but admire Teacher Chang for being such an accurate diagnose even though he was not a cardiopulmonary doctor.
Next to her, she could only hear classmate Geng asking the monitor: Why did some people say that his brother was suspected of having tuberculosis?
There are currently no signs of tuberculosis on the lung films.
Before Fu Xinheng and Chang Jiawei arrived, the only ones who suspected the patient had tuberculosis were Teacher Ren or Doctor Guo. To be specific, Teacher Ren was not a clinical doctor and would not express his opinion but was here to understand the situation. It could only be Doctor Guo who was suspicious.
Hearing the students' comments, Fu Xinheng, who had just arrived and had not yet understood the patient's full condition, asked Dr. Guo: "Why do you suspect he has tuberculosis?"
Anyway, as a cardiothoracic surgeon, he can guarantee that these films are completely incapable of confirming that the patient has tuberculosis.
Facing the question from his superior, Dr. Guo wiped his palms carefully and answered his own medical reasoning: "It cannot be seen in the film for now. But I have learned about the patient's medical history before. It is said that the patient has a grandfather who smokes and coughs all the time. It is not ruled out that the old man has a history of tuberculosis. Pulmonary tuberculosis is just a type of tuberculosis, Teacher Fu."
Most tuberculosis bacteria invade the lungs, so it is commonly known as pulmonary tuberculosis. Most people tend to equate pulmonary tuberculosis when talking about tuberculosis, which is wrong. Tuberculosis refers to the infection of the human body by Mycobacterium tuberculosis. According to the different parts of the body invaded by the bacteria, it can be divided into pulmonary tuberculosis, digestive tract tuberculosis, lymph node tuberculosis, etc., but the latter are not clinically seen and are rare cases, just like spinal tuberculosis.
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One difference with spinal tuberculosis is that most cases seem to be secondary tuberculosis rather than primary disease. Secondary means that, like tumor metastasis, the tuberculosis bacilli do not directly invade the spine but instead come to the spine from other primary tuberculosis lesions such as pulmonary tuberculosis, digestive tract tuberculosis, etc. through the blood circulation.
Dr. Guo’s suspicion of tuberculosis was definitely not based on the featureless lung films, but on the spinal films.
There are two types of spinal X-rays: frontal and lateral. The frontal X-ray shows that the lesion is located between several vertebrae of the patient, and it seems that the soft tissue is invaded and the bone is destroyed. It just so happens that a huge difference between spinal tuberculosis and spinal cord tumors may be in this regard.
Unlike tumors, tuberculosis bacteria are jokingly called bullies by medical experts. They only dare to attack the soft tissues of the human body, which is equivalent to bullying the weak. Tumors are completely the opposite. They like to fight the human body head-on. In clinical practice, tumors are more likely to directly destroy bone tissue like a large army, and they are a bit dismissive of the soft tissues of the human body. The typical difference between the two makes ordinary doctors question whether it is tuberculosis when they see soft tissue damage on the film.
Of course, each patient has his or her own individual differences. Some patients have special physical conditions and may present opposite symptoms, which are all factors that doctors must consider.
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