The attenuated measles vaccine is a free compulsory vaccination program in the country, and most citizens have completed the vaccination when they were children.
Universal vaccination has significantly reduced the number of measles cases in China. Unfortunately, some people have individual differences and will still get sick after vaccination, but the symptoms are milder than those who have not been vaccinated, and are basically mild to moderate symptoms.
Even so, early detection and accurate diagnosis of the disease is definitely in the best interest of the patient. A careful doctor will check the patient for all common key diseases.
Measles patients will have specific physical signs such as measles mucosal plaques, so the doctor will examine the buccal mucosa in the patient's mouth.
Measles mucosal plaques refer to the grayish white spots that appear on the buccal mucosa of the patient's mouth 1 to 2 days before the rash. The diameter is about 0.5 to 1.0 mm, and there will be some redness around them. It is called a measles-specific sign because this symptom only occurs in measles, and it can be distinguished from other diseases to a large extent. Once measles mucosal plaques are found during the examination, the probability of measles is 90%.
Xie Wanying carefully examined the buccal mucosa and did not see any measles mucosal patches. Then, two cotton swabs continued to carefully press the child's tongue to check the throat. The cotton swabs are used instead of tongue depressors to examine the patient. The precautions for using tongue depressors are the same. The placement should be at the anatomical position of the V-shaped groove at the junction of the front 1/3 and the middle 1/3 of the tongue, called the sulcus terminalis. If it is too far forward, the root and back of the tongue cannot be pressed in place. If it is too high, it will block the doctor's vision and make it impossible to see the condition of the tonsils and pharyngeal mucosa clearly. If it is too far back, it will easily cause nausea and vomiting in the patient.
"Ah."
The doctor said this, and the boy obediently made an "ah" sound.
The child opened his throat wide, and with the help of the tongue depressor, the doctor could soon see two small pink lumps of flesh on both sides of the throat. These are the palatine tonsils, commonly known as tonsils.
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The flashlight revealed that the child's tonsils were congested and swollen, and there seemed to be white spots on the surface. It was definitely acute tonsillitis.
"My grandson has a cold, right, doctor? Please prescribe some cold medicine for him." The sick child's grandmother was anxiously urging the doctor to prescribe medicine so that she could take it home and cook.
Xie Wanying was not in a hurry. She put down the cotton swab and asked about the child's diet, bowel movements, urination, and any body pain. She then checked the child's skin to see if there were any wounds or rashes.
"He can eat. His stool is yellow and his urine is a little yellow."
Based on the information provided by the patient's family, the overall preliminary diagnosis is acute tonsillitis in children. Xie Wanying told the child's grandmother: "He needs blood tests, intravenous infusion, and drips."
"Aren't you going to prescribe cold medicine for him?" the sick child's grandmother asked in surprise.
"He doesn't have a cold, but acute childhood tonsillitis. There are signs of suppuration. He must get an injection. Oral medication alone will not work." Xie Wanying emphasized that the child's condition was quite serious.
"Injection? Oh, I don't have that much money. I need to call his parents." The sick child's grandmother patted her thigh.
As a doctor, Xie Wanying did not dare to suggest that the child should be hospitalized for treatment, mainly because judging from the family's clothing and appearance, they probably did not have good financial conditions.
Most doctors in clinical practice will try their best to consider the patient and his family and their financial situation. If the financial situation really does not allow, the patient can be treated in the outpatient department instead of hospitalization.
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