My Medical Skills Give Me Experience Points Chapter 1246 - 491: Unexplained High Fever Reaction, Multiple Sources of Hemorrhage (Part 2)

It is getting quite late, and she is concerned that the cafeteria will run out of food.

"You guys go ahead and eat! I will get my own meal once I am finished here," she stated.

Zhou Can realized that this case of digestive tract bleeding would be difficult to manage.

It remained uncertain how long the process would take.

Why did the patient suddenly experience a high fever only three to four hours after receiving medication?

Following Ali into the emergency unit, they found the patient lying on the bed with his eyes closed and his complexion slightly pale. Nevertheless, he showed marked improvement compared to his condition upon admission that morning.

A transfusion volume of 1000ml had been administered, which was truly a substantial amount.

"Did you administer ranitidine?"

After assessing the patient's status, Zhou Can directed the question to Dr. Ali.

The Emergency Department follows a first-visit policy for patients; the physician who accepts the case retains responsibility for it.

Junior doctors are often particularly intimidated by the prospect of managing critically ill patients.

Nonetheless, whenever an attending physician or higher-ranking doctor is on shift, they will immediately intervene if they hear a patient requires rescue. It is strictly against protocol for a new doctor to be left managing a critical patient without senior oversight.

"Yes, we did!" Ali nodded in affirmation.

Ranitidine is a common medication used to treat conditions characterized by high gastric acid levels, such as duodenal ulcers, gastric ulcers, reflux esophagitis, and Zollinger-Ellison Syndrome. It is occasionally deployed to address Helicobacter pylori infections as well.

The root cause of the patient’s fever remained a mystery that deeply troubled Ali.

This dilemma was the primary reason she had requested a consultation with Zhou Can.

"The patient’s other vital signs remain stable; he has no chills, only a high fever, which is quite strange. We cannot rule out the possibility of an intestinal infection," Zhou Can noted, his brow furrowing as he began his comprehensive diagnostic assessment.

Blood transfusion could not have triggered the fever, so that factor was essentially dismissed.

Ali had been extremely cautious regarding the medication, utilizing only the two hemostatic agents she had previously discussed with Zhou Can. Ranitidine, used here for gastric ulcers, is a standard therapeutic choice.

Logically, the probability of the medication inducing a high fever was exceptionally low.

Yet, the patient indeed developed a high fever three to four hours following his hospital treatment.

According to the nurse’s temperature charts, the patient's temperature had climbed in a steady, progressive gradient over the course of four hours.

It was not an abrupt spike.

The initial concern regarding the medication still lingered.

Zhou Can’s pathology diagnostic ability was at level five, comparable to that of an Associate Chief Physician. His pharmacological expertise had also hit level five, having recently reached the intermediate standard of an Associate Chief Physician.

However, there was still a noticeable disparity compared to the depth of his pathology diagnostic skill.

The patient had undergone a 1000ml blood transfusion, which was sufficient to restore hemoglobin to a more acceptable level, yet his anemia remained largely unresolved.

Zhou Can found himself reviewing the patient’s emergency endoscopy report once more.

In theory, bleeding caused by gastric mucosal erosion should not be this severe; even if it had been bleeding continuously for a month, it should not have caused such profound anemia or sudden shock.

Where exactly did the problem lie?

At this moment, Zhou Can began to suspect that the patient’s issues extended beyond simple gastritis-related bleeding.

Furthermore, erosive hemorrhagic gastritis typically resolves quickly on its own; the condition is naturally self-limiting. However, the patient had been passing black stool for over a month, which contradicted that diagnosis.

This served as further confirmation that the patient was suffering from more than just gastritis bleeding.

His mind raced, desperately searching for the possibility of another hidden source of hemorrhage.

The fact that the patient experienced severe anemia and shock indicated an massive volume of blood loss.

If there were significant bleeding occurring within the stomach or duodenum, the blood would typically backflow into the stomach, causing the patient to vomit coffee-ground-like gastric contents or perhaps even direct hematemesis.

For instance, historical accounts in the "Three Kingdoms" claim that Zhuge Liang berated Wang Lang until he vomited blood and died on the battlefield.

The novel guessed Wang Lang perished from a ruptured heart, which is medically groundless.

The heart is located in the chest cavity, and cardiac rupture rarely results in direct vomiting of blood. Profuse hematemesis is almost exclusively caused by upper gastrointestinal or upper airway hemorrhaging.

Upper respiratory tract bleeding usually presents as blood-tinged froth.

When a patient suddenly collapses while vomiting blood, physicians rely on the color and the presence of foam in the expelled fluids to pinpoint the source of the bleed.

Pulmonary hemorrhaging typically involves blood-flecked foam and coughing, manifesting as hemoptysis.

Stomach or duodenal bleeding results in large volumes of hematemesis.

This patient showed no clinical evidence of vomiting.

The possibility of massive upper gastrointestinal bleeding occurring in such a short window could largely be set aside.

However, the patient’s unexpected nosebleed prior to his shock was a detail that warranted caution.

The human pharynx and nasal cavity possess an incredibly intricate architecture.

The nasal mucosa is rich in blood vessels, making nosebleeds quite common if there is inflammation or trauma to the area.

Occasionally, the volume of such bleeding can be startling.

Nevertheless, since neither the patient nor his family reported a history of frequent nosebleeds, this hypothesis remained secondary for the time being.

The urgent priority was to identify the true source of the hemorrhaging.

Though the patient’s vital signs were currently stable following treatment, failure to isolate the cause of such heavy bleeding could result in a sudden, life-threatening turn.

Why did the patient develop a high fever post-admission, after receiving infusions and blood transfusions?

Was it merely a coincidence, or was there an underlying cause?

Only three medications were administered via infusion; whether using ranitidine for gastric ulcers, or Batroxobin and tranexamic acid for hemostasis, none were known to trigger a sudden high fever.