This miracle doctor just wants to be fired!

Chapter 99

To diagnose meningitis, a lumbar puncture is required to examine the cerebrospinal fluid.

Zhou Cheng went outside the emergency room and had another brief conversation with the family.

Upon hearing the words "meningitis," the two family members turned deathly pale.

The woman suddenly grabbed Zhou Cheng's white coat: "Dr. Zhou, you said my child might have meningitis? Is that very serious? Will it leave any lasting effects?"

The man leaned closer, a hint of panic in his eyes: "The previous checkups all said there was nothing seriously wrong, how could it suddenly be meningitis? Did the examination just now upset her?"

Zhou Cheng quickly helped the agitated woman up: "Don't panic. This is just a preliminary assessment, not a final diagnosis. We've only made this initial judgment based on the test results and symptoms. Further tests are needed to confirm the diagnosis. And even if it is meningitis, most patients have a good prognosis if it's detected early and treated promptly. Don't worry too much."

He paused, then continued, "This has nothing to do with the MRI scan we just had. MRI is a non-invasive procedure and won't cause meningitis. The patient's symptoms are more likely a result of the disease progressing on its own. The previous scan simply helped us detect abnormalities earlier."

Hearing Zhou Cheng's explanation, the two family members calmed down a little, but the worry on their faces still remained.

At this point, Zhou Cheng continued, "We may need to perform a lumbar puncture on the patient. This test is an important standard for diagnosing meningitis, as it can clarify the nature of the cerebrospinal fluid and determine whether it is a viral, bacterial, or other type of infection. Only in this way can we formulate a targeted treatment plan."

"I will ask the neurologist to come for a consultation again, so that the specialist can explain to you in detail the necessity of the examination and the precautions. You should also prepare yourselves mentally."

The man hesitated before nodding, "We'll cooperate as long as it cures the child, but aren't there any risks associated with this examination?"

"Any medical examination carries certain risks, but lumbar puncture is a routine examination commonly used in clinical practice. The technique is already very mature, and we will have experienced doctors perform it to minimize the risks as much as possible," Zhou Cheng explained patiently.

Upon hearing this, the two family members said nothing more.

……

Back to the doctor's office.

Zhou Cheng looked at Chen Xi and Li Yang: "Chen Xi, you immediately contact the neurology department for another consultation. Compile the latest MRI and EEG reports and the patient's symptom changes, and explain them clearly to the consulting physician, focusing on the investigation and treatment recommendations for meningitis."

"Li Yang, go and complete the relevant test application forms, including repeat blood routine, C-reactive protein, and procalcitonin."

After receiving Zhou Cheng's instructions, the two turned around and went their separate ways.

Zhou Cheng then instructed Lin Ling, "Closely monitor the patient's temperature and level of consciousness. Take the temperature every half hour and let me know immediately if there are any changes. Also, prepare the necessary items for the lumbar puncture, as a lumbar puncture to obtain cerebrospinal fluid may be needed later. Be prepared in advance."

Lin Ling nodded quickly, "Okay, Dr. Zhou, I'll go prepare right away!"

About ten minutes later, Chen Xi arrived in a hurry with Liu Chi, the associate chief physician of the Department of Neurology.

As soon as Liu Chi entered the emergency room, he asked directly, "Dr. Zhou, I heard the patient has new symptoms and test results?"

Zhou Cheng immediately stepped forward and handed over the latest information and examination report: "Director Liu, the patient developed a headache and low-grade fever after the MRI, with a body temperature of 37.8°C. The MRI showed no obvious abnormalities, but the EEG showed diffuse slow waves. We initially considered that meningitis could not be ruled out, and would like to ask you to reassess the situation."

Dr. Liu took the report, quickly flipped through it, and then pondered, "Judging from the symptoms and examination results, the possibility of meningitis cannot be ruled out."

"Although meningeal irritation signs are not obvious at present, considering the patient's abnormal mental state and abnormal imaging and electrophysiological findings of the central nervous system, central nervous system inflammation is highly suspected. It is recommended to complete a lumbar puncture as soon as possible to clarify the cerebrospinal fluid results, so as to make a final diagnosis."

Zhou Cheng nodded: "We are already preparing for the lumbar puncture. We will communicate with you again if there are any further developments."

Director Liu Chi nodded, gave a few more instructions, and then turned and left.

……

After the neurologist left, Zhou Cheng immediately reported to Li Degang.

He instructed Chen Xi to stay in the emergency room to closely monitor the patient's condition, and then quickly led Li Yang toward the doctor's office.

At that moment, Li Degang was organizing medical records. Seeing the two enter, he looked up and asked, "What did the neurology department say? Has the patient's condition changed?"

"Teacher Li, Director Liu of the neurology department also believes that the possibility of meningitis cannot be ruled out, and suggests that a lumbar puncture be performed as soon as possible to confirm the diagnosis through the cerebrospinal fluid results."

Zhou Cheng handed over the MRI and EEG reports, adding, "The patient currently has a persistent low-grade fever and no relief from headache symptoms. Combined with the abnormalities in the imaging and electrophysiological examinations, a lumbar puncture is indeed the key to a definitive diagnosis. The earlier it is done, the sooner a targeted treatment plan can be developed."

Li Degang took the report and carefully read through it, his brows furrowing deeper and deeper.

After a long pause, he slowly said, "I know the necessity of a lumbar puncture, but the risk of performing this examination in our emergency department is too great."

He looked up at Zhou Cheng, his tone tinged with concern, "This patient's family is notoriously difficult. They already questioned the safety of the MRI because of the headache and low-grade fever they experienced. If a lumbar puncture is performed in the emergency department, even if it's a routine procedure, they will definitely cause a scene at the slightest sign of trouble, and a complaint is inevitable."

Listening from the side, Li Yang couldn't help but interject, "Teacher Li, but the patient's condition can't wait. If the treatment for meningitis is delayed, the consequences will be even more serious."

"I know the condition is urgent, but the risks must be manageable." Li Degang shook his head and turned to Zhou Cheng. "Let's go together to report to Director Wang and hear his opinion. After all, this is a critical period for the review of the Grade A tertiary hospital, and the department cannot afford any complaints or disputes."

Zhou Cheng had no choice but to follow Li Degang to the director's office.

The two then rushed to Wang Jianming's office. When they knocked and entered, Wang Jianming was reviewing the relevant materials for the re-evaluation of the Class A tertiary hospital.

Upon hearing the purpose of their visit, he put down the documents in his hand, took the examination report and Zhou Cheng's medical report, and silently reviewed them for a moment, his expression even more serious than Li Degang's.

"Zhou Cheng, your judgment and suggestions are correct. From a medical perspective, a lumbar puncture should indeed be performed as soon as possible."

Wang Jianming put down the report, but his tone carried a clear rejection: "But it absolutely cannot be done in the emergency department."

He looked at the two of them and explained further, "The review of the tertiary hospital is now at the most critical stage. Any complaint could affect the review result, and our department, or even the hospital, cannot afford this risk. You are aware of the attitude of this patient's family. They threaten to file complaints at the drop of a hat. Lumbar puncture is an invasive procedure, and even if the procedure is performed completely according to regulations, they may still nitpick and say that we 'over-examined' or 'operated improperly'."