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Abstract: Aunt Zhao developed symptoms of unprovoked hyperthermia, which could reach 39.3°C without chills. As her condition developed, she developed vague pain in the upper abdomen with radiating pain and malaise, and was diagnosed with cholangitis after examination. Auntie Zhao’s cholangitis was probably caused by bacterial infection. After anti-infection treatment with drugs, the discomfort symptoms were significantly improved and the prognosis was good.
Basic information】Female, 70 years old
Disease Type】Cholangitis
Hospital】The First Affiliated Hospital of Xi’an Jiaotong University
Date of consultation】August 2021
Treatment plan] Oral medication (moxifloxacin hydrochloride tablets) + intravenous infusion (hydrocortisone injection)
Treatment Period】2 days in hospital
Treatment effect】Aunt Zhao’s fever disappeared and her abdominal pain improved.
I. Initial consultation
When we first saw Auntie Zhao, she was emaciated and in a general state of mind. She reported the presence of intrahepatic bile duct stenting surgery, hypertension and diabetes mellitus, but they were well controlled. Five days ago, she developed a high fever with no cause, which could reach 39.3℃ without abdominal pain, radiating pain, nausea and headache, and the fever subsided after self-treatment with medication. However, 3 days ago, there was vague pain in the upper abdomen with radiating pain and weakness in the back of the right shoulder, along with re-fever, and the effect of self-medication was not good, so she came to the hospital for consultation. Upon inquiry, we learned that Auntie Zhao’s appetite was relatively poor and her weight had decreased, but her urine and stool were normal, which could be initially diagnosed as cholangitis, and hospitalization was recommended for further diagnosis.
Second, the treatment process
After admission, Auntie Zhao was examined. Auntie Zhao’s abdomen was flat and soft, with no pressure pain or rebound pain, and no abdominal mass was palpated. Subsequently, ultrasound examination of the upper abdomen was performed, and the results suggested the presence of intrahepatic bile duct pneumatosis, followed by blood examination, and the results suggested the presence of direct bilirubin of 11.31umol/L, glutamyl transaminase of 68.00U/L, total protein of 33.70g/L, glutamyl transpeptidase of 144.00U/L, and potassium of 2.88mmol/L, which led to the diagnosis of cholangitis. I formulated an anti-infection treatment plan for Auntie Zhao, and administered hydrocortisone injection intravenously to eliminate the inflammation, together with moxifloxacin hydrochloride tablets orally, and Auntie Zhao could be discharged after her symptoms were relieved.
III. Treatment effect
On the first day of treatment, Auntie Zhao’s fever had started to decrease and her abdominal pain was reduced. On the second day, Auntie Zhao’s fever had completely subsided, and the abdominal pain and radiating pain were further reduced compared with the previous day. The examination of the abdomen was soft and without pressure pain, suggesting that the treatment effect was good and that Auntie Zhao’s cholangitis was basically controlled and could be discharged.
IV. Notes
After the drug treatment, Auntie Zhao’s symptoms have been significantly improved, I am also happy for her in my heart, and remind her and her family to pay attention to the following points.
1, in life should pay attention to Auntie Zhao observe changes in body temperature, fever symptoms can be appropriate to drink more water, while using warm water to wipe the armpits, elbows and other parts to help dissipate heat.
2, Zhao aunt in the daily can also carry out appropriate exercise, such as walking, playing tai chi, etc., to help enhance physical fitness, but need to pay attention to avoid excessive exercise, so as not to lead to excessive physical exertion, but not conducive to recovery;.
3, Zhao aunt in the diet can be appropriate to eat some light, nutritious food, such as meat, eggs, fruits, vegetables, etc., avoid eating high oil food, so as not to cause discomfort.
V. Personal insight
Cholangitis is an infectious disease, the main symptoms of which are abdominal pain, fever, jaundice, etc. Generally, the condition can be improved significantly through active treatment, but if the treatment is not timely, it may lead to aggravation of the condition, and may even be life-threatening. In this case, 70-year-old Auntie Zhao was diagnosed with cholangitis due to unprovoked high fever. Luckily, Auntie Zhao was seen in time and her condition improved after systematic treatment. In addition, for the elderly population, daily exercise should also be appropriate to help improve the body’s ability to resist disease, thereby reducing the probability of cholangitis and other diseases.