Patient: Description of condition (onset, main symptoms, hospital visited, etc.): The patient was male, 67 years old, had been diabetic, sought medical attention for discomfort half a month ago, was found to have a myocardial infarction, and was scheduled for admission to the hospital. He was admitted to the hospital in fair mental condition. After hospitalization, he was examined and had renal deficiency (controlled) and tuberculosis. During the hospitalization, he had a constant high fever of 39.5°. However, the family could not see that the patient had tuberculosis. Now the patient is lying in bed unable to move. The doctor now does not know how to treat. Current situation (1) Kidney failure is under control and myocardial infarction is temporarily stabilized. (2) Tuberculosis was detected and the patient was transferred to the infection unit. However, no tuberculosis symptoms can be seen. (3) The root cause of the disease could not be found, and the fever was treated for fever and whatever was present. The cause of the disease cannot be found. Q: How do you want to know how to treat the disease? How can I find out if I have tuberculosis? Thank you, doctor! Wen Wenpei, Department of Tuberculosis, Guangdong Tuberculosis Control Center
Wen Wenpei, Department of Tuberculosis, Guangzhou Chest Hospital.
Elderly patients usually have more underlying diseases, such as heart disease and diabetes, and are prone to complications of tuberculosis. At present, the attending physician is faced with a large number of problems, and should prioritize and grasp what the main conflict is. This is especially true for multispecialty care.
From the patient’s point of view, because TB is a chronic disease, it is generally not a critical problem that needs to be dealt with urgently, so when there are other systemic emergencies (such as heart, liver and kidney), the top priority should be to deal with acute and critical illnesses. In this case, the hospital can ask the TB hospital experts to consult and propose TB treatment for the reference of the attending physician. Hospitals should strengthen the protection of medical and nursing staff at the same time, until the patient’s condition can be transferred to the tuberculosis hospital before transferring to the hospital is appropriate. (From the hospital management point of view, hospitals may transfer patients to TB hospitals because they may be infectious)
As for the diagnosis of tuberculosis, the characteristic symptoms of tuberculosis do not always appear. Because the development of each disease is from mild to severe, and only to a certain extent will there be characteristic manifestations. Moreover, this elderly patient has a combination of various diseases, and the characteristics of tuberculosis are even less prominent, so the family should not make their own decisions, but should communicate more with the doctor.
Patient: The old man has been transferred to Guangzhou Chest Hospital for inpatient treatment today. However, it has not been found out whether it is infectious or non-infectious. I hope your hospital can treat the old man well. Thanks a lot!
Wen Wenpei, Department of Tuberculosis, Guangzhou Chest Hospital.
You are welcome! Thank you for your trust in Guangzhou Chest Hospital! If you need to, directly communicate with the medical staff to ask. I hope you will be satisfied. And wish you a speedy recovery!