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Abstract: This patient developed high fever for unknown reasons and took oral ibuprofen extended-release capsule to lower the temperature by himself. After the fever subsided, he fell into a coma instead, and was admitted to the hospital in an emergency with only red face, red neck, and red chest, and swollen eyes, swollen face, and swollen feet. He was diagnosed with epidemic hemorrhagic fever, also called renal syndrome hemorrhagic fever, and was given hemodialysis and drug treatment, and the patient’s condition was controlled.
Basic information】Male, 59 years old
Disease Type】Epidemic hemorrhagic fever
Hospital】The 988th Hospital of the PLA Joint Logistics and Security Forces
Date of consultation】November 2021
Treatment plan】Hemodialysis + drug treatment (sodium chloride glucose injection, vitamin C injection, furosemide injection, lactulose oral solution)
Treatment period】28 days of hospitalization, 1 month of outpatient follow up
Treatment effect】The condition has been controlled, and all indicators are improving
I. Initial consultation
The patient was a 59-year-old male, a construction worker at a construction site, usually living in relatively poor conditions, workers complained that they could occasionally see rats at the construction site, the patient felt uncomfortable after the evening shift, did not care, went straight to bed, felt chills at night, felt his forehead hot, thermometer measured the temperature 38.9 ℃, after taking an oral ibuprofen extended-release capsule, sweating profusely, the temperature dropped, morning after breakfast again appeared fever, measured the body temperature 39.6℃, again took oral ibuprofen extended-release capsule, then sweated a lot, although the body temperature also dropped, but gradually fell into a state of lethargy, was found by the workers and rushed to call 120 to the hospital. After admission, I saw the patient, who was in a lethargic state and could respond to the call. On physical examination, I saw red face, red neck, red chest, and swollen eyes, swollen face and swollen feet. 40.32mmol/L, confirmed the diagnosis of epidemic hemorrhagic fever.
II. Treatment history
After admission, the blood pressure was measured to be low, and there was obvious edema in the eyes, face and both lower limbs, and the patient had no urine for 24 hours. After repeated communication with the patient’s family, the patient was given hemodialysis treatment to reduce nephrotoxins, intravenous infusion of glucose sodium chloride injection to maintain blood volume, vitamin C injection to resist extravasation, furosemide injection to diuretic, adjust the intake volume according to the change of urine volume to stabilize the internal environment, and lactulose oral solution to induce diarrhea.
III. Treatment effect
After the joint efforts of medical and nursing staff and the close cooperation of family members, the patient was conscious and mentally improved, and passed the hypotensive shock period, oliguria period, polyuria period and recovery period smoothly, the urine protein disappeared in the routine urine examination, and the liver and kidney function gradually returned to normal in the reexamination.
IV. Notes
Although the patient recovered from the disease, the patient was still weak after a serious illness, so the patient was advised to take a full rest for 3 months outside the hospital, actively supplement nutrition, high protein, high vitamin, high calorie diet, but to do less slag, low fat, easy to digest diet, but also avoid eating spicy and stimulating, cold and cold, coarse fiber food, regular re-examination of liver and kidney Regular review of liver and kidney function, blood and urine routine, blood coagulation.
V. Personal insight
Epidemic hemorrhagic fever is less common in clinical practice, with occasional small seasonal epidemics, in which transmission peaks from March to May, and the incidence is higher among young and strong male farmers and workers.
This patient recovered from the disease through active treatment, although the process is a twist and turn, but the end is good, this case also want to remind our people, clinical fever discomfort to actively seek medical advice, by professionals to determine the cause of the disease, remind our migrant workers and construction workers, to do a good job of their own cleanliness and hygiene, always have a vigilant mind, do not paralyze carelessness, resulting in a big disaster.