As the weather warms up, “snakes and insects” are rampant. Recently, Zhejiang Provincial People’s Hospital admitted a patient with severely infected “novel Bunia virus”-induced fever with thrombocytopenia syndrome, multiple organ failure, Sent to the intensive care unit (ICU) for rescue. The culprits that spread the disease are ticks.
“This patient is not only severely neurological, but rarely seen. system, for the novel Bunia virus encephalitis.” said Sun Renhua, director of the Department of Critical Care Medicine.
The growth and activity period of the tick is from April to October every year, and the peak period of its activity is from May to July. Tick season is here again.
Multiple organ failure, life on the line
“The patient was sent The patient is in critical condition, and his life is in danger at any time!” said the patient’s doctor in charge and deputy chief physician of the Department of Critical Care Medicine Jiang Xiaohui.
The condition is menacing, “except for encephalitis, the patient’s platelets dropped to a rare low, only one-fifth of the lower limit of the normal range; It has multiple bleeding, such as tongue coating, gum oozing, intraoral bleeding, pulmonary bleeding, gastric occult blood ++++, etc…” Jiang Xiaohui said, checking the blood routine and coagulation function, indicating the critical value of platelets and fibrinogen, and poor coagulation function . The patient was in shock for a time, and his blood pressure has dropped to 80/46… his life is hanging by a thread. Sun Renhua and other experts evaluated the patient’s systemic organ function, and the patient had multiple organ failure (nervous system, circulatory system, liver damage, kidney damage, gastrointestinal bleeding, respiratory failure, hematopoietic system platelets) drop.)
Q: Why does a small tick bite so badly? as a result of?
A: When the tick absorbs human blood, it will also bring its venom (new bunya virus) into the human blood, and the virus will gradually spread with the blood circulation To the whole body, causing damage to multiple organ functions, it will threaten people’s life and health.
The race against time is the key to the treatment of severe and novel bunya virus infection. Under the guidance of Director Sun Renhua, ICU doctors and nurses took a series of powerful measures: Give antiviral and immune globulin pulse therapy, at the same time use ventilator, tracheotomy, blood transfusion and platelet transfusion, increase Platelet and other comprehensive treatment and artificial kidney replacement therapy.
“Faced with such critically ill patients, we must always be on high alert, and the patient’s condition suddenly Changes occurred, and everyone had to enter the rescue state soon, and sometimes it was late at night when the patient’s vital signs stabilized.” Jiang Xiaohui recalled.
The expert team checked the patient’s condition
after symptomatic support and treatment, The patient’s condition has improved significantly. At present, he is conscious for many days, and has been released from the ventilator. His blood pressure is stable, his body temperature is normal, and his platelet and coagulation functions are gradually improving. What makes the doctors relieved is that the bleeding in the gastrointestinal tract has decreased, and the functions of the heart, liver and kidney are also obvious. It’s getting better… The expert ward round assessment believes that the patient can be transferred to the general ward.
Prevention is very important
“We treat ticks almost every year new bite infectionIt is rare for bunya virus patients to enter the ICU for rescue. “Pan Hongying, Director of the Department of Infectious Diseases, said that after being bitten by ticks, most people will experience symptoms such as allergies or inflammation, which are generally mild, so there is no need to panic. The disease depends on whether the tick is “virulent” – carrying a pathogen.Ticks can harbor a variety of pathogens (viruses, bacteria, parasites, such as the new bunya virus), The disease occurs only after being bitten by a small number of pathogen-carrying ticks. There are underlying diseases and the elderly are more prone to severe disease.
“Under normal circumstances, patients infected with the novel bunya virus can feel fever the most, and the body temperature is mostly Above 38°C, severe cases continue to have high fever, which can reach above 40°C, and some cases can last for more than 10 days, accompanied by fatigue, anorexia, nausea, vomiting, etc. Some cases have headache, Muscle soreness, diarrhea, etc., gastrointestinal symptoms, myalgia, thrombocytopenia and leukopenia can also occur after infection with the virus. ” Pan Hongying said that a small number of patients with bleeding tendencies may die due to multiple organ failure.
There is currently no specific antiviral treatment, and clinical treatment is mainly symptomatic and supportive.
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Prevention suggestions given by Director Pan Hongying:
1. Friends who like to play in the wild, take protective measures: such as wearing long-sleeved clothes, tying up trousers, try not to wear sandals, and apply repellent to the bare skin.
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2. After moving in the living environment of ticks, such as woods, hills, mountains, low shrubs, etc., it is necessary to check whether there are ticks attached to the body in time; if there are pets, be careful when leaving Check the pet for ticks.
3. If you find a tick bite, do not force the wound to pinch and remove the tick. ; After being bitten by a tick, the shortest time of onset is 2-3 days, usually about 1-2 weeks. Once you have suspected symptoms or signs such as fever, you should seek medical treatment as soon as possible and inform the doctor about the situation.
4. The patient’s family members, especially the accompanying family members, should pay attention to self-protection and avoid contact with the patient’s blood, body fluids or vomit.
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