Returning to the ward, Liu Meng couldn't help but ask the serious-looking Zhao Heng, "Dr. Zhao, has it been confirmed?"

"Yes, it has been confirmed. The patient is indeed infected with Naegleria fowleri."

Zhao Heng nodded.

"Oh..."

Upon hearing the confirmed news, Liu Meng's mind went blank for a moment, not knowing what to say.

She had previously read a report about a 43-year-old man in Shenzhen who played with water at a scenic spot and experienced symptoms from headaches and coughs to death, all within a brief two weeks. Upon examination, the patient was confirmed to have Primary Amebic Meningoencephalitis (PAM) caused by Naegleria fowleri.

It's indeed terrifying to think about; after being infected by this brain-eating amoeba, the initial symptoms include nausea, headaches, and fever, which then worsen to back pain, hallucinations, and lack of concentration. Patients typically die within two weeks.

"Dr. Zhao, how should we treat it now?"

Always the professional doctor, Liu Meng quickly regained her composure after a brief shock and asked Zhao Heng.

"The pathogen is parasitizing the patient's brain, and the patient is now experiencing severe brain edema. The brain edema will further compress the brain tissue, so currently, the most important thing is to treat the brain edema."

"First, intracranial pressure must be reduced. Next, maintain adequate cerebral perfusion to prevent further ischemia and hypoxia. Finally, prevent the occurrence of brain herniation."

Zhao Heng pondered for a moment and quickly provided a general treatment plan and principles.

"Should we currently administer mannitol, compound glycerol, and Lasix together for the patient?"

Liu Meng asked again.

Mannitol is most commonly used in clinical treatment of acute brain edema as an osmotic diuretic. Clinically, a 20% mannitol solution is mainly used because of its strong effect and rapid excretion. In most cases, it is the first choice for treating acute brain edema.

Compound glycerol, with pharmacological effects similar to mannitol, is also a hypertonic dehydrator but without the adverse reactions of mannitol, like rebound, electrolyte imbalance, kidney damage, etc., and is especially suitable for brain edema patients with partial organ dysfunction and failure.

Lastly, Lasix, a commonly used potent diuretic in clinical settings, is an important choice for drug treatment of brain edema. It can inhibit the reabsorption of chloride and sodium ions in the medullary and cortical sections of the ascending loop of Henle, affecting the formation and maintenance of the high osmotic state in renal medulla, reducing urine concentration function, promoting the excretion of chloride, sodium, potassium ions and water, thus resulting in strong diuretic action and alleviating brain edema.

"They can be used in combination, but for treating brain edema, simply using dehydration methods isn't enough. Brain vascular spasms must also be prevented, and cerebral blood flow needs to be improved."

"Additionally, nimodipine should be used and mild hypothermia therapy should be administered to the patient."

Zhao Heng thought for a moment and said. Liu Meng's approach to treatment was evidently still at the level of an emergency doctor, but for this patient, treatment should not only consider symptomatic relief.

"Indeed, nimodipine, a dihydropyridine calcium channel blocker, can inhibit the entry of calcium ions into cells, thus inhibiting the contraction of vascular smooth muscle, providing some therapeutic effect for nerve damage caused by brain edema. Mild hypothermia therapy can further regulate cerebral blood flow, reduce brain oxygen metabolic rate, and improve cellular energy metabolism, thereby reducing the release of excitatory amino acids, diminishing oxygen free radical survival, reducing intracellular calcium overload, increasing the synthesis of neuronal ubiquitin, decreasing neuron necrosis and apoptosis, and promoting the restoration of intercellular signal transmission."

"Dr. Zhao, your treatment plan is truly ingenious!"

Liu Meng exclaimed in admiration.

Before coming to the ward, she had only heard about Zhao Heng's extremely high level of diagnosis and treatment, but now she realized that his level was not only high but borderless.

For treating brain edema, even a seasoned ER department head like Song Siming might not be able to propose such a comprehensive treatment plan during practical handling.

Zhao Heng's treatment plan wasn't just symptomatic but also laid a good foundation for the patient's future recovery.

Without extremely rich experience and high-level theoretical knowledge of medicine, and understanding of diverse drug treatment mechanisms, it would be impossible to propose such a comprehensive treatment plan.

"It's just a bit more experience; today, we probably won't be able to leave work as usual. Be prepared for an all-nighter."

With a calm demeanor, Zhao Heng spoke. He was quite indifferent to Liu Meng's praise, having seen such amazement on many faces before.

That's quite normal; at this age in his early twenties, he seemingly shouldn't possess such clinical experience.

But in the modern world, all kinds of unbelievable geniuses emerge, and many people are influenced by various media promotions, so having a genius like Zhao Heng at Eastern Hospital is not surprising.

"Well, I've gotten used to overtime in emergencies. Dr. Zhao, I may not match up to your medical skills, but when it comes to tasty take-outs, I'm definitely more informed."

Liu Meng smiled slightly as she spoke.

Working with Zhao Heng was still quite enjoyable, and as for overtime, for doctors, especially those at top-tier hospitals like Eastern Hospital, it's quite routine.

If there's a week without overtime, that would feel strange.

"Then let's proceed with the treatment methods we've discussed. Closely monitor the patient's condition; I'll be in the office, so come talk to me anytime."

Zhao Heng nodded, stating that Liu Meng was quite good, very solid professionally, though her thinking still needed to broaden.

It's important to realize that while solid professional skills and knowledge are vital, clinical thinking is actually harder to cultivate.

In terms of treatment methods, even the most cutting-edge, advanced methods in the extremely well-developed information society is known by doctors.

But to truly cure a patient, there are two key points. The first is diagnosis, which involves confirming the patient's condition with minimal examinations.

The second is treatment methods. Although textbooks offer treatment plans for certain diseases, those are based on statistical probability and data, and aren't applicable to every patient.

The individual differences between people are great, and disease progression within specific individuals is extremely complex, requiring targeted treatment and personal understanding on the foundation provided by textbooks.

These two points may sound simple, but truly achieving them is exceedingly difficult. Many doctors, after decades of practice, honestly may not reach this level or achieve this realm.

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