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患者,男,14岁,学生。1985年9月2日以发热待查入院。患者于1月前无明显诱因,慢起发热,自测体温持续在37.6～38.5℃之间10天,伴全身乏力、不适。在当地按上感治疗无效。10天后转为持续高热,自测体温38.5～39.5℃之间,此时来我院门诊查血、尿常规无异常,拍胸片、查肥达反应、鼠伤寒沙门菌抗体、肝功能均未发现异常,但仍按鼠伤寒沙门菌感染败血症型给予氨卡青霉素、氮霉素加地塞米松各一组静滴8天,仅可暂时退热,此间查抗“O”250U,ESR50mm/h。由于急于办入初中手续而中断治疗。1周后再次高热,门诊查血常规发现三系减少及多量幼稚细胞收入血液科。体检:T 39.0℃,P130次/分,R26次/分,BP104/69mmHg(1mmHg=0.133kPa),意识清,中度贫血,皮肤无淤点、淤斑,浅表淋巴结不肿大,长骨和脊柱无压痛、叩
Patient, male, 14 years old, student. On September 2, 1985, I was hospitalized with fever. The patient had no obvious cause before January, and he had a fever. The temperature of the self-rated body lasted between 37.6 and 38.5°C for 10 days, with generalized fatigue and discomfort. In the local area, the treatment is not effective. After 10 days, the patient became hyperthermia, and the self-test body temperature was between 38.5 and 39.5°C. At this time, no blood or urine abnormalities were found in the outpatient department of our hospital. Chest radiographs, examination of the fat response, Salmonella typhimurium antibody, and liver function were not performed. Abnormalities were found, but septicaemia of Salmonella typhimurium was still given to each group of intravenous injection of amikacin penicillin, nitromycin, and dexamethasone for 8 days. Only temporary fever was available. During this period, the resistance was “O” 250 U and ESR 50 mm/h. The treatment was interrupted due to eagerness to go to junior high school. After 1 week of high fever again, outpatient blood tests revealed a decrease in the three lines and a large number of infant cells in the hematology department. Physical examination: T 39.0°C, P130 beats/min, R26 beats/min, BP104/69mmHg (1mmHg=0.133kPa), clear consciousness, moderate anemia, no stasis, ecchymosis, no superficial lymph nodes, long bones, and Spinal no pain, cramps