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1998年2月,接某医院报告1例“疑似白喉”病例,威海市卫生防疫站立即派员到现场调查,现将调查情况报告如下: 患者王某,女,25岁,威海市人,白喉免疫史不详。1998年2月12日,患者发热、寒战、全身不适,经当地卫生院用抗生素(药名、剂量不详)治疗好转。2月23日,出现咽喉疼,吞咽时加重,并出现吸气喘憋,声音嘶哑,急诊入院。体温39℃,心率92次/min,律整,咽部粘膜无充血,双侧扁桃体无肿大,会厌部充血肿胀。右侧舌面梨状窝有大片白色“假膜”。24日出现吸气时呼吸困难,三凹症,诊断“喉梗阻”,及时作气管切开,经用先锋霉素、丁胺卡那霉素、氟美松治疗17d痊愈出院。 患者血液白细胞12.5×10~3/L,中性粒细胞86.4％,淋巴细胞13.6％。取患者喉部“假膜”进行细菌培养,检出肺炎双球菌,未检出白喉杆菌;药敏试验,肺炎双球菌对复方新诺明、先锋霉素、丁胺卡那、乙酰螺旋霉素敏感,对青霉素、红霉素、庆大霉素、链霉素耐药。
In February 1998, a hospital report of a case of “suspected diphtheria” cases, Weihai City Health and Epidemic Prevention Station immediately sent to the scene investigation, the investigation is now reported as follows: Patient Wang, female, 25 years old, Weihai City, Diphtheria Unknown history of immunization. February 12, 1998, patients with fever, chills, general malaise, antibiotics by the local hospitals (drug name, dose unknown) treatment improved. February 23, a sore throat, swallowing aggravated, and breathing wheezing, hoarse voice, emergency admission. Body temperature 39 ℃, heart rate 92 beats / min, law, pharyngeal mucosa without congestion, bilateral tonsil enlargement, epiglottis hyperemia and swelling. The right lingual pear-shaped nest has a large white “pseudomembrane.” On the 24th, when breathing, he had dyspnea, three-recession, diagnosis of “laryngeal obstruction” and timely tracheotomy. After being treated with Pioneermycin, amikacin and dexamethasone for 17 days, he was discharged. Patients with blood leukocytes 12.5 × 10 ~ 3 / L, 86.4% of neutrophils, lymphocytes 13.6%. Take the patient’s larynx “pseudomembrane” for bacterial culture, detection of pneumococcus, did not detect diphtheria bacilli; drug susceptibility test, pneumococcal on cotrimoxazole, cephalosporins, amikacin, acetylspiramycin Sensitive to penicillin, erythromycin, gentamicin, streptomycin resistance.