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患者,男,18岁。2月前渐起畏寒发热,持续39℃以上,伴咳嗽气促、盗汗。一周来,咯血痰,量多,牙龈出血。查体:T38℃,P130次/分,R30次/分,Bp15/9kPa。皮肤无出血点,颈侧、腋下及腹股沟均可触及花生米或枣样大小淋巴结,无压痛。气管右偏、右肺呼吸音低,叩浊、语颤减弱、未闻啰音、心界不大,无杂音、肝肋下3cm,脾肋下1cm。实验室检查:Hb91g/L,白细胞350×10~9/L,血小板69×10~9/L,血片:原
Patient, male, 18 years old. 2 months ago, chills and fever gradually increased, lasting more than 39 ℃, with cough and shortness of breath, night sweats. A week ago, hemoptysis sputum, the amount of bleeding gums. Physical examination: T38 ℃, P130 times / min, R30 times / min, Bp15 / 9kPa. No skin bleeding, neck side, armpit and groin can reach peanuts or jujube-like lymph nodes, no tenderness. Trachea right deviation, right lung breath sounds low, knock turbidity, tremor weakening, unheard rales, little heart, no noise, liver ribs 3cm, 1cm spleen ribs. Laboratory tests: Hb91g / L, white blood cells 350 × 10 ~ 9 / L, platelets 69 × 10 ~ 9 / L, blood films: the original