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病例报告病儿×××,男,9 1/2岁,住院号59,897。患儿于17天前因发热、乏力、伴颈项部和右侧肩胛部疼痛,曾在本院门诊治疗。肌注青霉素(PG),体温曾一度下降正常,但2～3夭后体温又再上升至39℃以上,患儿精神较差,胃纳欠佳,二便正常。入院前1周有与腮腺炎患者接触史。体格检查:神志清,消瘦,皮肤粘膜无黄杂,面色较苍白,左侧腋下淋巴结多个,如黄豆、蚕豆大,余浅表淋巴结未扪及。无环形红斑及皮下结节,口腔粘膜光滑,咽不充血。右侧肩部肌肉轻压痛。心率132次/分,律整,第一心音低钝,心尖区SMⅡ级,主动脉第二听诊区SMⅡ级、粗糙、吹风样。双肺呼吸音清。腹平软,肝脾不大,四肢活动自如,关节无红、肿、热痛。实验室检查:Hb6.9g,RBC260万,WBC14200,N69%,L30%,ASO阴性,ESR88mm/h,GOT、CPK、LDH均在正常范围,血培养2次阴性,肥达氏阴性,MP阴性,中段尿培养阴性,蛋白电泳:α_2球蛋白17.9%,余正常,胸片、心电图、超声心动图、眼底检查正常,骨髓检查均正常。入
Case report × × ×, male, 9 1/2 years old, hospital number 59,897. Children with fever, fatigue, with neck and right scapular pain in 17 days, was treated in our hospital. Intramuscular injection of penicillin (PG), body temperature dropped to normal once, but after 2 to 3 yrs body temperature rose again to 39 ° C above, children with poor spirit, poor appetite, two normal. 1 week before admission and mumps patients with history of exposure. Physical examination: Consciousness, weight loss, skin and mucosa no yellow complexion, looking pale, the left axillary lymph nodes, such as soybeans, broad beans, Yu superficial lymph nodes not palpable. No annular erythema and subcutaneous nodules, oral mucosa smooth, pharynx is not congestive. Right shoulder muscle tenderness. Heart rate 132 beats / min, law, the first heart sound low blunt, apex SM Ⅱ level, aortic second auscultation SM Ⅱ level, rough, hair style. Breath sounds clear lungs. Abdomen soft, small spleen and liver, limbs freely, no joint redness, swelling, heat pain. Laboratory tests: Hb6.9g, RBC2600, WBC14200, N69%, L30%, ASO negative, ESR88mm / h, GOT, CPK, LDH are in the normal range, blood culture twice negative, Wadda negative, MP negative, In the middle of urine culture negative, protein electrophoresis: α 2 globulin 17.9%, more than normal, chest X-ray, electrocardiogram, echocardiography, fundus examination was normal, bone marrow examination were normal. Into