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某女,26岁,因头痛、发热4d,耳痛2d入院。4d前出现头痛、发热(体温37～38℃),外院按“上呼吸道感染(以下简称上感)”行对症处理,2d后出现右耳持续性刺痛,伴恶心、呕吐(4次均为胃内容物),门诊以“上感”收治。入院第2天出现右侧面瘫。检查:体温37.2℃,脉搏80/min,血压16.0/10.6kPa(120/80mmHg);心、肺、腹无异常。右额纹消失,右睑裂扩大,右鼻唇沟变浅,右口角下垂,右眼不能完全闭合,不能鼓腮,露齿受限,说话时口角左歪。耳部检查:右耳廓肿胀,右耳甲腔内粟粒大小疱疹密布,有的相互融合;外耳道无红肿,未见脓性分泌物,鼓膜无充血、穿孔,乳突无压痛;右耳周围淋巴结肿痛,听力正常。鼻咽部未见异常。治疗经过:给青霉素80万U,肌注,每日2次,强的松10mg,每日3次,复合维生素B2片,每日
A woman, 26 years old, because of headaches, fever 4d, 2d admitted to hospital. 4 days before the onset of headache, fever (body temperature 37 ~ 38 ℃), the outer court by the “upper respiratory tract infection (hereinafter referred to as the sense of”) line symptomatic treatment, 2d after the right ear persistent tingling, with nausea and vomiting (4 Are stomach contents), outpatient to “sense ” admitted. The right side of the paralysis appeared on the 2nd day after admission. Check: body temperature 37.2 ℃, pulse 80 / min, blood pressure 16.0 / 10.6kPa (120 / 80mmHg); heart, lung, abdomen without exception. The right forehead pattern disappears, the right palpebral fissure expands, the right nasolabial fold shallow, right mouth drooping, the right eye can not be completely closed, can not drum gills, tooth exposure is limited, speak crooked left crooked. Ear examination: swelling of the right ear, the size of the right ear shell cavity miliary herpes dense, and some mutual fusion; external auditory canal without swelling, no purulent discharge, tympanic membrane without congestion, perforation, papillae no tenderness; right ear lymph nodes Sore throat, normal hearing. No abnormal nasopharyngeal. After treatment: 800000 U to penicillin, intramuscular injection, 2 times a day, prednisone 10mg, 3 times a day, vitamin B2 tablets, daily