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本文报告2例金黄色葡萄球菌(以下简称金葡菌)心内膜炎并发脑膜炎、出血性皮肤损害和弥漫性血管内凝血(DIC),其临床表现与脑膜炎球菌血症伴发脑膜炎极为相似。例一为22岁男性,因发热、头痛、颈项强直、嗜睡伴意识不清入院。体检:心率145次/分,呼吸40次/分,体温40℃,颈项强直,胸部散在瘀点,无心脏杂音。白细胞15,400,血小板3万。胸部X线检查示两肺底浸润灶。脑脊液混浊,白细胞141个/mm~3,凝血酶原和部份凝血活酶时间延长,纤维蛋白降解物>40μg/ml。初诊为脑膜炎球菌血症伴脑膜炎,经大剂量青霉素治疗,瘀点继续增多,双臂出现紫癜样损害,血培养获耐青霉素的金葡菌。患者先后出现三尖
This article reports 2 cases of Staphylococcus aureus (hereinafter referred to Staphylococcus aureus) endocarditis complicated with meningitis, hemorrhagic skin lesions and diffuse intravascular coagulation (DIC), its clinical manifestations associated with meningococcal meningitis Very similar. One example is a 22-year-old man who was admitted to hospital because of fever, headache, neck stiffness, and somnolence. Physical examination: heart rate 145 beats / min, breathing 40 beats / min, body temperature 40 ℃, neck stiffness, chest scattered petechia, no heart murmur. 15,400 white blood cells, 30,000 platelets. Chest X-ray examination showed two lung infiltration stove. Cerebrospinal fluid cloudy, white blood cells 141 / mm ~ 3, prothrombin time and partial thromboplastin time, fibrin degradation products> 40μg / ml. The first diagnosis of meningococcal disease associated with meningitis, the treatment of large doses of penicillin, petechia continue to increase, purpura-like arms appear damage, blood culture of penicillin-resistant Staphylococcus aureus. Patients have three sharp tip