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患者,男,28岁,因发热、咽痛2天,来我院就诊.2天前无明显诱因发热,体温38.9℃,感咽痛,眼睛畏光流泪,无寒颤,无咳嗽,无尿频、尿痛、尿急,无关节痛.查体:全身皮肤未见皮疹,全身浅表淋巴结未扪及肿大,眼结膜充血,咽部充血,双侧扁桃体Ⅱ°肿大,见脓栓,心肺腹未见异常.查白细胞:9.6×10~9/L,诊断为:急性化脓性扁桃体炎.给予青霉素治疗3天,仍发热,体温高达40.2℃,咽痛加重,自面部到躯干、四肢顺次出现较密实的红色斑丘疹,查体发现患者两侧颊粘膜有灰白色小点,绕以红晕.追问病史,有与麻疹病人密切接触史.用ELISA法测麻疹IgM阳性.修正诊断:麻疹.讨论
Patients, male, 28 years old, due to fever, sore throat for 2 days to our hospital .2 days ago no obvious incentive to fever, body temperature 38.9 ℃, sore throat, photophobia tears, no chills, no cough, no urinary frequency, Urine pain, urgency, no joint pain. Physical examination: no skin rash, systemic superficial lymph nodes without palpable enlargement, conjunctival hyperemia, throat congestion, bilateral tonsil enlargement, see pus plug, heart and lung Abdominal abnormalities were not observed. White blood cells: 9.6 × 10 ~ 9 / L, diagnosed as: acute suppurative tonsillitis given penicillin treatment for 3 days, still fever, body temperature up to 40.2 ℃, sore throat ache, from the face to the trunk, Times appear more dense red rash, examination revealed that patients with small white spots on both sides of the buccal mucosa, around the blush .Question history, have close contact with the history of measles patients.Immune measles IgM positive measles. discuss