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1个8月龄的男性婴儿,因有不断扩展的皮肤损害4个月,腹泻10天,于1982年7月入儿童医院。病孩为健康父母的第三个小孩,孕龄不清楚,正常分娩,出生时体重低于2,000g。母乳喂养至6个月,4个月开始附加含有蛋、香蕉、米饭和猪肉的食物。没有与本病有关的家族史。入院体查:无发热,体重5.6Kg,嗜睡;头发全脱,眉毛稀疏;于口周、鼻褶、颈、手、脚和臀部有红斑鳞屑性损害,并见趾甲营养障碍。实验室检查:血、尿、粪检查正常,连续3天大便培养未发现肠道病原菌。血清锌水平正常。X线照片骨龄正常。入院后仅给予对症和支持疗法,并按年龄给予合适的附加食物,但未补加锌;于1星期内大便情况改善,皮肤损害逐渐好转。于入院后3星期病孩再发展成水性腹泻,大便检查有大量的白细胞,大便培养志贺氏痢疾杆菌阳性,并见低血清锌和碱性磷酸酶降低;用复方增效磺胺治疗腹泻逐渐好转,血清锌和碱
One male infant of 8 months of age was admitted to Children’s Hospital in July 1982 for 4 months due to expanding skin lesions and 10 days of diarrhea. The third child of a healthy parent is ill-defined, normal childbirth and weighs less than 2,000g at birth. Breastfeeding to 6 months, 4 months start with additional food containing eggs, bananas, rice and pork. There is no family history related to this disease. Admission physical examination: no fever, weight 5.6Kg, lethargy; hair off, thin eyebrows; in the mouth week, nose fold, neck, hands, feet and buttocks erythema scaly damage, and see nail dystrophy. Laboratory tests: blood, urine, stool examination was normal, stool for 3 consecutive days did not find intestinal pathogenic bacteria. Serum zinc levels were normal. X-ray bone age normal. Only symptomatic and supportive therapies were given after admission, and appropriate supplements were given by age without supplementation with zinc; the stools improved within one week and skin lesions improved gradually. 3 weeks after admission, the patient developed watery diarrhea again, a large number of white blood cells were found in the stool, stool was positive for Shigella dysenteriae, and low serum zinc and alkaline phosphatase were reduced. Diarrhea was gradually improved with compound synergistic sulfonamides , Serum zinc and alkali