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男,1岁。8天前开始持续发热39℃左右,畏光,流泪。4天前自耳后渐及躯干四肢出现红色皮疹,同时伴咳嗽,喘憋。既往未患过麻疹及注射过麻疹疫苗,当地有麻疹流行,病前有密切接触史。体温38.2℃,精神萎靡,全身皮肤可见密集的粟粒大小的红色丘疹,部分融合,疹间皮肤正常。双眼结膜充血,口腔粘膜粗糙,可见Koplik斑。两肺密集水泡音,呼吸60次,心率160次,心音低钝。肝右肋下1.5cm。神经系统未见异常。诊为麻疹并肺炎,经青霉素等常规治疗。入院第二天前囟略紧,第8天前囟明显凸出,并有喷射性呕吐,意识清楚,腱反射正常,无脑膜及病理征。血红蛋白115g/L,白细胞
Male, 1 year old. 8 days ago began to fever 39 ℃ or so, photophobia, tearing. Four days ago, a red rash appeared on his trunk and his limbs, accompanied by coughing and wheezing. Past no measles and measles vaccine, the local epidemic of measles, have a close contact before the disease history. Body temperature 38.2 ℃, apathetic, the body can be seen dense dense miliary-size red papules, partial fusion, rash skin normal. Eyes conjunctival hyperemia, oral mucosa rough, visible Koplik spot. Dense blisters tone lungs, breathing 60 times, heart rate 160 times, low heart sound blunt. Liver right rib 1.5cm. Nervous system no abnormalities. Diagnosis of measles and pneumonia, penicillin and other conventional treatment. The first day before admission, the fontanelle was slightly tight. On the 8th day, the frontal fontanelle was prominent with jet-elicited vomiting, clear consciousness, normal tendon reflexes, no meninges and pathological sign. Hemoglobin 115g / L, white blood cells