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成人D族链球菌脑膜炎较罕见,现将我们于1983年收治的1例报告于下。 男,27岁,工人。因发热、头痛、呕吐3d,神志不清、躁动6h,于5月3日急诊入院。急诊时,T39.5℃,颈强,血WBC17×10~9/L,N0.92,L0.08,胸片(-)。予甘露醇及安定后行腰穿,CSF立即喷出(未测压力),呈毛玻璃状混浊,送检常规,生化和细菌培养,即以“化脓性脑膜炎”收入。以往无外伤、中耳炎及颅脑手术史。入院时,T40℃,急性病容,神志不清,躁动不安,有时四肢抽动,皮肤、粘膜未见出血点。压眶反射消失。瞳孔等大,对光反应灵敏。颈强。克氏征(+)。CSF混浊。潘氏试验+++。WBC4.5×10~8/L。
Adult group D streptococcal meningitis is rare, and we now report a case of 1983 admitted to the next. Male, 27 years old, worker. Due to fever, headache, vomiting 3d, confusion, restlessness 6h, on May 3 emergency admission. Emergency, T39.5 ℃, neck strong, blood WBC17 × 10 ~ 9 / L, N0.92, L0.08, chest radiograph (-). To mannitol and stability after lumbar puncture, CSF immediately spurt (not measured pressure), was frosted glassy opacity, inspection routine, biochemical and bacterial culture, that is, “purulent meningitis” income. No previous trauma, otitis media and craniocerebral surgery history. Admission, T40 ℃, acute illness, unconscious, restless, and sometimes limbs twitching, skin, mucous membrane no bleeding. Pressure orbital reflex disappears. Pupils and other large, sensitive to light. Neck strong. Kirschner Sign (+). CSF cloudy. Pan’s test +++. WBC 4.5 × 10 ~ 8 / L.