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患者,男,48岁,以“间断发热1年半,发现肾功能异常1周”为主诉,于2016年1月4日入院。患者18个月前出现反复发热,体温最高39.5℃,伴乏力、头痛、四肢肌肉疼痛,间断口服波尼松,体温控制欠佳。1周前因乏力加重至门诊查肌酐308μmol/L,门诊以“肾功能衰竭”为诊断收入科。患者既往高血压、糖尿病病史16个月,未治疗。入院体格检查,体温38.1℃,脉搏85次/min,呼吸20次/min,血压
The patient, male, 48 years old, was chiefly complain of “intermittent fever for 1 year and a half with 1 week of renal dysfunction” and was admitted on January 4, 2016. The patient experienced repeated fever 18 months earlier, with a maximum body temperature of 39.5 ° C, with fatigue, headache, and muscle pain in the extremities, intermittent oral prednisolone, and poor body temperature control. 1 week ago because of fatigue increased to the clinic to check creatinine 308μmol / L, outpatient to “renal failure ” for the diagnosis of income section. Patients with previous history of hypertension, diabetes, 16 months, untreated. Admission physical examination, body temperature 38.1 ℃, pulse 85 beats / min, breathing 20 times / min, blood pressure