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病历摘要患儿男性,7个半月。因生后数日起腹泻伴不规则发热3～4天于1986年4月3日第一次入院。体检:体温39.8℃。发育营养差,精神萎。鼻腔脓性分泌物,左耳糜烂、溃疡。预部湿疹。躯干及头面部皮肤散在出血点(生后两月即有出血点,诊断为血小板减少性紫瘢)。心肺无异常。腹软,肝肋下2cm。肛周红肿压扁明显。全身皮下脂肪消失。实验室检查:血Hb90g/L,Rbc3.20×10~(12)/L,Wbc15.7×10~9/L,N17%,L38%,血小板66×10~9/L。脓液培养:致病性葡萄球菌。血培养阴性。血清IgG0.85g/L,IgA
Summary of medical records Male children, 7 and a half months. Due to a few days after birth, diarrhea with irregular fever 3 to 4 days in April 3, 1986 the first admission. Physical examination: body temperature 39.8 ℃. Development of poor nutrition, mental wilt. Nasal purulent discharge, left ear erosion, ulcers. Pre-eczema. Torso and head and face skin scattered in the bleeding point (two months after birth have bleeding, diagnosis of thrombocytopenic purpura). No abnormal heart and lung. Abdomen soft, liver ribs 2cm. Perianal swelling significantly flatten. Body subcutaneous fat disappears. Laboratory tests: blood Hb90g / L, Rbc3.20 × 10 ~ (12) / L, Wbc15.7 × 10 ~ 9/L, N17%, L38%, platelets 66 × 10 ~ 9 / L. Pus culture: pathogenic Staphylococcus aureus. Negative blood culture. Serum IgG 0.85g / L, IgA