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风湿性肺炎既少见又不易确定,常表现为暴发性过程而死亡,尸解所见为肺泡出血、纤维蛋白性水肿、间质炎症性渗出和Masson小体、尽管这些未必都具有特异性或诊断价值,肺浸润多与心脏炎并存,诊断上难于区别是充血性心衰的肺部表现或是肺炎。病例10岁男孩,入院前1个月微热,右足、左大腿和下背部痛。尿检查有微量蛋白并有酮体、尿胆原、红白细胞和中度细菌尿,用磺胺二甲基异恶唑后疼痛消失。2周后有咽痛,未治疗,又2周因耻骨弓上及左侧腹痛影响睡眠而入院。6年前患过血尿住院,家族有风湿性心脏病患者。
Rheumatic pneumonia is both uncommon and not readily identifiable, often manifested as an episodic process that dies as alveolar hemorrhage, fibroedema, interstitial inflammatory exudate, and Masson bodies, although these may not all be specific or Diagnostic value, pulmonary infiltrates and coexist more cardiomyopathy, the diagnosis is difficult to distinguish the pulmonary manifestations of congestive heart failure or pneumonia. Case 10-year-old boy, 1 month before admission, slightly warm, right foot, left thigh and lower back pain. Urine test trace protein and ketone body, urobilinogen, red and white cells and moderate bacterial urine, with sulfamethoxazole disappeared after pain. 2 weeks after sore throat, untreated, and 2 weeks because of suprapubic and left abdominal pain affect sleep and hospitalization. 6 years ago, hematuria hospitalized, family members with rheumatic heart disease.