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患者,男性、19岁。因左耳疼痛、听力下降4天,左面颊及口腔内疱疹伴疼痛3天,于1987年3月10日住院。3天前左面部、下唇、颊粘膜,牙龈,舌背出现多个红色斑疹及小水疱,伴有明显烧灼样疼痛,影响进食及睡眠。既往无耳疾史。体检:体温38.4℃,左耳前至左下颌部皮肤有成簇疱疹,呈水疱或脓疱样,少数已破溃形成黄色结痂。左侧下唇疱疹多破溃结痂。舌背左前2/3,左侧牙龈及颊粘膜上破溃疱疹形成多个溃疡面,病变粘膜充血,触痛明显。耳镜检查:左外耳道底部有疱疹及黄色分泌物结痂。鼓膜后下象限有一穿孔,周围充血;并有少量分泌物。用青霉素控制继发感染,肌注维生素B_12,口服维生素A、C及复B。皮肤
Patient, male, 19 years old. Due to left ear pain, hearing loss for 4 days, left cheek and oral herpes with pain for 3 days, March 10, 1987 hospitalization. Three days ago left facial, lower lip, buccal mucosa, gums, tongue back appear multiple red rash and small blisters, accompanied by significant burning pain, affecting eating and sleeping. Past history without ear disease. Physical examination: body temperature 38.4 ℃, the left ear to the left mandibular group of skin herpes, was blisters or pustular-like, a few have been ruptured the formation of yellow scab. Left lower lip herpes ulceration scab. Tongue back left 2/3, the left gum and buccal mucosa rupture herpes form multiple ulcers, lesions mucosal congestion, tenderness significantly. Otoscope: the bottom of the left ear canal herpes and yellow secretions scab. Posterior tympanic quadrant of a perforation, congestion around; and a small amount of secretions. With penicillin control of secondary infection, intramuscular injection of vitamin B_12, oral vitamin A, C and complex B. skin