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患儿男,3月。因咳嗽10多天,以支气管炎收住。同病室中有一菌痢患儿。住院后第5d,患儿开始腹泻,每d10次至几十次,每次量少,初起以稀水便为主,后转为粘液带血丝便。患儿频繁哭闹,不能安静。病程中不发热,无呕吐,吃奶尚好。查体无阳性体征。粪常规:红细胞(+++),脓细胞(+++),未找到巨噬细胞。3次粪细菌培养,无致病菌生长。考虑患儿与菌痢患儿接触史,诊断为细菌性痢疾,先后用痢特灵、SMZCo、庆大霉素、吡哌酸、氯霉素、利福平等治疗3月余,均无效。患儿仍为脓血便,次数不减,白天与夜间除睡眠外无休止地哭闹。
Children male, March. Due to cough for more than 10 days, admitted to bronchitis. In the same ward there is a dysentery in children. 5d after hospitalization, children with diarrhea, each d10 times to dozens of times, each less, initially to dilute the water-based, then converted to mucus with bloodshot stools. Frequent crying children can not be quiet. No fever during the course of the disease, no vomiting, feeding is still good. Physical examination without positive signs. Dung routine: red blood cells (+++), pus (+++), macrophages not found. 3 fecal bacteria culture, non-pathogen growth. Consider the history of contact with children with bacillary dysentery, the diagnosis of bacterial dysentery, followed by furazolidone, SMZCo, gentamicin, pipemidic acid, chloramphenicol, rifampin for more than 3 months treatment, are ineffective. Children still abscess bloody, the number of diminished, except during sleep day and night crying endlessly.