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病历摘要:患儿女,8岁。入院前2个半月开始发热,伴纳差、多汗、乏力。1987年7月24日住入当地医院,1周后血培养有绿色链球菌生长,当即行抗菌治疗,先后用过青霉素、氨苄青霉素、庆大和先锋霉素,疗程达14天,发热仍然不退,1987年8月13日转入我院。体检:体温38.5℃,脉搏120次/分,呼吸34次/分,血压右上肢90/40mmHg。重症贫血外貌,胸骨左缘第3、4肋间可闻及Ⅳ级以上连续性杂音伴双期震颤。周围血管征阳性,脾肋下3cm,质软,轻压痛。化验及其他检查:血红蛋白74g/L,白细胞25.8×10~9/L,中性90%,血沉74mm/h,血培养5次均阴性。心电图
Medical history summary: Children, 8 years old. 2 and a half months before admission, fever, with anorexia, sweating, fatigue. July 24, 1987 admitted to a local hospital, a week after the blood culture of Streptococcus agalactiae growth, antibacterial treatment immediately, has used penicillin, ampicillin, Qingda and Pioneer ADM, treatment up to 14 days, the fever is still not refundable August 13, 1987 into our hospital. Physical examination: body temperature 38.5 ℃, pulse 120 beats / min, breathing 34 beats / min, blood pressure right upper limb 90 / 40mmHg. Severe anemia appearance, the 3rd and 4th intercostal sternum can be heard on the left margin of the fourth grade and above consecutive murmur with double tremor. Surrounding blood vessels sign positive, splenic rib 3cm, soft, light tenderness. Laboratory and other tests: hemoglobin 74g / L, leukocytes 25.8 × 10 ~ 9 / L, 90% neutral, erythrocyte sedimentation rate 74mm / h, blood culture were negative 5 times. Electrocardiogram