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患儿男性,9岁,学生,病案号108938。因腰背肿痛、低热、不能行走2月余.于1991年3月26日入院。患儿于2个金月前无原因出现双足跟痛,继而腰背痛,伴低热,盗汗。半个月后渐不能行走,食欲减退、疲乏,进行性消瘦,在当地医院用青霉素、抗结核药(具体不详)治疗无好转,腰部肿痛加剧,双下肢水肿。无外伤史,无慢性咳嗽及结核病接触史。入院时,体温38.0℃,精神差,营养较差,消瘦,面色苍白,被迫左侧蜷曲卧位,翻身则疼痛不已,他人搀扶下可勉强坐起,不能站立及行走,全身冷汗淋漓。皮肤无黄染、皮疹、出血点及瘀斑。浅表淋巴结无明显肿大。胸廓无畸形,左肺呼吸音减弱及少许细温罗音。心脏(一)腹部饱满膨隆,未扪及包块,肝肋下
Male child, 9 years old, student, medical record number 108938. Due to low back pain, fever, can not walk more than 2 months in March 26, 1991 admitted. Children with two gold months before no reason to appear with both feet with pain, followed by low back pain, with fever, night sweats. Gradually unable to walk after half an month, loss of appetite, fatigue, progressive weight loss, in the local hospital with penicillin, anti-TB drugs (specific unknown) no improvement in treatment, increased soreness of the waist, lower extremity edema. No history of trauma, no history of chronic cough and TB exposure. Admission, the body temperature 38.0 ℃, poor spirits, poor nutrition, weight loss, pale, forced left curled supine, stand up painful, others can barely sit up, can not stand and walk, body sweat dripping. No skin yellow dye, rash, bleeding and ecchymosis. Superficial lymph nodes without obvious enlargement. Thorax without deformity, left lung breath sounds weakened and a little warm rales. Heart (a) Abdominal full bulging, palpable mass, liver ribs