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患儿 女,6岁。因发热3天入院。查体:体温39.1℃,呼吸23次。神清,皮肤无黄染,腹部皮肤散在数个针尖大小出血点。颈软,两肺呼吸音粗糙,心律齐,心率116次/分,心音有力,各瓣膜区未闻及器质性杂音。腹软,肝脾均未触及。实验室检查:白细胞8.5×10~9/L,中性粒细胞0.85,淋巴细胞0.13,单核细胞0.02。入院诊断:败血症。入院第2天胸片回报为肺炎。第3天出现头痛,精神萎糜,皮肤出血点增多。颈强直,全腹肌紧张,有压痛、反跳痛,布氏征、克氏征阳性。心电图:多
Children with children, 6 years old. 3 days due to fever admitted to hospital. Physical examination: body temperature 39.1 ℃, breathing 23 times. Clear, no yellow skin, abdomen scattered in the number of small needle-like bleeding point. Neck soft, rough breathing sounds of both lungs, heart rate Qi, heart rate 116 beats / min, heart sounds strong, the valve area has not heard organic noise. Abdomen soft, liver and spleen are not touched. Laboratory tests: white blood cells 8.5 × 10 ~ 9 / L, neutrophils 0.85, lymphocytes 0.13, mononuclear cells 0.02. Admission diagnosis: sepsis. On the second day of admission, the chest radiograph returned to pneumonia. The first 3 days of headache, spiritual wilt, skin bleeding increased. Neck stiffness, the whole abdominal muscle tension, tenderness, rebound tenderness, Clinton sign, Krypton sign positive. ECG: more