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花季少女,因低热伴膝、踝关节游走性红、肿、热、痛3个月,在某医院按“风湿热”治疗3个月无效,来我院就诊。查体:体温37.8℃,双膝、踝关节叫显红、肿.活动受限,双胫前及踝关节附近可见大小不等之结节性红斑,双腋下、腹股沟可触及多个蚕豆大淋巴结,尚活动。红细胞沉降率(ESR)54mm/h,结核蓖素试验(OT)强阳性,抗链球菌溶血素(抗“O”)正常,胸部 X 线片、心电图检查未见异常。腋下淋巴结活检,病理报告为干酪样坏死,遂确诊为淋
Young girl, because of fever with knee, ankle wandering sexual red, swollen, hot, pain for 3 months, according to a hospital by the “rheumatic fever” 3 months of treatment is invalid, to our hospital. Physical examination: Body temperature 37.8 ℃, knees, ankle called red, swollen. Activities are limited, both anterior tibial and ankle joints can be seen around the size of the nodular erythema, double armpit, groin can reach a number of broad beans Lymph nodes, still active. Erythrocyte sedimentation rate (ESR) 54mm / h, tuberculin test (OT) strong positive, anti-streptolysin (anti “O”) normal, chest X-ray, ECG abnormalities. Underarm lymph node biopsy, pathological reports of caseous necrosis, was diagnosed as leaching