男患,19岁,因四肢大关节肿痛10余天入院。入院前20余天,在菌痢流行中出现脓血便、发热。大便常规检查见有脓细胞,红细胞及吞噬细胞。经按菌痢治疗5天后症状消失,约10天后出现尿频、尿急、尿痛,继之左髋、左膝、右踝及右肘关节肿痛,呈非游走性,伴发热、乏力。经用青霉素治疗3天后尿频、尿痛等症状消失,但关节肿痛渐重,仍有发热,不畏寒,并有右眼痛、畏光、流泪而入院。病患平素健康,其父、叔父均有强直性脊柱炎病史。查体:T 39.5℃,一般情况可,右眼球结膜充血明显,右踝、右肘关节肿胀压痛明显,左 Male suffering, 19 years old, because of limbs, joint pain and swelling more than 10 days admission. More than 20 days before admission, abercrombie deutschland, in the dysentery epidemic of pus and blood, fever. Stool routine examination see pus, red blood cells and phagocytes. After 5 days according to the treatment of dysentery symptoms disappeared, about 10 days after the occurrence of frequent urination, urgency, dysuria, followed by left hip, left knee, right ankle and right elbow joint swelling and pain was non-migratory with fever and fatigue. 3 days after treatment with penicillin frequent urination, dysuria and other symptoms disappear, but the joint swelling and pain gradually heavier, there is still fever, no chills, and right eye pain, photophobia, tearing and admission. Patients usually healthy, his father and uncle have ankylosing spondylitis history. Physical examination: T 39.5 ℃, under normal circumstances, the right eye conjunctiva congestion was obvious swelling of the right ankle and right elbow tenderness significantly left