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男,11岁,因发热40余天,黄疸1周入院,患者自6月底发热,体温39～40℃,热型不规则,右上腹间歇性胀痛,某院诊断为“肝脓肿”,自7月7日住院起用氨苄青霉素,庆大霉素,先锋霉素治疗。至7月15日B超检查认为“肝脓肿”已好转,但发热不退,干咳。7月25日肺部X线检查显示双肺粟粒状改变,病情恶化,改用抗痨及先锋V治疗。8月4日B超复查“肝脓肿”已消失,但上述全身症状越来越重,1周前皮肤巩膜逐渐黄染,面、胸、背部在发热高峰期分批出现红色丘疹,压之不褪色、无痒感及渗液,2日后皮疹结黑色痂,不易脱落,病后二便正常,神智清醒。8月7日。某院诊断为“Ⅱ型肺结核”
Male, 11 years old, fever due to more than 40 days, jaundice 1 week admission, the patient fever since the end of June, body temperature 39 ~ 40 ℃, irregular heat, intermittent abdominal pain on the right upper quadrant, a hospital diagnosis of “liver abscess,” since 7 On the 7th from the hospital with ampicillin, gentamicin, cephalosporin treatment. To July 15 B-ultrasound that “liver abscess” has improved, but fever, dry cough. July 25 lung X-ray examination showed lung miliary changes, the disease deteriorated, switch to anti-痨 and Vanguard V treatment. August 4 B-ultrasound “liver abscess” has disappeared, but the above-mentioned systemic symptoms more and more heavier, 1 week before the skin sclera gradually yellow dye, face, chest, back in the peak fever period in batches of red papules, pressure is not Fade, no itching and exudate, 2 days after the rash knot black scab, not easy to fall off, the two will be normal, sober. August 7. A hospital diagnosed as “type II pulmonary tuberculosis”