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患者女性,48岁,湖北浠水县养鱼专业户。因畏寒、发热、右上腹持续胀痛17天,于1987年8月11日入我科。体检:体温39℃,血压90/60mmHg,脉搏124次/分。皮肤、巩膜无黄染。心肺未见异常。肝肋下6cm,剑突下7cm,质地中等,压痛。实验室检查:血红蛋白60g/L.红细胞2.07×10~(12)/L,白细胞8.4×10~9/L,中性86%,淋巴14%,谷丙转氨酶正常。血培养2次阴性。甲胎蛋白5μg/L。B超:肝右后叶内可见6.8×7.2cm边缘不规则液性暗区。入院后每天用氨苄青霉素6g及对症支持疗法,体温控制在正常。8月17日行肝穿,抽出稀黄色脓液60ml,味恶臭,生理盐水冲洗后注入庆大霉素24万u。脓液做细菌培养,反复系列生化鉴定为“迟钝爱德华
Patient female, 48 years old, Hubei Xishui County fish specialized households. Because of chills, fever, sustained right upper quadrant pain for 17 days, on August 11, 1987 into my department. Physical examination: body temperature 39 ℃, blood pressure 90 / 60mmHg, pulse 124 beats / min. Skin, sclera without yellow dye. Heart and lung no abnormalities. Liver ribs 6cm, xiphoid 7cm, medium texture, tenderness. Laboratory tests: hemoglobin 60g / L. Erythrocytes 2.07 × 10-12 / L, leukocytes 8.4 × 10 ~ 9 / L, 86% neutral, lymph, 14%, alanine aminotransferase normal. Blood culture 2 negative. A fetoprotein 5μg / L. B super: the right posterior lobe of the liver can be seen 6.8 × 7.2cm edge irregular liquid dark area. Every day after admission with ampicillin 6g and symptomatic and supportive therapy, body temperature control in normal. August 17, liver wear, remove the dilute yellow pus 60ml, smelly stench, saline injected gentamicin 240000 u. Pus bacterial culture, repeated series of biochemical identification as "retarded Edward