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患男,8岁,以狗咬伤下肢9个月,头痛4d,惊恐不安2d于1992年3月13日急诊入院。9个月前不慎被家犬咬伤左小腿部,曾在当地清创包扎,伤后第5天开始注射狂犬疫苗,共注射5次,后伤口痊愈。于4d前患儿先感原咬伤部位有异物骚动感、头痛。查体:T38.5℃,P120次/min,R25欠/min,BP16.0/10.6kPa。发育可,营养一般,神志清,急性痛苦病容,惊恐畏惧状,瞳孔等大,对光反射敏感,颈软无抵抗,心肺(-),腹部(-),四肢未见异常。吹风及饮水惊恐症状加剧。诊断:狂犬病。即予以隔离,抗感染、镇静、全身支持疗法,但一旦吹风及饮水,即出现烦躁不安。
Male, 8 years old, bitten to the lower extremities of dogs for 9 months, headache 4d, frightened 2d on March 13, 1992 emergency room admission. 9 months ago, the dog was bitten by the left leg, was debridement bandage in the local, 5 days after the injury began rabies vaccine injection, a total of 5 times the injection, the wound recovered. Prior to 4d, the patient had a sense of foreign body movement and headache. Physical examination: T38.5 ℃, P120 times / min, R25 ow / min, BP16.0/10.6kPa. Developmental, nutritious, delirious, acute pain, panic, pupil and other large, sensitive to light reflex, soft neck, cardiopulmonary (-), abdomen (-), limbs and anomalies. Hair and drinking panic symptoms worsened. Diagnosis: rabies. That is to be isolated, anti-infective, sedation, body support therapy, but once the hair and drinking water, there is irritability.