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患者男性,46岁,因咳嗽、多痰,继之发冷、发热伴全身关节酸痛二天来华山医院急诊。当时病人软弱无力、精神萎靡,体温38.4℃,心率100次/分,律齐。咽稍红,两肺呼吸音粗糙.腹平软,肝在肋缘下1横指,剑突下2横指,有触痛,脾未及。胸部透视心肺未见异常,心电图正常。在留察期间病人常有恶心和肝区间歇性疼痛(五年前有肝炎史)。给予静脉滴注5％葡萄糖盐水,肌肉注射冬眠灵,口服四环素、APC片、棕色合剂等药物。于死亡当天早晨起床解大便时突然昏厥,随即清醒,但呼吸急促,精神十分萎靡,面色土黄,此时检查血压为108/98 mmHg,巩膜轻度黄染,眼睑轻度浮肿,无紫绀表现,二肺有散在性哮鸣音,无明显湿啰音,心率100次/分,律齐,肝在肋缘下2横指半,剑突下未满意触及,肝、肾区均有叩痛。白细胞计数9,200/mm~3,中性粒细胞78％,淋巴细胞22％。当天中午开始用四环素1g+10％
Male patient, 46 years old, due to cough, phlegm, followed by chills, fever with joint soreness two days to Huashan Hospital emergency. At that time, patients were weak, apathetic, body temperature 38.4 ℃, heart rate 100 beats / min, law Qi. Throat slightly red, rough breathing sounds of both lungs. Abdomen soft, liver in the transverse edge of a horizontal, under the xiphoid 2 horizontal fingers, tenderness, spleen and. Cardiopulmonary chest chest seen no abnormalities, normal ECG. During the visit, patients often have nausea and intermittent liver pain (history of hepatitis five years ago). Given intravenous infusion of 5% glucose saline, intramuscular injection of winter sleep Ling, oral tetracycline, APC tablets, brown mixture and other drugs. Sudden fainting, but shortness of breath, very depressed, looking yellowish, then check the blood pressure was 108/98 mmHg, scleral mild yellow dye, eyelid mild edema, no cyanosis, Two lungs have scattered wheeze, no obvious wet rales, heart rate 100 beats / min, law Qi, liver in the ribs under the two horizontal and a half, the xiphoid is not satisfied with the touch, the liver and kidney area have percussion pain. White blood cell count 9,200 / mm ~ 3, 78% of neutrophils, lymphocytes 22%. The beginning of the day with tetracycline 1g + 10%