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患者 男,45岁,农民.因发热伴排尿困难10天收治.发病当日发热、出汗、排尿呈点滴状,伴尿频、尿急、尿痛.次日排尿困难、需留置导尿管排尿.用庆大霉素治疗无效.入院体检:T37.4～39.8℃、BP13/10kPa.精神好,浅表淋巴结不肿大,胸骨无压痛,心肺无异常,肝脾不大.实验室检查:多次尿常规正常.血:Hbll8g/L、WBC 4.O×10~9/L、N 0.76、L0.24、BPC 91×10~9/L.中段尿培养、血培养均无细菌生长.泌尿系及前列腺B超检查正常.按“泌感”给予丁胺卡那霉素、灭滴灵,先锋霉素等抗炎治疗半月.上述症状不缓解,且渐出现胸骨压痛、肝脾肿大,WBC 3.0×10~9/L,及时行骨髓穿刺检查,骨髓象:粒系增生,原始细胞占16%,体积大,外形不规则,确
Male, 45 years old, farmer .Due to fever with dysuria admitted for 10 days .At the onset of fever, sweating, urination was drip-like, with frequent urination, urgency, dysuria. The next day dysuria, urinary catheter indwelling catheter. Treatment with gentamicin invalid. Physical examination admission: T37.4 ~ 39.8 ℃, BP13 / 10kPa. Good spirit, superficial lymph nodes are not enlarged, sternal no tenderness, no abnormal heart and lung, liver and spleen is not. The urinary routine was normal.Hbll8g / L, WBC 4.O × 10 ~ 9 / L, N 0.76, L0.24, BPC 91 × 10 ~ 9 / L. There was no bacterial growth in the middle urine culture and blood culture. Department and prostate B-ultrasound normal.According to the “sense of bleeding” to give amikacin, metronidazole, Pioneer and other anti-inflammatory treatment for half a month.The above symptoms do not ease, and gradually appear sternal tenderness, hepatosplenomegaly, WBC 3.0 × 10 ~ 9 / L, timely bone marrow biopsy, bone marrow like: myeloid hyperplasia, primitive cells accounted for 16%, bulky, irregular shape, and indeed