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患儿,男,5岁。因发热6d,体温波动在39℃左右,静滴青霉素体温不见下降,轻咳入院。入院后患儿呕吐数次,食欲差,查体:心肺(-),腹软,肝肋下1cm,剑下1.5cm,入院次日查肝功能:转氨酶1146U/L,HBAg(-),余均(-),考虑为急性病毒性肝炎,立即床边隔离。但观察患儿持续高热不退,且咳嗽加重,刺激性干咳,立即再胸透(病程第8d)示右肺大片状阴影,考虑为支原体肺炎,立即抽血送检冷凝集试验,结果阴性。试用红霉素静滴3d后体温下降,1周内转氨酶下降至177U/L,病后12d冷凝
Children, male, 5 years old. Due to fever 6d, body temperature fluctuations at about 39 ℃, intravenous infusion of penicillin body temperature decreased, light cough hospitalization. After admission, children vomited several times, poor appetite, physical examination: cardiopulmonary (-), abdominal soft, liver ribs 1cm, 1.5cm under the sword, check liver function after admission the next day: ALT 1146U / L, Both (-), considered acute viral hepatitis, immediately bedside isolation. However, the observation of children with persistent high fever, and coughing, irritating dry cough, and immediately then chest (the course of the first 8d) showed a large shadow of the right lung, consider mycoplasma pneumonia, immediately sent blood coagulation test, the result was negative. Trial erythromycin intravenous infusion of body temperature decreased after 3d, aminotransferase decreased to 177U / L within 1 week, 12d after the disease condensation