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例1,男,58岁。因左足背第一跖趾关节红肿、疼痛伴低热4天经门诊抗生素治疗未见好转以“左足蜂窝织炎”入院。体查:T36.5℃,左足背第一跖趾关节处可见10×6cm红肿区,局部皮温升高,触痛(+),第一跖趾关节活动受限,WBC10.7×10~9/L,中性粒细胞72％,尿常规(-)。以“左足背蜂窝织炎”给予氨苄青霉素、链霉素抗炎治疗,症状未见好转,怀疑是痛风性关节炎,测血尿酸10mg/dL,血沉25mm/h,抗“O”1/330单位,左足照片未发现异常而获确诊。改用消炎痛等治疗后好转出院。
Example 1, male, 58 years old. Due to the left foot and the first metatarsophalangeal joint swelling, pain with fever 4 days after treatment with antibiotics clinically improved to “left foot cellulitis” admission. Physical examination: T36.5 ℃, the first metatarsophalangeal joints of the left foot and back showed 10 × 6cm red and swollen area, local skin temperature increased, tenderness (+), the first metatarsophalangeal joint activity is limited, WBC10.7 × 10 ~ 9 / L, neutrophils 72%, urine routine (-). To “left foot dorsal cellulitis,” given ampicillin, streptomycin anti-inflammatory treatment, the symptoms did not improve, suspected gouty arthritis, uric acid test 10mg / dL, erythrocyte sedimentation rate 25mm / h, anti “O” Unit, left foot photo was found without exception was diagnosed. Switch to indomethacin and other improved after discharge.