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患者,男,25岁,住院号60197。因咽痛、发热2d于1996年5月16日入院。既往体建。体检:T39℃、P 96次/min、R 23次/min、BP 13/10kPa。神志清楚,全身浅表淋巴结无肿大。咽部充血,扁桃体无肿大。心、肺无异常。腹部肝、脾未扪及。双下肢无水肿。实验室检查:血WBC 10.38×10~9/L,N 58％,L25.8％。尿常规:RBC少许,脓球十。肝、肾功能及血电解质正常。胸部X线检查未见异常。B型超声波检查:肾脏无异常。入院诊断为急性咽炎,予青霉素800万u 1次/d与头孢唑啉钠5.0g 1次/d静滴2d治疗。据尿检结果于5月18日改用环丙沙星(悉复欢)100mL(0.2g)2次/d静滴结束后2h时,患者突然发生腹痛,呈持续性,伴恶心不适,即停用环丙沙星、腹痛逐渐缓解。5月19日改用头孢噻肟钠(凯福隆)2.0g 1次/d静滴,又复发持续性上腹胀痛伴频繁呕吐。急请外科会诊并行腹腔穿刺检查均未发现明显外科情况。继续泰利得抗感染治疗,病情未控制,于5月20日上午11时至21日中午12时尿闭(尿量为0)伴颜面及前胸皮肤大小不等红色斑疹。复查尿常规:RBC++,WBC+,PRO+4,中段尿培养
Patient, male, 25 years old, hospital number 60197. Due to sore throat, fever 2d on May 16, 1996 admitted. Past build. Physical examination: T39 ° C, P 96 times / min, R 23 times / min, BP 13/10 kPa. Consciousness, systemic superficial lymph nodes without swelling. Throat congestion, tonsils without swelling. Heart, lungs without exception. Abdominal liver, spleen not palpable. No lower extremity edema. Laboratory tests: blood WBC 10.38 × 10 ~ 9 / L, N 58%, L25.8%. Urine routine: a little RBC, pus ball ten. Liver, kidney function and blood electrolyte normal. Chest X-ray examination no abnormalities. B-mode ultrasound: no abnormalities in the kidneys. Admission was diagnosed as acute pharyngitis, to penicillin 8000000 u 1 times / d and cefazolin sodium 5.0g 1 times / d infusion 2d treatment. According to the urinalysis results on May 18 switch to ciprofloxacin (sinafu) 100mL (0.2g) 2 times / d 2h after the end of intravenous infusion, the patient suddenly abdominal pain, was persistent, with nausea and discomfort, that is, stop With ciprofloxacin, abdominal pain gradually ease. May 19 switch to cefotaxime sodium (Kefalon) 2.0g 1 / d intravenous infusion, and recurrent persistent abdominal pain with frequent vomiting. Anxious Surgery consultation parallel paracentesis examination showed no significant surgical conditions. To continue the anti-infective treatment of Telit, the condition was uncontrolled, at 11:00 am on May 20 to 12:00 noon on the 21st (urine output 0) with face and chest skin ranging in size from red rash. Review of urine routine: RBC ++, WBC +, PRO + 4, urine culture in the middle