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患者,男性28岁,以发烧腰痛6d,黑便、少尿1d而收住院。持续性发热4d,体温高达39.7℃,当地按上感处理,第四病日体温下降,但血压下降为8.0/4.0kPa,继扩容,对症治疗后血压回升正常。五病日腰痛、头痛、全身酸痛加重,尿少,300ml/d,黑便。第六病日转住我院。既往无心血管及肾脏病史。检查:T36.9℃、P70次/min、R80次/min、Bp16.0/9.0kPa。神志清,精神差,左手背注射部位可见2×1.5cm暗红色淤斑。球结膜轻度充血、水肿、咽红,扁桃体不大,双肺呼吸音略粗,未闻及干、湿性罗音。心界不大,心率70次/min,律齐,各瓣膜听诊区未闻及病理性杂音。
Patients, male 28 years old, with fever low back pain 6d, melena, oliguria 1d and admitted to hospital. Persistent fever 4d, body temperature as high as 39.7 ℃, according to the local sense of the flu, the fourth day temperature decreased, but the blood pressure dropped to 8.0 / 4.0kPa, following expansion, symptomatic treatment after the normal blood pressure rise. Five-day low back pain, headache, aggravating body aches, oliguria, 300ml / d, melena. The sixth day transferred to our hospital. No past history of cardiovascular and kidney disease. Check: T36.9 ℃, P70 times / min, R80 times / min, Bp16.0/9.0kPa. Consciousness, poor spirit, left back injection site visible 2 × 1.5cm dark red ecchymosis. Bulbar conjunctiva mild congestion, edema, throat, tonsil, lung breath sounds slightly coarse, unheard of, dry rales. Heart, heart rate 70 beats / min, law Qi, the valve auscultation area has not heard of pathological murmurs.