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鼠伤寒沙门氏菌感染合并溶血尿毒综合征、肠道广泛出血坏死,比较少见。现将本人在天津儿童医院进修期间所遇一例报告如下:吴××,女,1(1/2)岁。住院号167662.因发热腹泻六天,抽风无尿两天入院。腹泻每日7～30余次,为粘液脓性、黄水样、血水及果酱祥大便。两天前导尿200毫升,淡黄色。应用速尿也无尿。体查:T37.3℃,R46次/分,B P90/60mmHg。表情淡漠,贫血貌。心律齐,心尖部闻收缩期杂音Ⅰ～Ⅱ级.双肺无异。腹略胀,轻微压痛,有移动性浊音。肝脾未及。双下肢轻度浮肿。肛门松驰,直肠粘膜脱出如核桃大小呈紫黑色。实验室检查:Hb7.1g/dl,WBC66800/mm~3,N77%,中性白细胞有中毒颗粒。血小板4.4万/mm~3。大便常规:红细胞~(+++),白细胞0～7/H P。血钠为115.5mEq/L、钾5.3mEq/L、氯91.8mEq/L、二氧化碳
Salmonella typhimurium infection with hemolytic uremic syndrome, extensive bleeding hemorrhage necrosis, relatively rare. Now I am in Tianjin Children’s Hospital during the study encountered an example is as follows: Wu × ×, female, 1 (1/2) years old. Hospital number 167662. Due to fever, diarrhea, six days, ventilation, anuria admitted to hospital for two days. Diarrhea 7 to more than 30 times a day, for mucopurulent, yellow watery, blood and jam Cheung stool. Two days ago catheterization 200 ml, light yellow. Application furosemide is also no urine. Physical examination: T37.3 ℃, R46 times / min, B P90 / 60mmHg. Indifferent expression, anemic appearance. Qi heart, apical systolic murmur Ⅰ ~ Ⅱ level. Abdominal swelling, slight tenderness, shifting dullness. Liver and spleen not yet. Lower extremity mild edema. Anal relaxation, rectal mucosal prolapse, such as walnut size was purple black. Laboratory tests: Hb7.1g / dl, WBC66800 / mm ~ 3, N77%, neutrophil poisoning particles. Platelets 44,000 / mm ~ 3. Stool routine: red blood cells ~ (+++), white blood cells 0 ~ 7 / H P. Serum sodium was 115.5 mEq / L, potassium 5.3 mEq / L, chlorine 91.8 mEq / L, carbon dioxide