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患者男,11岁半.因发热、胸闷2天,“关节肿痛1天於1991年5月28日“以发热待查:败血症?”入院.入院前2天始发热、体温在39℃左右、自觉头晕和胸闷,无气急及胸痛.翌日出现右侧膝关节肿痛、行走不便,无咳嗽、呕吐,无腹痛腹泻,无皮疹.有扁桃体炎病史,否认有关节炎、结核等病史.体检:T38.8℃,P64次/分,R18次/分,Bp13.9/9.1kPa.面色苍白,咽充血,两侧扁桃体Ⅱ度～Ⅲ度肿大.颈软,颈部浅表淋巴结未及,两肺听诊正常,心前区无隆起,心尖搏动在第V肋间锁骨中线上.无猫喘,心界叩诊无扩大,心率64次/分,律尚齐、各瓣膜区未闻及明显杂音.腹软,肝脾未触及,在膝关节稍肿.内侧有压痛,运动轻度受限,全身皮肤无皮疹.实验室检查:WBC18.4×1O~9/L,NO.96.L0.04;血沉83mm/h,抗“O”正常;C反应蛋白阴性;血IgG为28.5g/
Patients male, 11 years and a half due to fever, chest tightness for 2 days, “joint swelling and pain 1 day in May 28, 1991” fever to be investigated: sepsis? “Admission .2 days before admission fever, body temperature at 39 ℃ Left and right, conscious dizziness and chest tightness, no shortness of breath and chest pain. The next day the right knee pain, walking inconvenience, no cough, vomiting, no abdominal pain and diarrhea, no rash. A history of tonsillitis, denied a history of arthritis, tuberculosis and other. Physical examination: T38.8 ℃, P64 beats / min, R18 beats / min, Bp13.9 / 9.1kPa. Pale, pharyngeal congestion, both sides of the tonsil degree Ⅱ ~ Ⅲ degree enlargement. Neck soft, neck superficial lymph nodes And, the two lung auscultation normal, no anterior erection, apical beating in the intercostal space in the clavicle V. No cat asthma, heart percussion no expansion, the heart rate 64 beats / min, the law is still Qi, the valve area is not known Obvious noise. Abdominal soft, liver and spleen not touched, slightly swollen in the knee. Medial tenderness, mild exercise limited, systemic skin rash. Laboratory tests: WBC18.4 × 1O ~ 9 / L, NO.96. L0.04; ESR 83mm / h, anti-”O" normal; C-reactive protein negative; blood IgG was 28.5g /