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患者××,女,23岁,汉族,教师,未婚,住院号4442.病员于入院前四天,因受凉开始发烧(体温不详),口干,头昏,乏力,食欲减退,但不恶寒,不流涕,不流泪,无喷嚏,无头身痛.当时在我院门诊先后用过青霉素,柴胡注射液,克感敏,APC,以及葡萄糖液等,并物理降温,患者体温无下降,有时竟高达40.3℃.加氢化可的松静滴,以发烧待查入院诊治.入院查体:体温38℃,脉搏120次/分,呼吸20次/分,血压15/10KPa,急性热病容,精神差,神志清,口干,咽中度充血,双侧扁桃体Ⅰ—Ⅱ°肿大,颈软,活动,双肺无特殊体征.心尖区Ⅱ°缩鸣,全身浅表淋巴结未及,神经系统无异常.入院诊断,上呼吸道感染.给抗病毒冲剂,速效感冒冲剂,柴胡注射液及青霉素,vitc,GS等治疗,患者体温及上述症状均无减轻,且体温于患病第七天(住院第三天)稽留在39.5℃—40.8℃,故又增加庆大霉素肌肉注射治疗,仍持续超高热三天,但仍无新的症状体征出现.于患病第十天,患者体温开始下降,又三天后体温降至正常,以后无反复,其他症状也渐消失.患者于患病的第四天查白细胞3.8×10~9/L,中性70%,淋巴30%;是日第二次验血白细胞3.1×10~9/L,中性73%,淋巴27%;第五天查血白细胞2.5×10~9/L,中性75%,淋巴23%,单核2%,血色素95g/L,红细胞3.8×10~(12)/L,血小板12.6×10~9/L;第七天查血白细胞1.5
Patient × ×, female, 23 years old, Han nationality, teacher, unmarried, hospital number 4442. Patient was feverish (body temperature unknown), dry mouth, dizziness, weakness, loss of appetite, , No runny nose, no tears, no sneeze, no headache .At that time in our hospital outpatient has penicillin, Bupleurum injection, g sensitive, APC, and glucose solution, and physical cooling, the patient’s temperature did not drop , Sometimes as high as 40.3 ° C Hydrocortisone intravenous infusion of fever to be admitted to hospital for diagnosis and treatment Admission examination: body temperature 38 ℃, pulse 120 beats / min, breathing 20 beats / min, blood pressure 15 / 10KPa, acute heat Sickness, poor spirit, clear consciousness, dry mouth, moderate pharyngeal hyperemia, bilateral tonsil Ⅰ-Ⅱ ° enlargement, neck soft, activity, no special signs of both lungs .Apex apical Ⅱ ° Ming, systemic superficial lymph nodes less than , No abnormal nervous system.Admission diagnosis, upper respiratory tract infection.Antiviral granules, quick cold granules, Bupleurum injection and penicillin, vitc, GS and other treatment, the patient’s body temperature and the above symptoms were not alleviated, and body temperature in the sick Seven days (the third day of hospital stay) in the 39.5 ℃ -40.8 ℃, it is also an increase of gentamicin intramuscular injection therapy, still sustained fever for three days, but still no new disease Like symptoms appear on the tenth day of illness, the patient began to decline in body temperature, and three days after the body temperature dropped to normal, after no recurrence, other symptoms gradually disappear.Patients in the fourth day of illness check leukocytes 3.8 × 10 9 / L, neutral 70%, lymphatic 30%; on the day the second white blood cells 3.1 × 10 ~ 9 / L, neutral 73%, lymph 27%; the fifth day of white blood cells 2.5 × 10 ~ 9 / L, Neutrophil 75%, lymphatic 23%, mononuclear 2%, hemoglobin 95g / L, erythrocyte 3.8 × 10-12 / L, platelet 12.6 × 10-9 / L;