患者男性 ,6 9岁。以反复发热 ,四肢关节痛 8个月 ,咳嗽 2个月为主诉入院。 8个月前 ,无明显诱因出现发热 ,体温波动在 37 6℃ 39℃ ,四肢关节、肌肉疼痛 ,以双侧膝、踝、肘和肩关节为重 ,局部红肿 ,活动受限。无咽痛、咳嗽 ,在当地医院诊断为“风湿性关节炎” ,静滴青霉素、口 Male patient, 6 9 years old. Repeated fever, joint pain in limbs for 8 months, cough 2 months as the main complaint. 8 months ago, no obvious incentive to fever, temperature fluctuations in 376 ℃ 39 ℃, limbs and joints, muscle pain, with bilateral knees, ankles, elbows and shoulder joints as the most important, local swelling and limited mobility. No sore throat, cough, diagnosed at a local hospital as “rheumatoid arthritis”, intravenous penicillin, mouth