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例1 男,53岁,汉族,工人。因不规则畏寒,发热伴多汗、四肢关节疼痛1个月、当地医院诊断为“风湿性关节炎”用青霉素加庆大霉素治疗,无好转。于1988年8月22日以“发热待查”收入我院。体格检查:体温39℃、脉搏120、心肺(-),腹平软、肝未扪及,脾脏肋下3cm。化验:白细胞14.2×10~9/L,中性0.90、淋巴0.10、拟诊为“败血症”。血培养两次均阴性。用氨苄青霉素加先锋霉素治疗,1周后体温恢复正常出院。出院1周后复又发热40℃、且伴咳嗽,咯少许白
Example 1 Male, 53 years old, Han nationality, worker. Due to irregular chills, fever with hyperhidrosis, limbs and joints pain for 1 month, the local hospital diagnosed as “rheumatoid arthritis” with penicillin plus gentamicin treatment, no improvement. On August 22, 1988 with “fever to be checked” income in our hospital. Physical examination: body temperature 39 ℃, pulse 120, cardiopulmonary (-), abdominal soft, liver palpable, the spleen ribs 3cm. Laboratory tests: white blood cells 14.2 × 10 ~ 9 / L, neutral 0.90, lymphatic 0.10, to be diagnosed as “sepsis.” Blood cultures were negative twice. With ampicillin and cephalosporin treatment, 1 week after the temperature returned to normal. After 1 week of discharge and fever 40 ℃, and with cough, slightly white