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患者,男,3岁,于1987年9月底出现低热、咳嗽,在当地医院治疗后症状稍有改善,但10月上旬起患儿咳嗽加剧,持续发热不退,至12月10日出现头痛、呕吐、神志不清及小便失禁。12月15日患儿以“粟粒性肺结核”及“结脑”急诊入我院。入院时体检:T37.2,P72,R20,患儿深度昏迷,颈项强直,角膜反射消失,右侧瞳孔5.5mm,左侧瞳孔5mm,对光反射消失。两肺呼吸音粗糙,未闻及罗音。心(-),肝脾未触及,左侧上下肢软瘫,痛觉消失。失语巴彬基氏征(+),克尼格氏征(+)。
The patient, male, aged 3 years old, developed fever and cough at the end of September 1987. He developed a slight improvement in symptoms after treatment at a local hospital. However, his cough increased in early October and continued to develop fever and headache until December 10, Vomiting, confusion and urinary incontinence. December 15 children with “miliary tuberculosis” and “knot brain” emergency into our hospital. Physical examination on admission: T37.2, P72, R20, children with deep coma, neck stiffness, corneal reflex disappeared, the right pupil 5.5mm, left pupil 5mm, the light reflex disappeared. Breathe sound rough between the two lungs, did not smell and rales. Heart (-), liver and spleen not touched, the left upper limb paralysis, pain disappeared. Aphasia Palinkey’s sign (+), Koneg’s sign (+).