男,47岁,工人。因发热、恶心、呕吐,不能进食20多天,于1981年7月2日入院。患者曾于1975年患类风湿性关节炎,同年开始使用强的松,每日服四片(早晚各二片)相当于20毫克,长达6年之久。1979年首见指甲甲癣,继之出现皮肤散在红斑,日见增多。于入院前20多天因跌伤(一般跌伤)、感冒而停止服用强的松,此后遂出现发热、恶心、呕吐、不能进食、疲乏无力。在当地医院住院诊断为肺部感染、皮肤湿疹。经抗感染输液治疗20多天,病情日见加重,不能进食、不能行动,遂怀疑肺结核转结核病 Male, 47 years old, worker. Due to fever, nausea, vomiting, can not eat more than 20 days, on July 2, 1981 admission. Patient had rheumatoid arthritis in 1975, the same year began using prednisone, serving four daily (morning and evening each two) equivalent to 20 mg, up to 6 years. In 1979, the first nail onychomycosis, followed by the skin scattered erythema, increasing day by day. More than 20 days before admission due to falls (usually falls), cold and stop taking prednisone, then there was fever, nausea, vomiting, can not eat, tired and weak. Hospitalized in a local hospital diagnosed with pulmonary infection, skin eczema. Transfusion by anti-infective therapy for more than 20 days, the condition increased day by day, can not eat, can not act, then suspect tuberculosis to tuberculosis