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患者女,11岁,因头昏,头痛4 d,全身皮疹,发热,腹痛,腹泻3 d 入院,门诊以“猩红热,麻疹?细菌性痢疾?”收入传染科。体检:体温39.0℃,脉搏120次/min,呼吸30次/min,血压80/50 mmHg,急性发热病容,神清,全身皮肤轻微浮肿,潮红,满布淡红色斑丘疹,有融合,伴瘙痒,压之退色,眼结膜充血,眼睑浮肿。口唇红,牙龈红肿、出血,口腔黏膜充血,满布大小不等之溃疡,双侧扁桃体二度肿大,充血,无脓。双肺清晰,心音有力,率快(120次/min),律齐,无杂音。腹软,无压痛,肝脾未扪及,肠鸣正常,外阴小阴唇内见—0.3×2 cm~2大小之白斑,质硬。辅助检查三大常规及肝功正常。血钾2.6 mmol/L,钠131.9mmol/L,氯91.7 mmol/L,均低。ECG 窦性心律,T 波倒置。入院诊断:皮肤过敏?急性溃疡性口腔炎、水电解质紊乱、低血压、外阴白斑。转入儿科予抗感染,抗过敏,补液纠正水电解质紊乱等治疗,治疗4 d,皮疹无减轻,仍发热,头昏,头痛。后经再三
Female patient, 11 years old, dizziness, headache 4 d, whole body rash, fever, abdominal pain, diarrhea 3 d admission, outpatient services to “scarlet fever, measles? Bacillary dysentery?” Infectious Diseases. Physical examination: body temperature 39.0 ℃, pulse 120 beats / min, breathing 30 beats / min, blood pressure 80/50 mmHg, acute febrile disease, Shen Qing, whole body skin edema, flushing, covered with pink rash, fusion, with itching , Pressure of the fade, conjunctival hyperemia, eyelid edema. Lip red, swollen gums, bleeding, oral mucosal hyperemia, covered with ulcers of varying sizes, bilateral tonsil enlargement, congestion, no pus. Clear lungs, powerful heart sounds, fast (120 times / min), law Qi, no noise. Abdominal soft, no tenderness, liver and spleen not palpable, normal bowel, the genital labia minora see -0.3 × 2 cm ~ 2 the size of the white, hard. Auxiliary examination of the three major routine and normal liver function. Potassium 2.6 mmol / L, sodium 131.9 mmol / L, chlorine 91.7 mmol / L, were low. ECG sinus rhythm, T wave inversion. Admission diagnosis: skin allergies? Acute ulcerative stomatitis, water and electrolyte disorders, hypotension, leukoplakia. Into the pediatric to anti-infective, anti-allergy, rehydration correction water and electrolyte disorders and other treatment, treatment 4 d, no reduction of the rash, still fever, dizziness, headache. After another