患者邝某,女性,30岁,住院号210173。因反复发热4年,于1979年5月9日入院。缘患者于1975年产一男婴后即经常有低热。于1976年3月因高热黄疸在县医院疑为胆囊炎败血症,使用多种抗生素治疗,住院8个月病情无好转自动出院,延中医治疗,病情稍好,但仍经常发热。至1978年10月又因高热黄疸拟诊胆囊炎第二次住县医院,再用抗生素治疗一月好转出院,但自此渐觉视力下降。于1979年1月起又高热,并先后于背、额、胸、肩、左臀、膝部出现疼瘤性肿物,高热持续不退,双眼失明。体查:体温38.8℃,慢性病容,贫血貌,无黄疸,前额、双肩、胸骨柄部、背、左臀、左膝部各有大小不等的脓肿,有波动感,触痛明显,有些表面红热。双眼晶体混浊。心尖轻度收缩期杂音。肺清。肝脾肋下各一指半。化验:红细胞160万,血色素5.5克,白细胞18,640,分类正常。脓肿穿刺脓液培养4次有酵母样真菌生长,骨髓培养2次有酵母样真菌生长,血培养2次有酵母样真菌生长,大便培养2次有酵母样真菌生长。骨髓活检:海绵骨组织是慢性炎症。X线照片:全身多骨性损害,脓肿形成,符合感染性,以霉菌性骨髓炎可能性大。住院经过:入院后体温波动在38～39℃之间。使用静脉点滴二性霉素乙治疗,剂量由每日1毫克开始,逐日增至5、10、20、4O毫克。用药一周后体温降至正常,总量达2克。同时间歇使用克霉唑,每日3克,历时3月。住院5月余症状消失,一般情况良好出院。本例4年来反复发热,长期使用多种抗生素治疗无效,病情日趋恶化,最后导致双目失明(并发白内障),多发性骨髓炎伴皮下脓肿形成,经多次脓液、血、大便,骨髓培养均有酵母样真菌生长。确诊为真 Patient Kuang Mou, female, 30 years old, hospital number 210173. Due to repeated fever for 4 years, on May 9, 1979 admission. Patients with fever in 1975, a baby boy who often have fever. In March 1976 due to high fever jaundice in the county hospital suspected cholecystitis sepsis, the use of a variety of antibiotic treatment, hospitalization for 8 months, no improvement in condition and discharged automatically, Chinese medicine treatment, the condition is slightly better, but still often fever. To October 1978 and because of fever jaundice diagnosed cholecystitis second live in county hospital, and then antibiotic treatment January discharged, but since then gradually decreased visual acuity. In January 1979 and fever, and has in the back, forehead, chest, shoulders, left hip, knee tumor appeared tumor, high fever continued, the eyes blind. Physical examination: body temperature 38.8 ℃, chronic disease, anemia, jaundice, forehead, shoulders, sternum handle, back, left hip, left knee abscess of varying sizes, a sense of volatility, tenderness, and some surface Red hot. Eyes crystal opacity. Apex mild systolic murmur. Lung clear. Liver and spleen ribs mean one and a half. Laboratory tests: 1.6 million red blood cells, 5.5 grams hemoglobin, 18,640 white blood cells, normal classification. Abscess pus culture 4 times with yeast-like fungal growth, bone marrow culture yeast growth in 2 times, 2 times with yeast-like growth of blood culture, stool culture yeast-like fungi 2 times. Bone marrow biopsy: Sponge bone tissue is a chronic inflammation. X-ray: systemic bony damage, abscess formation, consistent with infectivity, the possibility of fungal osteomyelitis. After hospitalization: temperature fluctuations after admission 38 ~ 39 ℃. The use of intravenous amphotericin B treatment, the dose from the beginning of 1 mg daily, daily increased to 5,10,20,4 O mg. After a week the temperature dropped to normal, the total amount of 2 grams. At the same time intermittent use of clotrimazole, 3 grams daily, which lasted in March. Inpatient symptoms disappeared in May, the general situation of good discharge. This case of repeated fever over the past 4 years, long-term use of multiple antibiotics ineffective treatment, deteriorating condition, and ultimately lead to blindness (complicated by cataracts), multiple myelitis with subcutaneous abscess formation, after repeated pus, blood, stool, bone marrow culture Yeast-like fungus growth. Confirmed as true