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男,52岁.因畏寒、高热、咳嗽并咳腥臭脓痰7天,于1986年2月22日入院,既往无结核病史.查体:体温38.6℃,胸廓无畸形,右上肺呼吸音低,未闻及管状呼吸音.心律整.肝脾未及。X 线示:右上肺野见片状阴影,内有一直径5cm 空洞,可见液平.化验:白细胞14.6×10~9/L(中性0.81);血小板1640~1850×10~9/L,血沉40mm/h.痰涂片及培养未找到结核杆菌.骨髓像:增生活跃。各系统细胞形态、比例大致正常,全片可见巨核细胞17个,可见成堆血小板,形态正常.临床诊断:肺脓肿并发反应性血小板增多症.治疗经过:常规青、链霉素治疗,排痰,加用(?)生丁(25mg,每日3次)治疗10天后体温正常,白细胞9.0×10g/L(中性0.69),血小板800×10~9
Male, aged 52. Because of chills, fever, cough and coughing purulent sputum for 7 days, admitted to hospital on February 22, 1986, with no previous history of tuberculosis. Physical examination: body temperature 38.6 ℃, thoracic deformity, right upper lung respiratory sounds low , Not heard and tubular breath sounds. Whole heart rhythm. X-ray showed: the right upper lung field to see the shadow of the film, there is a hole diameter of 5cm, the level can be seen.Experiment: white blood cells 14.6 × 10 ~ 9 / L (neutral 0.81); platelets 1640 ~ 1850 × 10 ~ 9 / L, ESR 40mm / h. Sputum smear and culture did not find Mycobacterium tuberculosis. Bone marrow: hyperplasia active. The system of cell morphology, the proportion of roughly normal, the whole film can be seen in 17 megakaryocytes, showing piles of platelets, normal morphology. Clinical diagnosis: pulmonary abscess complicated by reactive thrombocythemia. Treatment after: routine cyanosis, streptomycin treatment, phlegm , Plus (?) Shengding (25mg, 3 times a day) after 10 days of normal body temperature, white blood cells 9.0 × 10g / L (neutral 0.69), platelets 800 × 10 ~ 9