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1临床资料患者,女性,60岁。因“间断发热、头痛伴双下肢、双侧膝踝关节疼痛5 d”于2012年6月19日入我院。5 d前患者无明显诱因出现发热,体温在38.5℃,午后或夜间出现畏寒、寒颤后发热,症状持续2~3 h,出汗后体温逐渐恢复正常。发热时感头部持续性胀痛、双下肢关节疼痛,左侧足背可见一2 cm×2 cm大小红斑,表面皮温稍高、轻压痛,不影响下肢活动。胸部CT示右肺下叶实变影(图1),血常规提示:WBC 3.07×109/L、RBC 3.66×1012/L、HGB 106 g/L、NEU 75.9%,肝肾功能、降钙
1 clinical data, female, 60 years old. Because of “intermittent fever, headache with both lower extremities, bilateral knee and ankle pain 5 d ” on June 19, 2012 into our hospital. 5 days before the patient had no obvious incentive to fever, body temperature at 38.5 ℃, afternoon or night chills, chills and fever, symptoms persist for 2 ~ 3 h, sweating body temperature gradually returned to normal. Hearing headache persistent pain, both lower extremity joint pain, the left dorsal foot shows a 2 cm × 2 cm size erythema, the skin surface temperature slightly higher, light tenderness, does not affect the lower extremity activity. Chest CT showed real right lower lobe consolidation (Figure 1), blood routine prompted: WBC 3.07 × 109 / L, RBC 3.66 × 1012 / L, HGB 106 g / L, NEU 75.9%, liver and kidney function,