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患者男,53岁,农民。因发热、头痛、多汗20天于1998年4月8日入院。于20天前出现间歇性发热,体温38～39℃,下午明显。伴头痛、头晕、全身多汗,双肩关节及双下肢疼痛。呕吐6次,为胃内容物。既往有长期饲养羊及饮生羊奶史。查体:体温38.6℃,脉搏100次/分,呼吸20次/分,血压15/10kPa,表情淡漠,反应迟钝。皮肤无皮疹与出血点。浅表淋巴无肿大。五官正常。颈项强直。心、肺末见异常,肝、脾肋下未及。四肢肌力及肌张力正常,克氏征阳性,病
Male patient, 53 years old, farmer. Due to fever, headache, sweating 20 days in April 8, 1998 admission. In 20 days before the onset of intermittent fever, body temperature 38 ~ 39 ℃, afternoon significantly. With headache, dizziness, sweaty body, shoulders and lower extremity pain. Vomit 6 times, as stomach contents. In the past have long-term sheep and drinking sheep milk history. Physical examination: body temperature 38.6 ℃, pulse 100 beats / min, breathing 20 beats / min, blood pressure 15 / 10kPa, apathy, unresponsive. No skin rashes and bleeding points. Superficial lymph no swelling. Facial features normal. Neck stiffness. Heart, lung end abnormalities, liver, spleen and ribs did not. Limb muscle strength and normal muscle tension, positive Keshi sign, disease