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患者男性,45岁,因头痛,腰痛24天,多尿7天,视物不清,右侧肢体活动障碍4天入院。患者于24天前出现寒战,高热,体温39℃左右,伴头痛、腰痛、恶心。第4病日出现少尿,每日约200ml,持续2天。当地县医院诊为“流行性出血热”。经对症治疗,第7病日体温降至正常,临床症状渐好转,尿量渐增多,最多时达每日8升。发病第20天患者行走时,突然出现头痛,视物不清,右侧肢体活动障碍。当地医院治疗无效,转我院。体温:37.4℃,血压:140/100mmHg,反应迟钝,视力障碍,瞳孔等大等圆,光反射灵敏,双侧鼻唇沟对称,颈部抵抗。双下肢肌张力增强。左侧膑阵挛及踝阵挛阳性,右上肢肌力Ⅳ级,右下肢
Male patient, 45 years old, due to headache, low back pain for 24 days, polyuria for 7 days, depending on the material is not clear, the right limb movement disorders admitted to hospital for 4 days. Patients in cholera 24 days ago, fever, body temperature 39 ℃, with headache, back pain, nausea. Day 4 appeared oliguria day, about 200ml daily for 2 days. Local county hospital diagnosed as “epidemic hemorrhagic fever.” After symptomatic treatment, the 7th day the body temperature dropped to normal, clinical symptoms gradually improved, urine volume increased more, up to 8 liters daily. On the 20th day of onset, the patient suddenly had a headache, blurred vision, and a malfunctioning limb on the right. Invalid local hospital treatment, transfer to our hospital. Body temperature: 37.4 ℃, blood pressure: 140 / 100mmHg, unresponsive, visual impairment, pupil and other large circle, sensitive to light reflex, bilateral nasolabial fold symmetry, neck resistance. Double lower extremity muscle tone enhancement. Left 膑 clonus and ankle clonus positive, right upper limb muscle strength Ⅳ, right lower limb