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患儿女,12岁.发热20余天伴右颈部淋巴结肿痛于1993年2月20日入院.体温高达39℃,热型不规则.诊断为颈部淋巴结炎给予青霉素、先锋霉素静脉滴注6天,颈部淋巴结未见缩小,体温不退,且于躯干、四肢部位出现红色斑丘疹,不痒,胃纳差,消瘦,乏力,疑诊恶性淋巴瘤.无皮肤感染灶,无结核接触史,卡介苗接种3次.体检:T39.5℃,P110次/分,R24次/分,BP13/7kPa.躯干部、手臂、大腿内侧红色斑丘疹,眼结膜无充血,右颈部触及2个2cm×3cm淋巴结,质中,光滑,活动,压痛明显.咽无充血,扁桃腺不肿大,心肺听诊正常,腹部未触及肿块,肝肋下1.5cm,剑突下2cm,无压痛,脾未及.四肢关节、神经系统检查均正常.实验室检查:Hb 109g/L,WBC4.4×10~9/L,LO.66,NO.
Children with children, aged 12. Fever for more than 20 days with right cervical lymph node pain was admitted on February 20, 1993. Body temperature as high as 39 ℃, irregular heat-type diagnosis of cervical lymphadenitis given penicillin, cephalosporin intravenous infusion Note 6 days, cervical lymph nodes did not shrink, body temperature does not retreat, and in the trunk, limbs appeared red rash, itch, poor appetite, weight loss, fatigue, suspected malignant lymphoma. No skin lesions, no tuberculosis Contact history, BCG vaccination 3. Physical examination: T39.5 ℃, P110 beats / min, R24 beats / min, BP13 / 7kPa. Body parts, arms, thighs red rash, conjunctival hyperemia, right neck touched 2 A 2cm × 3cm lymph node, quality, smooth, activity, tenderness significantly. Pharyngeal no congestion, tonsil does not enlarge, cardiopulmonary auscultation normal, abdomen without touching the mass, liver rib 1.5cm, xiphoid 2cm, no tenderness, spleen Limbs and joints, nervous system tests were normal laboratory tests: Hb 109g / L, WBC4.4 × 10 ~ 9 / L, LO.66, NO.