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患者男,19岁,战士。畏寒发热,腹痛腹泻2天入院。入院前两天开始畏寒发热,恶心欲吐。第二天出现腹痛腹泻,1日6～7次。初为水样便,后转为粘液脓血便,伴里急后重。既往无疟疾及腹泻病史。门诊按细菌性痢疾治疗无效,于1982年8月5日入院。入院时体温39.7℃,血压120/70。一般情况良好。心肺无异常发现。腹部平坦柔软,脐周压痛(?),无包块,肝脾未触及。血红蛋白14.5g,红细胞500万,白细胞4,600,中性67%,淋巴33%。尿常规无异常。粪便镜检:红细胞>50、白细胞20～30/高倍镜,细菌培养阴性。诊断为急性细菌性痢疾,给予地锦草加甲氧苄胺嘧啶(TMP)口服治疗,同时静脉点注葡萄糖生理盐水1,000ml。8月6
Patient male, 19 years old, warrior. Chills fever, abdominal pain and diarrhea 2 days admitted. Chills and fever started two days before admission, nausea and vomiting. The next day abdominal pain and diarrhea, on the 1st 6 to 7 times. The beginning of the watery stools, later converted to mucus pus and blood, with tenesmus. No past history of malaria and diarrhea. Outpatient treatment of bacterial dysentery invalid, admitted on August 5, 1982. Admission temperature 39.7 ℃, blood pressure 120/70. Generally good. No abnormal heart and lung findings. Abdomen flat and soft, umbilical tenderness (?), No mass, no contact with liver and spleen. 14.5 g hemoglobin, 5 million erythrocytes, 4,600 leukocytes, 67% neutral, 33% lymphatic. No abnormal urine. Stool microscopy: red blood cells> 50, white blood cells 20 ~ 30 / high power, negative bacterial culture. Diagnosed as acute bacillary dysentery, given Ducao grass plus trimethoprim (TMP) oral treatment, while intravenous injection of glucose saline 1,000ml. August 6