林某,男,6个月.因发热、咳嗽、气促6天,诊为肺炎入院.体检:体温38.7℃,脉搏120次/分,呼吸20次/分,神清,急性重病容,发育正常,营养中度,呼吸促,轻度鼻煽,巩膜无黄染,皮肤无出血点,囱门无隆起,颈软,咽稍充血,扁桃体无肿大,双肺湿罗音,心率120次/分,律齐.实验室检查;白细胞 23×10~9/L,中性 0.9,淋巴球 0.1,红细胞 2.1×10~12/L,血红蛋白 42g/L.大小便常规、肝功、血钾、钠、钙均正常,二氧化碳结合力11.2mmol/L.入院诊断:支气管肺炎并心衰,酸中毒.予吸氧、强心、输血、抗感染、激素(均静脉给药),纠正酸中毒等治疗8天后症状无改善,胸片报告右侧原发性结核并右肺感染.即由儿科转传染科治疗,改用青霉素、异菸肼、链霉素、激素(均静脉给药)等治疗,入院第13天,病情加重,发热在 39.5℃～40.5℃间,呼吸困难,频繁抽搐,脑脊液常规检查在正常范围.加用氯霉素静脉滴在,持续冰敷,冬眠灵、水合氯醛灌肠,甘露醇脱水等措施,抽搐不能停止.邀余往诊时证见:昏迷,高 Lin, male, 6 months due to fever, cough, breathlessness for 6 days, diagnosed as pneumonia admitted to hospital Physical examination: body temperature 38.7 ℃, pulse 120 beats / min, breathing 20 beats / min, Shen Qing, acute severe disease, development Normal, moderate nutrition, breathing, mild nasal infection, scleral no yellow dye, no bleeding skin, the door has no hilar, neck soft, pharynx slightly hyperemic, tonsil no swelling, lung wet rales, heart rate 120 / Min, Law Qi. Laboratory tests; white blood cells 23 × 10 ~ 9 / L, neutral 0.9, lymphocytes 0.1, erythrocytes 2.1 × 10-12 / L, hemoglobin 42g / L. Conventional urine, liver function, potassium , Sodium and calcium were normal, carbon dioxide binding 11.2mmol / L. Admission diagnosis: bronchopneumonia and heart failure, acidosis. To oxygen, cardiac, transfusion, anti-infective, hormones (intravenous administration), correct acidosis After 8 days of treatment, the symptoms did not improve, the chest report the right side of the primary tuberculosis and right lung infection .That is, from the pediatric transfer of infection treatment, to penicillin, isoniazid, streptomycin, hormone (intravenous administration), etc. Treatment, on the 13th day of admission, exacerbations, fever 39.5 ℃ ~ 40.5 ℃, difficulty breathing, frequent convulsions, cerebrospinal fluid routine examination in the normal range. Add chloramphenicol intravenous infusion, continuous ice pack, winter Ling, chloral hydrate enema, mannitol and other measures, seizures can not be stopped when invited over to see evidence diagnosis: coma, high