论文部分内容阅读
患者 男,53岁。主因反复发热、口腔溃疡、腹泻半年,伴腹痛,头晕半月于1994年3月18日入院。半年前无诱因出现发热,体温39～40℃间,舌尖、齿龈出现痛性溃疡,稀水便3～4次/日。在外院用抗生素治疗无效。OT试验(1:2000)(+++),痰PCR TB(+),给予异烟肼、链霉素治疗1月后体温正常、症状减轻。但2个月后体温又升至39.5℃,并出现右下腹痛、头晕转入我院。1963年曾患结核性胸膜炎已治愈。查体:体温40℃,脉搏122次,血压18/10kPa。消瘦,贫血貌,巩膜无黄染,结膜无充血。舌尖及齿龈均有一0.5×0.8cm较深椭圆形溃疡,围以红晕。心肺无异常发现。腹平软,右下腹压痛,无反跳痛,肝肋下3cm、睥肋下4cm,移动性浊音阴性。实验室检查:血红蛋白44g/L,白细胞8.2×10~9/L,红细胞1.6×10~(12)/L,血小板103×10~9/L,网织红细胞0.01,中幼
Male patient, 53 years old. Mainly due to repeated fever, oral ulcers, diarrhea for six months, with abdominal pain, dizziness, half on March 18, 1994 admission. Six months ago no incentive to fever, body temperature 39 ~ 40 ℃, tongue, gums appear painful ulcer, dilute water will be 3 to 4 times / day. Treatment with antibiotics outside the hospital is invalid. OT test (1: 2000) (+++), sputum PCR TB (+), given isoniazid, streptomycin after 1 month of normal body temperature, reduce the symptoms. But after 2 months the body temperature rose again to 39.5 ℃, and right lower abdominal pain, dizziness, transferred to our hospital. Tuberculous pleurisy was cured in 1963. Physical examination: body temperature 40 ℃, pulse 122 times, blood pressure 18 / 10kPa. Thin, anemic appearance, Sclera no yellow dye, conjunctival hyperemia. Tongue and gums have a 0.5 × 0.8cm deep oval ulcers, surrounded by flush. No abnormal heart and lung findings. Abdomen soft, right lower quadrant tenderness, no rebound tenderness, liver ribs 3cm, ribs ribs 4cm, mobility dullness negative. Laboratory tests: hemoglobin 44g / L, white blood cells 8.2 × 10 ~ 9 / L, erythrocytes 1.6 × 10-12 / L, platelets 103 × 10 ~ 9 / L, reticulocytes 0.01,