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例1,男,2岁因发热、呕吐,抽搐急诊入院。入院前1个月患儿间断性发热、食欲不振、消瘦和倦怠,曾对症治疗效果欠佳。6小时前患儿突然高烧、呕吐,抽搐。入院后体温38.9℃神志清,体质消瘦,脱水外貌,眼窝凹陷,皮肤弹性差,颈部抵抗可疑,双肺呼吸音粗,心腹部无阳性体征。白细胞7×10~9/L,中性72％,淋巴28％,血沉2毫米/小时。拟诊发热待查①上呼吸道感染②高热惊厥,给予补液、抗炎、镇静等对症支持治疗三天,体温持续在39℃以上,神志嗜睡,继而进入浅昏迷状态,时而出现四肢不自主运动,颈项强直,克氏征、布氏征均呈阳性。脑脊液无色透明,压力50滴/分,白细胞0.11×10~9/L,蛋白定性阳性。糖0.5g/L,氯化物4.45g/L,静置24小时后脑脊液有蜘蛛网状藻膜
Example 1, male, 2 years old due to fever, vomiting, twitch emergency admission. One month before admission, children with intermittent fever, loss of appetite, weight loss and fatigue, had poor symptomatic treatment. 6 hours ago, children with sudden high fever, vomiting, convulsions. After admission, the body temperature of 38.9 ℃ conscious, weight loss, dehydration appearance, sunken eyes, skin elasticity, neck suspicious suspicious, lung breath sounds crude, no positive signs of heart and abdomen. White blood cells 7 × 10 ~ 9 / L, 72% of neutral, lymph nodes 28%, ESR 2 mm / h. To be diagnosed fever to be investigated ① upper respiratory tract infection ② febrile seizures, given rehydration, anti-inflammatory, sedation and other symptomatic and supportive treatment for three days, body temperature continued at 39 ℃ above, conscious drowsiness, and then enter the shallow coma, sometimes limb involuntary movements, Neck stiffness, Kirschner sign, Brinell sign were positive. Cerebrospinal fluid was colorless and transparent, the pressure of 50 drops / min, white blood cells 0.11 × 10 ~ 9 / L, protein qualitative positive. Sugar 0.5g / L, chloride 4.45g / L, after standing for 24 hours cerebrospinal fluid spider reticular algae membrane