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患儿男,13岁。因低热盗汗8个月头痛1周于1989年3月15日以结核性脑膜炎住院。1988年8月右腋下发现一鸡蛋大小肿块,质中等偏硬,表面光滑,肤色正常,不活动,压痛(一),体温波动在37～38.5℃,乏力、纳差、盗汗,无恶心呕吐,无皮肤及牙龈出血,经当地局部外敷中药,肿块消失,但症状不减。入院前1周开始头痛,呈胀痛,平卧加重,坐立缓解。曾在洛阳市某医院按结核性脑膜炎、淋巴结核,抗痨达半年未能奏效。否认有结核密切接触史及化学毒物接触史,入院查体:体温38.0℃,慢性病容,皮肤无出血点,双颌下、腋下均可触及黄豆至蚕豆大小淋巴结各2～4枚不等。压痛不明显,心肺无阳性发现,肝脾不大,生理反射正常存在,病理反射未引出,布氏征可疑。血常规:血红蛋白 62克/升;白细胞 2 ×10~9/升。中性粒细胞 56％、淋巴细胞 42％、嗜酸性粒细胞1％、大单核细胞1％;血沉89毫米/第
Children male, 13 years old. 8 months due to fever stolen sweating 1 week on March 15, 1989 with tuberculous meningitis hospitalization. In August 1988 the right axilla found an egg size mass, medium quality and hard, smooth surface, normal skin color, activity, tenderness (a), temperature fluctuations at 37 ~ 38.5 ℃, fatigue, anorexia, night sweats, no nausea and vomiting , No skin and bleeding gums, local topical Chinese medicine, lumps disappear, but the symptoms diminished. 1 week before admission, headache, pain, supine, sit ease. In a hospital in Luoyang according to tuberculous meningitis, lymph node tuberculosis, anti-up to six months failed to work. Denied a close history of exposure to TB and history of exposure to chemical poisons, admission examination: body temperature 38.0 ℃, chronic disease, no bleeding skin, double jaw, under the armpit can reach the beans to the size of the broad bean lymph nodes of 2 to 4 range. Tenderness is not obvious, no positive cardiopulmonary findings, liver and spleen is not large, normal physiological reflex, pathological reflex did not lead to, Buzheng sign suspicious. Blood: hemoglobin 62 g / l; white blood cells 2 x 10 ~ 9 / l. 56% of neutrophils, 42% of lymphocytes, 1% of eosinophils, 1% of large monocytes; erythrocyte sedimentation rate of 89 mm /