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患者,女,15岁。畏寒高热,轻咳1周,经青霉素,卡那霉素治疗无效。近3天神志恍忽,烦燥不安于1988年11月15日入院。查体:T39.5℃、P110次/分,R25次/分、BP10.7/6.7 kPa,高热病容,巩膜皮肤未见黄染或出血点,双下肢皮肤可见抓痕及灶性溃烂结痂4～6处,浅表淋巴结不肿大,左下肺闻到少许湿罗音,肝大1.5cm,质软无压痛,脾扪及边缘,未扪及腹部包块。实验室检查:Hb79g/L、RBC2.29×10~(12)/L、WBC7.9×10~9/L、N0.67、L0.33、BPC120×10~9/L,ESR65mm/h。胸片,血培养,肝功能,胸脊液,蛋白电泳,肥达氏反应,痰菌,类风湿因子,抗“O”均为正
Patient, female, 15 years old. Chills fever, light cough 1 week, penicillin, kanamycin ineffective treatment. Nearly 3 days unconscious, irritable on November 15, 1988 admission. Examination: T39.5 ℃, P110 beats / min, R25 beats / min, BP10.7 / 6.7 kPa, high fever, scleral skin no yellow dye or bleeding points, both lower extremity skin visible scratches and focal ulceration scab 4 to 6, superficial lymph nodes are not swollen, the left lower lung smell a little wet rales, liver 1.5cm, soft, no tenderness, palpable palpable edge, not palpable abdominal mass. Laboratory tests: Hb79g / L, RBC2.29 × 10 ~ (12) / L, WBC7.9 × 10 ~ 9/L, N0.67, L0.33, BPC120 × 10 ~ 9/L, ESR65mm / h. Chest radiograph, blood culture, liver function, thoracic spinal fluid, protein electrophoresis, Widal reaction, sputum bacteria, rheumatoid factor, anti-O are positive