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病历摘要5岁女孩,因尿黄、皮肤黄4周,间断发热3周,出疹1天,于1982年7月4日入院。患儿于入院前5周自感乏力,食欲减退、嗜睡。4周前乏力加重,尿呈茶黄色,且见巩膜黄皮肤黄,来发热,当地按“肝炎”治疗1周,疗效不著。3周前始发热,高达39℃,眼及面部黄染加深,在当地医院住院治疗共2周,其间体温于住院1周后下降(曾用激素),但黄染渐加深,肝脏渐缩小,黄疸指数30～30单位,谷丙转氨酶550～505单位,病情加重。于入院前1天始又发热,面部及两下肢出现红色皮疹,遂转住我院。病前无肝炎接触史,病后同家族中出现黄疸型肝炎患儿。体检体温37.1℃,呼吸28次/分,脉搏104次/分,血压130/80毫米汞柱,精神萎靡,神志清楚,巩膜及皮肤重度黄染,浅淋巴结不肿大,咽部轻度充
Medical record summary 5-year-old girl, due to urinary yellow, yellow skin 4 weeks, intermittent fever for 3 weeks, a rash 1 days, on July 4, 1982 admission. Children 5 weeks before admission, fatigue, loss of appetite, lethargy. 4 weeks ago, fatigue increased, urine was yellow, and see the sclera yellow skin yellow, to fever, according to the local “hepatitis” treatment for 1 week, curative effect. 3 weeks before onset of fever, up to 39 ℃, dark yellow facial and facial deepening hospitalization in the local hospital for a total of 2 weeks, during which body temperature decreased after 1 week of hospitalization (once used hormones), but the yellow dye gradually deepened, the liver is diminished , Jaundice index 30 to 30 units, alanine aminotransferase 550 to 505 units, the condition worsened. One day before admission, he began to have fever again. A red rash appeared on his face and both his lower limbs. He then transferred to our hospital. No history of hepatitis before exposure to illness, after the same family with jaundice hepatitis in children. Physical examination temperature 37.1 ℃, breathing 28 beats / min, pulse 104 beats / min, blood pressure 130/80 mm Hg, apathetic, conscious, sclera and skin severe yellow dye, superficial lymph nodes, mild pharyngeal charge