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患儿,男,6个月,住院号:51750.因发热5天,手足硬肿伴全身皮疹3天于1991年5月16日入院.否认传染病接触史.体检:体温39℃,全身皮肤均可见粟粒大充血性斑疹.双眼结合膜充血.颈、右颌下可触及蚕豆大小淋巴结,质中等,活动,触之哭吵.口腔粘膜潮红、咽充血,扁桃体Ⅱ°肿大.心肺未见异常.肝脾均未触及.实验室检查:血红蛋白94g/L,白细胞24×10~9/L,中性粒细胞0.75,淋巴细胞0.25.血小板490×10~9～550×10~9/L(49～55万/mm~3),血沉70mm,C 反应蛋白阳性,肝功能,出凝血时间(试管法)正常.心电图示“窦性心动过速”,二维超声心动图;左、右冠状动脉稍大(直径>5mm)未提示冠状动脉瘤.治疗:1)抗感染:青霉素、氨苄青霉素.2)抗凝:阿斯匹林、潘生丁等.3)对症及支持疗法:输血浆、补液等.经治疗于入院后第5天皮疹消退,肿大淋巴结消失.第10天体温降至正常.第14天见患儿指趾端及肛周膜状脱皮.血小板180×10~9/L(18万/mm~3,血沉20mm,心电图正常.住院19天后出
Children, male, 6 months, hospital number: 51750. 5 days due to fever, hand, foot and hard body with systemic rash 3 days admitted to hospital on May 16, 1991. Denied contact history of infectious diseases. Physical examination: body temperature 39 ℃, body skin Both are visible miliary congestive rash. Binocular conjunctival hyperemia. The neck, right leg can reach the size of the lymphatic nodes, medium quality, activity, crying noisy. Oral mucosal flushing, pharyngeal congestion, tonsil enlargement. See abnormalities were not touched the liver and spleen.Laboratory examination: hemoglobin 94g / L, white blood cells 24 × 10 ~ 9 / L, neutrophils 0.75, lymphocytes 0.25. Platelet 490 × 10 ~ 9 ~ 550 × 10 ~ 9 / L (49-55,000 / mm ~ 3), ESR 70mm, C-reactive protein positive, liver function, the clotting time (test tube method) normal ECG “sinus tachycardia,” two- Right coronary artery slightly larger (diameter> 5mm) did not suggest coronary aneurysms. Treatment: 1) anti-infective: penicillin, ampicillin 2) anticoagulant: aspirin, dipyridamole, etc. 3) symptomatic and supportive therapy: , Rehydration, etc .. After treatment on the 5th day after admission, the rash subsided, swollen lymph nodes disappeared on the 10th day the body temperature dropped to normal on the 14th day to see children with the toe and perianal membrane peeling. 180 × 10 ~ 9 / L (180,000 / mm ~ 3, erythrocyte sedimentation rate 20mm, normal ECG .19 days after hospitalization