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患者男,9个月。因反复发热9天、咳嗽5天、腹泻2天、昏迷7小时急诊入院。体查:体温39℃,脉搏140次/分,呼吸18次/分,营养不良,急性危重病容,呈浅昏迷,全身皮肤青灰,无黄染,无玫瑰疹。双侧瞳孔直径1.5mm,对光反射消失。口角有咖啡色样物,呼吸不规则,抽泣样呼吸,见三凹征,双肺散布中小水泡音,心音低钝,无相对缓脉,腹软,肝脾不大,肠鸣音活跃。入院后插胃管回抽胃内容物为咖啡色,
Patient male, 9 months. Due to repeated fever for 9 days, cough 5 days, 2 days diarrhea, coma 7 hours emergency admission. Physical examination: body temperature 39 ℃, pulse 140 beats / min, breathing 18 beats / min, malnutrition, acute and critically ill, was shallow coma, systemic skin ash, no yellow dye, no roseola. Bilateral pupil diameter 1.5mm, the light reflection disappears. Cigarette samples with mouth, irregular breathing, sobbing like breathing, see the three signs of depression, double small pulmonary interstitial sound distribution, low heart sound blunt, no relative slow pulse, abdominal soft, small spleen, bowel sounds active. Gastroenterology after admission to withdraw the contents of the stomach for the brown,