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病例介绍阮××男,16岁,未婚,清远县人,住院号19,533。因畏寒,发热、左侧胸痛53天,头痛、呕吐36天入院。患者于1981年11月8日突然左侧胸痛、畏寒、发热,体温在38℃左右,次日入当地医院。诊断左侧胸膜炎并积液。用广谱抗生素与皮质激素等治疗。3天后热退,症状缓解,住院9天。出院后8天再次出现畏寒、高热,伴有双颞部剧烈头痛、呕吐再次入院,又用上述药物治疗,但高热不退.伴剧烈头痛与频频呕吐,病情逐渐加重。12月25日转外院,经脑脊液检查发现新形隐球菌(简称隐球菌),12月31日转来我院。发病以来无精神异常,无抽搐等。既往身体健康,病前念高中,家中父母姊妹均健在。T:38.2℃,P72次,R20次,BP120/80。神志清,发育正常,营养中等。颌下可扪及数粒黄豆大淋巴结,质软,无压痛。五官端正,头颅与头颅器官正
Case introduction Nguyen × × male, 16 years old, unmarried, Qingyuan County, hospital number 19,533. Because of chills, fever, left chest pain for 53 days, headache, vomiting 36 days admitted. Patients on November 8, 1981 suddenly left chest pain, chills, fever, body temperature around 38 ℃, the next day into the local hospital. Diagnosis of left pleurisy and effusion. With broad-spectrum antibiotics and corticosteroids and other treatment. 3 days after the heat back, relieve symptoms, hospital 9 days. 8 days after discharge again chills, fever, accompanied by severe bilateral temporal headache, vomiting re-admission, but also with the above drug treatment, but high fever. With severe headache and frequent vomiting, the condition gradually aggravated. December 25 to the hospital, the cerebrospinal fluid examination revealed Cryptococcus neoformans (Cryptococcus neoformans), December 31 transferred to our hospital. Since the onset of mental disorders, no convulsions and so on. Past health, pre-sick high school, home parents are alive. T: 38.2 ° C, P72 times, R20 times, BP120 / 80. Conscious, normal development, moderate nutrition. Submaxillary palpable number of large beans, large lymph nodes, soft, no tenderness. Good facial features, positive skull and cranial organ