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4岁,因发热3天入院于1993年7月16日。患儿5天前皮肤散在丘疹,搔抓后破损3处,局部红肿疼痛。3天前起发热39℃,轻咳、流涕,精神不振。在门诊肌注/静滴青霉素、病毒唑无好转,高热达40℃。入院查体T39.7℃,P130次/分,R40次/分,神萎,热性卡他面容,右前臂、左小腿、左侧臀部各有一皮损,局部红肿1×1cm,无脓性渗出物,另有少许充血性斑疹,全身浅表淋巴结豌豆~葫豆大、活动、无触痛,双眼结合膜充血,少许黄白色渗出物,鼻前庭及鼻唇沟糜烂充血,口唇红,干燥,无杨梅舌,咽充血,扁桃体I°红肿,无脓点,心肺体检正常,肝脾不肿大。入院日查血Hb98g/L,WBC6.4×10~9/L,N49%,L51%,二便常规(-)。初步诊断为上呼吸道炎、皮肤感染,败血症待除外。静脉滴注苯唑青霉素+氨苄青霉素,肌注干扰素,外科和眼科局部换药。48小时
4 years old, admitted to hospital on 3 July for fever on July 16, 1993. Children with pimples scattered 5 days ago, after scratching damaged 3, local swelling and pain. 3 days ago, fever 39 ℃, light cough, runny nose, lack of energy. Intramuscular injection / intravenous penicillin, ribavirin no improvement, high fever up to 40 ℃. Admission examination T39.7 ℃, P130 beats / min, R40 beats / min, atrophy, thermal card his face, right forearm, left leg, left hip have a skin lesions, local swelling 1 × 1cm, no purulent Exudate, and a little congestive rash, systemic superficial lymph nodes peas ~ gourd big, activity, no tenderness, binocular conjunctival hyperemia, a little yellow-white exudate, nasal vestibule and nasolabial fold erosion erosion, lips Red, dry, no Bayberry tongue, pharyngeal congestion, tonsil I ° swelling, no suppurative point, normal cardiopulmonary examination, liver and spleen is not enlarged. Hb98g / L on admission examination, WBC 6.4 × 10 ~ 9 / L, N49%, L51%, then two routine (-). Initial diagnosis of upper respiratory tract inflammation, skin infections, sepsis to be excluded. Intravenous oxacillin + ampicillin, intramuscular injection of interferon, surgical and ophthalmic local dressing. 48 hours