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患者男性,21岁.余杭县人,油漆工.因发热,头痛,意识逐渐模糊5天伴有肢体癫痫样抽搐2次于1988年11月7日入院,既往无癫痫史,无钩体疫水接触史.体检:T38.1℃,P60次/分,R16次/分,BP14/8kPa.浅昏迷,巩膜、皮肤无黄染.双侧瞳孔等大,约0.4cm,对光反应存在.颈项强直有抵抗,克氏征(+),四肢肌力5级,两上肢肌张力增高,病理反射未引出.眼底视盘边界清楚.血WBC19.6×10~9/L,N84%,L14%,E 2%.脑脊液外观微黄,潘氏试验:痕迹,蛋白定量1.8g/L,白细胞40×10~6/L,糖2.75mmol/L,氯化物220.24mmol/L.拟诊散发性脑炎?癫痫?予脱水、抗抽搐处理.入院第2天巩膜出现黄染,血GPT200u,Ⅱ28u,总胆红素
Patient male, 21 years old. Yuhang County, painter. Due to fever, headache, gradually blurred consciousness 5 days with limb epileptic convulsions 2 were admitted to hospital on November 7, 1988, without prior epilepsy history, no hook water Exposure history: physical examination: T38.1 ℃, P60 beats / min, R16 beats / min, BP14 / 8kPa. Shallow coma, sclera, skin yellow dye. Bilateral pupils and other large, about 0.4cm, light reaction exists. (+), Limb muscle strength of 5, two upper limb muscle tension increased, the pathological reflex did not lead to clear boundary of fundus disc clear blood WBC19.6 × 10 ~ 9 / L, N84%, L14% E 2% .The appearance of cerebrospinal fluid was yellowish, Pan test: trace, protein quantitation 1.8g / L, white blood cells 40 × 10 ~ 6 / L, sugar 2.75mmol / L, chloride 220.24mmol / L. To be diagnosed with sporadic encephalitis Epilepsy dehydration, anti-seizure treatment.On the 2nd day sclera appear yellow dye, blood GPT200u, Ⅱ 28u, total bilirubin