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病例报告女性患者,47岁,因全身乏力,高热,经青霉素等药物治疗一周,来见好转,突然晕厥而入院。有急性黄疸型肝炎史。检查:T37℃,急性病容,神志恍惚。心率62次,双肺闻及罗音。肝脾(—)。WBC 总数13,000,N86%,L13%,血小板7万,HBsAg(—),X 片示肺纹理增粗,心脏略增大;心电图Ⅲ°房室传导阻滞(A—VB)。诊断:弥漫性病毒性心肌炎。入院后,经安装临时人工起搏器,抗生素及皮质激素等药物治疗,病情恶化,先后出现无尿,休克,黄疸等,入院第11天呼吸突然停止,经抢救无效死亡。病理检查:死者营养状况良好,全身皮肤及巩膜重度黄染。喉头极度水肿;双侧肺表面弥漫出血灶,切面可见散在结节状,境界清楚的灰白色病灶,大者直径达1.5cm,中央明显出血、坏死。用手挤压,肺泡腔内有粉红色液体渗出。镜下病变性质为曲菌性
Case report Female patients, 47 years old, due to generalized weakness, fever, penicillin and other drugs for a week to see the improvement, suddenly admitted to hospital with syncope. A history of acute jaundice hepatitis. Check: T37 ℃, acute disease, trance. Heart rate 62 times, the lungs smell rales. Liver and spleen (-). WBC count 13,000, N86%, L13%, platelet 70,000, HBsAg (-), X-ray showed thickening of the lungs, slightly enlarged heart; ECG Ⅲ ° atrioventricular block (A-VB). Diagnosis: diffuse viral myocarditis. Admission, after the installation of temporary artificial pacemaker, antibiotics and corticosteroids and other drug treatment, the condition deteriorated, there have been no urine, shock, jaundice and so on, the first 11 days of admission, breathing suddenly stopped after the rescue died. Pathological examination: the deceased good nutritional status, systemic skin and sclera severe yellow dye. Laryngeal edema; diffuse bilateral hemorrhagic lung surface lesions, the surface visible scattered nodules, the state clear gray lesions, the largest diameter of 1.5cm, the central hemorrhage and necrosis. Extrusion by hand, pink alveolar cavity effusion. Microscopic lesions of the nature of fungi