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唐××男39岁技术员住院号101814病史发烧半月,左目失明4日。既往有胆石胆囊炎。1年前在本院手术摘除胆囊,术后仍有反复高烧史。入院前半月上腹不适,畏寒、高烧达39°～40℃,发烧期间应心抗菌素、地塞米松等治疗体温下降即停药。入院前4天,左眼视力突然下降,门诊查体出现左眼底混浊,乳头周界不清,散在不规则出血,颞上方网膜灰白色高起,以左眼急性视神经网膜炎收入院。病人未及时入院,返家后又出现寒战、高烧,先后应用青、链、麦迪霉素以及地塞米松等治疗。体温下降方于4日后再次来院而以左眼转移性眼内容炎收入院。查体:T36℃P80次/min R20次/min BP120/75mmHg,慢性消瘦病容,神清合作,巩膜无黄染,心肺所见(-),右上腹有一术痕,神经系统所见(-)。视力右1.5,左光感。眼压右、左眼均为14.57mmHg。左球结膜轻度混合充血,角膜透明,前房下方积脓,房闪(+++),虹膜纹理不清,瞳孔约3
Tang XX male 39-year-old technician Hospital No. 101814 history of fever half a month, left eye blindness on the 4th. Past gallstone cholecystitis. A year ago in our hospital surgical removal of the gallbladder, there are still repeated high fever history. Abdominal discomfort in the first half of admission, chills, high fever up to 39 ° ~ 40 ℃, fever should be heart antibiotics, dexamethasone and other treatment of body temperature that is withdrawal. Four days prior to admission, the visual acuity suddenly decreased in the left eye. The ophthalmology of the left eye appeared opacity in the left eye, the unclear periphery of the nipple, and the irregular bleeding in the outpatient department. The upper retina was grayish white in height and the left optic nerve was admitted to the hospital for acute optic neuritis. The patient was not admitted to hospital in time, returned to chills and fever after having returned home, and successively treated with green, chain, midecamycin and dexamethasone. Body temperature dropped side to the hospital again after 4 days to the left eye metastatic eye content Yan hospital income. Physical examination: T36 ℃ P80 times / min R20 times / min BP120 / 75mmHg, chronic wasting disease, Shenqing cooperation, scleral no yellow dye, cardiopulmonary see (-), . Right vision 1.5, left light sense. IOP, left eye are 14.57mmHg. Left conjunctival mild mixed hyperemia, corneal transparency, hypopyon empyema, atrial flash (+++), iris texture is unclear, pupil about 3