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女性,20岁。因发热头痛1个月,上腹部疼痛半月于1987年9月28日拟诊“慢性胃炎”入院。体查:贫血,慢性病容。体温37.5℃、血压12.3/8.53kPa。双肺呼吸音清晰,心脏不扩大,心率96次、早搏3～4次/分,未闻杂音。腹软,剑突下及右上腹压痛,莫菲征阳性,肝肋下约1.5cm,质软、轻压痛,脾未触及。给予庆大霉素及能量合剂等治疗,5天后腹痛及头痛明显减轻。10月20日出现指关节及膝关节疼痛,指关节渐肿胀略呈梭形,握拳时疼痛加重;双膝关节无红肿。11月7日后曾两次于面部、双手及前臂出现红色皮疹。住院期间常有
Female, 20 years old. 1 month due to fever headache, upper half abdominal pain in September 28, 1987 to be diagnosed “chronic gastritis” admitted. Physical examination: anemia, chronic disease. Body temperature 37.5 ℃, blood pressure 12.3 / 8.53kPa. Breath sounds clear lungs, the heart does not expand, the heart rate 96 times, premature beats 3 to 4 times / min, no noise. Abdominal soft, xiphoid and right upper quadrant tenderness, Murphy sign positive, liver ribs about 1.5cm, soft, light tenderness, the spleen not touched. Given gentamicin and energy mixture and other treatment, abdominal pain and headache significantly reduced after 5 days. On October 20, there was pain in the joints and knees, swelling in the joints was slightly fusiform, and the pain in the fist was aggravated. There was no swelling in the knees. A red rash appeared on the face, hands and forearms twice after November 7. Often during hospitalization