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患儿,男,2岁。20天前腹痛、高热,17天前伴神志恍惚,当地医院诊为“败血症”、“右腹股沟蜂窝织炎”。用红、氯霉素和激素治疗,无显效。改用青、链霉素抗感染,发热稍有好转。5天前又现面黄、恶心、腹泻,神萎嗜睡、轻咳、大便棕褐色,胶冻状,每天10余次。体检:一般状况差,重10kg,T36.8℃,P132,R20,BP12/9kPa,哭声低微,呼吸深大。唇干裂,口粘膜出血,舌质鲜红、无苔。双肺散在干湿鸣,肝肋下4cm,轻压痛,肠鸣活跃。右下腹壁有2cm×2cm×1cm红色肿块。化验:Hb75g/L,WBC20.5×10~9/L,N 0.45,L 0.55。大便常规:粘液+,RBC+,发现酵母样菌。,潜血+～+++,涂片
Children, male, 2 years old. 20 days ago abdominal pain, fever, 17 days ago with trance, the local hospital diagnosed as “sepsis”, “right groin cellulitis.” Red, chloramphenicol and hormone therapy, no effective. Switch to blue, streptomycin anti-infection, fever slightly improved. 5 days ago is now yellow, nausea, diarrhea, Shen Shen sleepiness, light cough, stool tan, jelly-like, more than 10 times a day. Physical examination: poor general condition, weighing 10kg, T36.8 ℃, P132, R20, BP12 / 9kPa, low crying, deep breathing. Dry lips, mouth mucosal bleeding, red tongue, no moss. Wet lungs scattered in both lungs, liver ribs 4cm, light tenderness, bowel activity. Right lower abdominal wall with 2cm × 2cm × 1cm red mass. Assay: Hb75g / L, WBC20.5 × 10 ~ 9 / L, N 0.45, L 0.55. Stool routine: mucus +, RBC +, yeast-like bacteria found. , Occult blood + ~ +++, smear