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患者女,23岁,因发热8天、头痛5天于1990年10月25日入院。患者妊娠5月,因抽取羊水后,次日出现畏寒、高热,继而自然流产。产后3天高热不退,头痛、呕吐转我院。体检:体温38.7℃,血压12/9.5kPa,神志清,颈强直,心肺及腹部无异常,克氏征、布氏征均阳性。化验:WBC14.6×10~9/L,N0.88。脑脊液检查外观混浊,潘氏试验阳性,细胞数4500×10~6/L,N0.75,糖1.3mmol/L,蛋白5.4mmol/L,氯化物115mmol/L。血培养及脑脊液培养均为绿脓杆菌生长。确诊为绿脓杆菌败血症合并脑膜炎,给予氧哌嗪青霉素8克/日分两次静滴,丁胺卡那毒素0.4克/日,一次静滴,并以丁胺卡那霉素0.2克鞘内注射隔日一次,治疗一周无效,改用头孢他定4克/日分两次静滴,3天后体温正常,7天后症状及体征
Female patient, 23 years old, 8 days due to fever, headache 5 days in hospital on October 25, 1990. Patients with pregnancy in May, due to the extraction of amniotic fluid, the next day there chills, fever, then spontaneous abortion. 3 days postpartum fever, headache, vomiting transferred to our hospital. Physical examination: body temperature 38.7 ℃, blood pressure 12 / 9.5kPa, clear consciousness, neck stiffness, no abnormal heart and lungs, abdomen, Kirschner sign, Clinton sign were positive. Laboratory: WBC14.6 × 10 ~ 9 / L, N0.88. Cerebrospinal fluid was cloudy in appearance and positive in Pan’s test. The number of cells was 4500 × 10-6 / L, N0.75, sugar 1.3mmol / L, protein 5.4mmol / L and chloride 115mmol / L. Blood culture and cerebrospinal fluid culture are Pseudomonas aeruginosa growth. Confirmed as Pseudomonas aeruginosa sepsis with meningitis, giving piperacillin penicillin 8 g / day intravenous infusion, amikacin 0.4 g / day, an intravenous infusion of amikacin 0.2 g sheath Intra-injection every other day, the treatment of a week is invalid, switch to ceftazidime 4 g / day intravenous infusion, normal body temperature after 3 days, 7 days after the symptoms and signs