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1989年10月份,我们遇到以皮质类固醇作为解热药,导致二例严重的粟粒型肺结核,终于死亡。现报告如下:例1 患儿,男,1.5岁。近20天发热,伴轻咳、纳差、乏力、渐消瘦。曾肌注地塞米松解热。用药后,能降温1、2日。约用10次,每次5mg。因高热不退4天,脉搏200次/分。精神萎靡,面色灰暗,呼吸困难,鼻翼扇动。心无杂音,肺无罗音。血红蛋白70g/L,白细胞39×10~9/L,中性92％,“OT”1:2000“-”,胃液中找到结核杆菌,血培养阴性。胸片:两肺满布大小不等的粟粒影及边缘模糊的雪花状影,且有大片融合,两肺纹理被来诊。未曾接种卡介苗。其祖母体弱,经常咳嗽。入院时体温40℃,呼吸54次/分,
In October 1989, we encountered corticosteroids as antipyretics, which led to two serious miliary tuberculosis and finally died. Now report as follows: Example 1 children, male, 1.5 years old. Nearly 20 days fever, with light cough, anorexia, fatigue, gradually thinner. Had intramuscular dexamethasone antipyretic. After treatment, can cool 1, 2 days. About 10 times, each 5mg. 4 days due to high fever, pulse 200 beats / min. Apathetic, looking pale, breathing difficulties, nose flap. Heart no noise, lungs without rales. Hemoglobin 70g / L, white blood cells 39 × 10 ~ 9 / L, neutral 92%, “OT” 1: 2000 “-”, found in gastric juice Mycobacterium tuberculosis, blood culture negative. Chest radiograph: two lungs covered with varying sizes of milky shadow and fuzzy edge of the snowflake-like shadow, and there is a large integration, the two lungs were to be diagnosed. Have not been vaccinated with BCG. His grandmother is weak and often coughs. Admission temperature 40 ℃, breathing 54 beats / min,