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病史摘要:患者男性,47岁,因发热、咳嗽、咳痰、左胸痛12天,于1987年6月26日入院.患者1985年4月出现发热、咳嗽、咳痰,右胸痛,全身关节痛,血沉快;X 光片示右侧胸腔少量积液,诊断为结核性胸膜炎、肺部感染、布氏杆菌病?住院。入院后查布氏杆菌凝集试验阴性,氨苄青霉素、卡那霉素等治疗无效,给于强的松30mg/d 及抗痨治疗2月,体温正常,肺部炎症及胸腔积液消失,关节痛减轻出院,出院后继续抗痨9个月。1987年6月15日无原因再次出现发热(体温38℃左右)、咳嗽、咳白痰、左胸痛、血沉快(93mm/H),X 光检查:双下肺小片状阴影,于门诊肌注青、链霉素,口服雷米封治疗10天无效,收入院.既往患者曾在牧区工作,有羊群接触史.1963年发热(体温39～40℃)、关节痛(各大关节及指间关节),血培养阳性证实
Summary of history: The patient, 47 years old, was admitted to hospital on June 26, 1987 due to fever, cough, sputum and left chest pain for 12 days. The patient developed fever, cough, sputum, right chest pain, , Rapid ESR; X-ray showed a small amount of fluid on the right chest, diagnosed as tuberculous pleurisy, pulmonary infection, brucellosis? Hospitalization. Charlie’s bacilli agglutination test was negative after admission, ampicillin, kanamycin and other ineffective treatment given to prednisone 30mg / d and anti-tuberculosis treatment in February, normal body temperature, pulmonary inflammation and pleural effusion disappeared, joint pain Relieve discharge, continue to resist 痨 9 months after discharge. June 15, 1987 no reason fever again (body temperature about 38 ℃), cough, cough white sputum, left chest pain, ESR (93mm / H), X-ray examination: double inferior pulmonary patch shadow, Note green, streptomycin, oral Remy sealed treatment invalid for 10 days, income hospital. Past patients who worked in pastoral areas, history of contact with flocks .1963 fever (body temperature 39 ~ 40 ℃), joint pain Interphalangeal joint), positive blood culture confirmed