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患儿 男,23天,主因皮肤黄染20天,于1994年4月14日入院。患儿系第1胎足月顺产,生后第3天发现皮肤黄染并进行性加重。生后母乳喂养,母孕期健康。家中有养猫、狗史。查体:体温37℃,呼吸40次,脉搏132次,体重3.04kg。全身皮肤及巩膜明显黄染,未见出血点及皮疹,前囱门平软,双肺呼吸音粗,心脏未见异常。腹软,肝肋下1.5cm,剑突下0.5cm触及,质软;睥未及。四肢肌张力正常,生理反射存在。实验室检查:血直接胆红素17.1μmol/L,间接胆红素290.7μmol/L,肝功能正常。血培养阴性。血CMV-IgM阴性。乙肝五项血清学指标阴性。血弓形虫间接血凝试验(IHA)阳性,间接荧光抗体试验
Male children, 23 days, mainly due to skin yellow dye 20 days, in April 14, 1994 admission. Children with first full-term fetus at birth, 3 days after birth, found that the skin yellow dye and progressive increase. After birth, breastfeeding, pregnant motherhood health. Family has cats, dogs history. Physical examination: body temperature 37 ℃, breathing 40 times, pulse 132 times, weight 3.04kg. The body skin and sclera obvious yellow dye, no bleeding spots and rashes, front Huanmen soft, lung breath sounds thick, no abnormal heart. Abdomen soft, liver ribs 1.5cm, xiphoid 0.5cm touch, soft; Limb muscle tension normal, there is physiological reflex. Laboratory tests: blood direct bilirubin 17.1μmol / L, indirect bilirubin 290.7μmol / L, normal liver function. Negative blood culture. Blood CMV-IgM negative. Five serological indicators of hepatitis B negative. Indirect hemagglutination test (IHA) of blood toxoplasma gondii, indirect fluorescent antibody test