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王×,男,36岁,泰籍华裔,因寒战、高热1wk用林可霉素等治疗未见效,2d来神志朦胧,伴喷射性呕吐4—5次,无尿1d,急诊入院。体检:一般情况差,神志朦胧,心律齐,心率110次/min,血压16/11KPa,巩膜、皮肤无黄染,浅表淋巴结(-),心、肺(-),腹平软,肝肋下2.0cm,质中,无明显压痛,脾肋下触及,腹水征(-),四肢活动正常,皮肤未见皮疹,颈项强直(+),布、克氏征(-),深浅反射存在,病理反射未引出。检验结果:厚血膜染色镜检找到大量恶性疟原虫滋养体。红细胞轻度大小不一,偶见有核红细胞,红细胞:2.58×10~(12)/L,Hb 74.46g/L。白细胞:12×10~9/L,中性粒
Wang ×, male, 36 years old, Thai Chinese, due to chills, fever 1wk with lincomycin and other treatment did not work, 2d to ambiguity, with jet vomiting 4-5 times, no urine 1d, emergency admission. Physical examination: poor general condition, mind hazy, heart rate Qi, heart rate 110 beats / min, blood pressure 16 / 11KPa, sclera, skin without yellow dye, superficial lymph nodes (- Under the 2.0cm, quality, no significant tenderness, spleen ribs touch, signs of ascites (-), limbs normal, no skin rashes, neck stiffness (+), cloth, Pathological reflex did not lead. Test results: thick membrane staining found a large number of Plasmodium falciparum trophozoites. Erythrocytes were slightly different in size, occasionally with erythrocytes, erythrocytes: 2.58 × 10-12 / L and Hb 74.46g / L. White blood cells: 12 × 10 ~ 9 / L, neutral granules