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例1,女,20岁,因发热、全身关节游走性疼痛15天于1989年2月7日入院。既往无结核病史及结核病接触史。查体,T39.3℃,P107次/分,R23次/分,BP16.0/11.2kPa,急性病容,咽部轻度充血,双肘膝关节痛,轻度红肿,活动受限。Hb105g/L,WBC17×10~9/L, N0.71,L0.29,血沉90mm/h,抗“O” 883U;心电图报告:窦性心动过速,ST段稍降低,X线胸部透视及小便化验正常。诊断:急性风湿热。给予静滴青霉素,口服强的松30mg/日,扑炎痛及维生素C治疗,效果不明显。继续按上述方案治疗,体温又复升呈弛张热型,肘、膝关节红肿疼痛,活动受限。转外院查结核菌素试验强阳性,再摄胸片示两肺上中下野满布粟粒状小结节状影,X线诊断急性血性播散型肺结核,改用链霉素,异烟肼,利福平治疗,10天后体温正常,20天
Example 1, female, 20 years old, due to fever, systemic pain of walking joints 15 days in February 7, 1989 admission. No previous history of tuberculosis and tuberculosis exposure. Examination, T39.3 ℃, P107 beats / min, R23 beats / min, BP16.0 / 11.2kPa, acute illness, mild pharyngeal congestion, elbow knee pain, mild swelling, limited mobility. Hb 105g / L, WBC 17 × 10-9 / L, N0.71, L0.29, ESR 90mm / h, anti-O "883U; ECG report: sinus tachycardia, ST segment slightly lower, X-ray chest and Urine test normal. Diagnosis: Acute rheumatic fever. Given intravenous penicillin, oral prednisone 30mg / day, puerarin and vitamin C treatment, the effect is not obvious. Continue to press the above treatment, body temperature rose again Tension type, elbow, knee swelling and pain, limited mobility. Transferred to the hospital tuberculin test strong positive, and then the chest radiograph showed two lungs on the middle and lower reaches full of miliary nodular shadow, X-ray diagnosis of acute bloody disseminated pulmonary tuberculosis, use streptomycin, isoniazid, Rifampicin treatment, normal body temperature after 10 days, 20 days