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嵇萍医生(解放军后勤学院卫生所内科)病儿最初由细菌性肺炎、化脓性中耳炎起病,继而出现全身多系统的损害,如胃肠道、中枢神经系、心血管系等,最后休克直至死亡。临床诊断考虑由化脓感染引起的全身败血症,以金黄色葡萄球菌(简称金葡)感染的可能性最大。各系统病变为:①肺部胸片示肺部呈大片阴影,可诊断为金葡肺炎、肺脓肿、脓胸等;②化脓性中耳炎;③胃肠道因严重腹泻引起脱水酸中毒,大便常规脓球++,为金葡肠炎。病程中曾吐咖啡样物2次,应排除应激性溃疡;④中枢神经系有惊厥、昏迷,以脑脓肿可能性大,可为血源性或耳源性。呼吸不整、瞳孔两侧不等大,有脑疝发生,可加速死亡;
嵇 Ping doctor (People’s Liberation Army Logistics Institute Health Center) sick child initially by bacterial pneumonia, suppurative otitis media onset, followed by systemic multiple system damage, such as the gastrointestinal tract, central nervous system, cardiovascular system, the last shock until death. Clinical diagnosis Consider the systemic septicemia caused by purulent infection, the most likely to Staphylococcus aureus (Gyps) infection. The system lesions are: ① lung chest showed a large shadow of the lungs can be diagnosed as gypsum pneumonia, lung abscess, empyema, etc .; ② suppurative otitis media; ③ gastrointestinal tract due to severe diarrhea caused by dehydration acidosis, stool routine Pus ball ++, for the gold Pasteitis. Smell the course of the coffee sample twice, should be ruled out stress ulcer; ④ central nervous system convulsions, coma, the possibility of brain abscess, may be of blood or ear origin. Breathing, ranging from the pupil on both sides, there is a hernia, can accelerate the death;