第383例——腹泻、发热、突发意识丧失伴心脏杂音

病历摘要 患者女,51岁.因"腹泻2 d,伴高热1 d"于2007年12月13日来我院就诊.患者入院前2天晚上进冷食后出现腹泻,共4次,为绿色水样便.入院前1天凌晨出现发热,T 39℃,伴畏寒、寒战、心悸,无咳嗽、咳痰,无胸闷、胸痛及呼吸困难,自服退热药效果差.     

军团菌肺炎一例

1 病例简介 患者,男,47岁,主因发热4d于2010-11-01日入院.患者4d前无明显诱因出现发热,体温最高达41.2℃,有发冷、寒战、耳鸣、轻微咳嗽、咳白痰,无胸憋、胸痛、尿频、尿急及尿痛.院外在私人医院静脉滴注头孢唑肟钠2d,头孢曲松1d,炎琥宁3d,病情无好转,以"发热原因待查"收住我院呼吸科.患者既往体健.     

以发热为表现的脾血管肉瘤一例

患者男,54岁,于2004年1月3日因“发热、咳痰4d”入院。体温39·7℃,伴寒战、厌油腻,精神差。否认外伤史。体检:T38·7℃,P120次/min,R22次/min,BP105/60mm Hg(1mm Hg=0·133kPa),神清,呼吸稍急促,无黄疸及紫绀,右下肺闻及少量湿啰音穆善?120次/min,未闻及杂音。全腹软,右上腹     

猪霍乱沙门菌菌血症二例

例1男,23岁.腰部疼痛、活动受限4 d,畏寒、寒战、高热1 d入院.体格检查:体温40℃,脉搏96次/min,呼吸22次/min,BP 110/70 mm Hg(1 mm Hg=0.133 kPa).全身皮肤黏膜无出血点、淤点及皮疹,浅表淋巴结不大.心、肺无异常.     

间歇性右下腹痛,呕吐,寒战、发热、意识不清

病历摘要 患者男,86岁.主因"间歇性右下腹痛3个月,呕吐2 d,寒战、发热、意识不清1 d"于2009年3月11日入院.患者于3个月前出现间歇性右下腹痛,2 d前吃过晚饭后无明显诱因出现呕吐胃内容物8次,呕吐时神志清楚,否认误吸.1d前无明显诱因出现寒战、高热,无咳嗽、咳痰,伴间断神志不清、言语含糊不清,体温最高41.0℃,自服阿司匹林8片、肌注安痛定及柴胡后体温无好转.遂就诊于我院急诊,查血气     

氯喹、伯喹引起严重精神障碍

患者男性,24岁,因不规则高热2天于1979年7月20日入院。既往无疟疾及精神头 常病史。其兄和弟4天前患疟疾.体检:体温39。5℃,血压120/80,料 志清,急性热病容。心肺正常,肝脾未及,余无异常。化验:白细胞8,600,中性70%     

以血小板减少为主的恶性疟疾1例报告

患者因发热4d,尿黄1d入院,患者4d前从非洲归国后出现发热,体温最高40℃,伴有畏寒,无寒战,入院诊断为发热查因:1.疟疾?2.败血症?在当地医院给予头孢美唑抗感染、硫酸羟氯喹抗疟即对症支持治疗1天后患者仍有发热,体温达39℃,并于2天前患者出现小便深黄,伴有全身乏力,食欲减退,遂来我院就诊.     

NBAS基因突变致复发性肝功能异常1例报告

正1病例资料患者男性,17岁。因"发热咳嗽3 d"于2018年9月29日来本院诊治。患者10年前因"高热"后出现"瑞氏综合征",遗留"癫痫"病史,长期服用"丙戊酸钠",癫痫控制尚可。入院3 d前出现畏寒、发热达39℃,咽部不适,有咳嗽、无咳痰,自行服用"头孢氨苄分散片及奥司他韦"2 d,体温未下降。12月29日测最高体温39.8℃,再次至本院门诊就诊,胸片示两下肺少许渗出,怀疑肺炎并收治入院。入院体格检查:体温40.2℃,脉搏120次/min,呼吸21次/min,血压106/70 mm Hg。神志清,     

输液反应60例分析

1995～ 2 0 0 3年 ,笔者救治输液反应 6 0例。报告如下。临床资料 :本组男 36例 ,女 2 4例 ;年龄 2～ 6 3岁。既往有过敏史 11例 ,支气管哮喘 7例 ,青霉素过敏史 4例。多数患者于输液后 10分钟至 2小时出现输液反应。均有发冷、寒战、高热 ,体温在 38℃左右 2 2例 ,39℃以上 10例。恶心呕吐 32例 ,呼吸困难 12例 ,面色发绀 7例 ,头痛 2 3例 ,胸闷心慌 2 5例 ,四肢发冷 19例 ,血压下降 4例。方法及结果 :一旦确认为输液反应 ,立即停止输液 ,静脉推注地塞米松 0 .4～ 0 .6 mg/ kg;10 %葡萄糖酸钙及肌肉注射非那根 1mg/ kg;高热者给予物理降温…     

蒿甲醚联合氢化考的松治疗黑尿热

黑尿热(Alkaptonuria)是恶性疟疾最严重的并发症,临床见发热,急性溶血性贫血,血红蛋白尿、黄疸、肾功能损害等表现。现将收治两例报告如下。临床资料例1:患者男,17岁,因高烧、昏迷7天,急诊收住。既往有疟疾病史,曾口服氯喹(chloroquine)治疗,有皮肤搔痒,无外伤史。患者于入院前11天因寒战、高热、剧烈头痛、呕吐、腰痛,口服氯喹及APC治疗4天。继之失语,昏迷,急送入当地医院。住院7天,给予奎宁0.4g/d、钙剂等,治疗无效,患者一直处于昏迷状态,体温39℃不退,为进一步治疗转入本院。体查:T:39.5℃、BP:110/70mmHg     

An unusual case of Budd-Chiari syndrome--a case report

The authors report a rare case of congenital Budd-Chiari syndrome in a twenty-eight-year-old male mongoloid. The patient was submitted to azygous-portal disconnection, because of the syndrome of portal hypertension supposedly due to cirrhosis of the liver. He died of hemorrhage of the liver on the third postoperative day. Autopsy revealed a congenital fibrotic obstruction of all suprahepatic veins, with a wide, round ligament containing a functional umbilical vein, which had been routinely ligated during surgery. An extensive review of the literature showed no similar report. The authors speculate that the inadvertent interruption of the round ligament, which until then had served as a pathway for venous draining of the liver, followed by ligation of the anastomoses between the portal and azygous systems, was the factor that triggered the lethal outcome. Thus, this appears to be the first case of congenital Budd-Chiari syndrome predominantly maintained at the expense of the round ligament of the liver, with a patent vascular branch.     

In defense of case reports and case series

Case reports and case series have their own role in the progress of medical science. They permit discovery of new diseases and unexpected effects (adverse or beneficial) as well as the study of mechanisms, and they play an important role in medical education. Case reports and series have a high sensitivity for detecting novelty and therefore remain one of the cornerstones of medical progress; they provide many new ideas in medicine. At the same time, good case reporting demands a clear focus to make explicit to the audience why a particular observation is important in the context of existing knowledge.     

妊娠中期重症恙虫病1例并文献复习

<正>患者女,30岁,因"孕2产1孕22+周,发热4 d"于2016年6月30日急诊入住南方医科大学附属小榄医院产科。患者入院前4 d无明显诱因出现发热,T 39.5℃,伴干咳,无寒颤、抽搐,无腹痛、呕吐,在外院及我院门诊予对症治疗未见好转。入院查体:T39.7℃,P 82次/min,R 25次/min,BP 130/76 mm Hg。精神疲倦,双肺可闻及湿啰音。HR 82次/min,律齐,未闻及病理性杂音。腹部膨隆,肝脾触诊不满意,肠     

Tracheobronchomegaly--a case report

On the basis of a casuistics is referred to the infrequent tracheobronchomegaly with disturbed respiratory mechanics (tracheal collapse) and relapsing bronchitides due to a congenital or acquired loss of elasticity of trachea and main bronchi. Bronchoscopy and bronchography ascertain the diagnosis which may be supposed already on the full-size X-ray by the demonstration of an abnormally wide trachea. The conservative therapy of the in most cases mucopurulent bronchitis for the purpose of the prevention of a global respiratory insufficiency apart from mucolytics often demands the application of antibiotics. In individual cases the prognosis may be improved by stabilizing operative corrections of the trachea and the resection treatment of accompanying bronchiectases.     

Strongyloidosis--a case report

A case of Strongyloides stercoralis infection was described.     

Pseudohypoparathyroidism--a case report

The clinical picture of pseudohypoparathyroidism described by Albright and co-workers represents a morphological, functional and laboratory-chemical combination of symptoms which in the classical case is characterized by proportionate nanism, round face, oligophrenia and neuromuscular overexcitability, radiological changes as well as hypocalcaemia and hyperphosphataemia in increased parathormone. On the basis of casuistics typical findings are demonstrated and discussed with the data in literature.