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患儿男,7岁。因不明原因的发热4天,伴全身肌肉疼痛及下肢活动困难,门诊以风湿热收入院。查体:T 39.3℃,P 130次/min,R 30次/min。急性病容,皮肤干燥,全身皮下散在数十个结节,其颜色正常,直径为0.5～1.0cm不等,压痛明显,以四肢多见。四肢肌肉压痛明显,余无异常。化验:WBC 12×10~9/L,N 0.80,血沉46mm/h,ASO 1250U;心电图示窦性心动过速。即予青霉素、阿司匹林及强的松等抗风湿治疗。3天后体温恢复正常,四肢肌肉痛稍减,但皮下缩节未缓解,压痛仍明显,且躯干部有3～4个结节逐渐增大。
Children male, 7 years old. Due to unknown causes of fever for 4 days, with general muscle pain and difficulty in lower limb activity, outpatient rheumatic fever admitted to hospital. Examination: T 39.3 ℃, P 130 times / min, R 30 times / min. Acute disease, dry skin, body scattered in dozens of subcutaneous nodules, the normal color, diameter of 0.5 ~ 1.0cm range, tenderness evident to limbs more common. Distracted muscle tenderness, no abnormalities. Laboratory tests: WBC 12 × 10 ~ 9 / L, N 0.80, ESR 46mm / h, ASO 1250U; ECG showed sinus tachycardia. Namely to penicillin, aspirin and prednisone and other antirheumatic treatment. 3 days after the body temperature returned to normal, slightly reduced limb muscle pain, but did not alleviate subcutaneous contractions, tenderness is still obvious, and the trunk has 3 to 4 nodules gradually increased.