患者,男,25岁,因昏迷伴呼吸不规则四小时于1990年1月28日入院。患者于入院当日晨7时半起床时突然跌倒,继之神志不清,口吐白沫,四肢小抽动,无大小便失禁。在急症室静滴20%甘露醇200ml,速尿40mg,地塞米松10mg后,症状无改善且出现呼吸不规则而收入院。入院体检:体温37.3℃,脉搏80次,呼吸20次,血压17/9kpa,深昏迷,两瞳孔等大等圆,对光反射存在,颈无明显抵抗,浅表淋巴结不肿大。未见皮疹。潮式呼吸,两肺少许鼾音,心音心律无特殊,腹平软,肝脾未及,四肢肌张力高,双侧巴彬斯基氏征(+),克氏征(+)。化验:Hb135g/L,WBC 14.7×10~9/L,P91%,L 8%,M 1%,血培 Patient, male, 25 years old, admitted to hospital on January 28, 1990 due to coma with respiratory irregularities for four hours. The patient fell suddenly at 7:30 on the morning of admission, followed by unconsciousness, foaming at the mouth, twitching limbs and incontinence. In the emergency department intravenous infusion of 20% mannitol 200ml, furosemide 40mg, dexamethasone 10mg, no improvement in symptoms and irregular breathing and admission to hospital. Admission physical examination: body temperature 37.3 ℃, pulse 80 times, breathing 20 times, blood pressure 17 / 9kpa, deep coma, two pupils and other large circle, the presence of light reflex, neck no significant resistance, superficial lymph nodes is not enlarged. No rash. Tidal breathing, a little lungs in both lungs, heart sound cardiogram no special, abdominal soft, liver and spleen not, limb muscle tension, bilateral Babinski’s sign (+), Kirschner sign (+). Laboratory: Hb135g / L, WBC 14.7 × 10 ~ 9 / L, P91%, L8%, M1%, blood culture