患儿,男,3个月。因咳嗽、喘憋住当地县医院,按“肺炎、心衰”治疗,3天后开始发热,体温为39℃,伴腹泻6～12次/日,大便性质多样,为黄稀便、咖啡色稀便、绿色粘液便。第13天时出现抽摘,作脑脊液检查正常,血及大便培养均为鼠伤寒沙门氏菌,经治疗无效,于病后18天以“鼠伤寒败血症中毒性脑病”转入我院。入院时查体:T 37.3℃,呼吸40次/分,脉搏150次/分,神清,反应差,双瞳孔等大等圆、对光反射存在,双耳时有向左侧斜视,头颅骨软化(+),前囟张力不高,两肺呼吸音粗,心脏检查正常,腹软,略胀,肠鸣音活跃,肝肋下3.5 cm,脾未触及,四肢肌张力增高,双膝反射活跃,颈无抵抗,布氏征、克氏征及巴氏征均为阴性。入院后给予氧哌嗪青霉素1 g/日及先锋必(哌酮头孢菌素)1g/日静脉点滴,吡哌酸口服。来我院第二天发生抽 Children, male, 3 months. Due to cough, wheezing inhabit the local county hospital, according to “pneumonia, heart failure” treatment, fever began after 3 days, body temperature 39 ℃, with diarrhea 6 to 12 times / day, stool nature of a variety of loose stools, loose stools brown , Green mucus will be. On the thirteenth day, there was pumping and cerebrospinal fluid examination was normal. The blood and stool culture were all Salmonella typhimurium. After treatment, it was transferred to our hospital for 18 days after the onset of “typhoid septicemia toxic encephalopathy.” Admission examination: T 37.3 ℃, breathing 40 beats / min, pulse 150 beats / min, Shen Qing, poor response, double pupil and other large circle, the presence of light reflexes, both ears have left to strabismus, skull Softening (+), the anterior fontanelle tension is not high, the two lungs breath sounds coarse, normal heart examination, abdominal soft, slightly swollen, bowel sounds active, liver ribs 3.5 cm, spleen not touched, limb muscle tension increased, knees reflex Active, neck non-resistance, Bu’s sign, Kirschner sign and Pakistan’s sign were negative. After admission, give piperacillin penicillin 1 g / day and Pioneer will (Pifenthrin) 1g / day intravenous infusion of pipemidic acid. The next day pumping to our hospital