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病孩男,9岁。发热、头痛、全身不适两月。曾在当地卫生院诊治为“上感”、“支气管炎”,经消炎、对症治疗稍有缓解,但继而出现呕吐、烦躁、失眠、头痛加重来我院求治。父母健康,该村为结核病多发区。查体:体温39.2℃,脉搏132次/分,呼吸30次/分,血压76/50毫米汞柱(10.1/6.7kPa)。极度消瘦,精神萎靡,皮肤弹性差,瞳孔等大,无眼颤。心肺正常,肝脾不大。颈强(++),Kernig氏征(+),Brudzi-nski氏征(+)。眼底:未发现脉络膜结节。胸部X线片显示锁骨下絮状阴影。化验:血红蛋白10克/分升,
Sick boy, 9 years old. Fever, headache, malaise two months. In the local hospital diagnosis and treatment as “flu,” “bronchitis”, anti-inflammatory, symptomatic treatment a little relief, but then vomiting, irritability, insomnia, increased headache to our hospital for treatment. Parents health, the village is tuberculosis area. Examination: body temperature 39.2 ℃, pulse 132 beats / min, breathing 30 beats / min, blood pressure 76/50 mm Hg (10.1 / 6.7kPa). Extreme weight loss, apathetic, poor skin elasticity, pupils and other large, no eye flutter. Cardiopulmonary normal liver and spleen is not. Neck strength (++), Kernig’s sign (+), Brudzi-nski’s sign (+). Fundus: No choroidal nodules found. Chest X-ray showed subclavian floc shadows. Laboratory tests: hemoglobin 10 g / dL,