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患儿,女,8岁。因发热一月,左耳肿痛伴全身皮损10天入院。体检:贫血貌,巩膜轻度黄染,左侧周围性面瘫,左耳肿胀,局部溃破,有脓性分泌物。左臀部有6×6cm大小之溃破肿块,右下肢散在红班。右上肺可闻及湿性罗音,肝肋下3cm、质中、脾肋下2cm。实验室检查::Hb 60g/L,RBC 2.0×10~(12)/L,WBC 3.5×10~9/L,N 0.80,L 0.20。胸片提示支气管肺炎。左侧乳突片无明显骨质破坏。肝功能:黄疸指数12u,SGPT 80u。脑脊液正常。诊断:1.脓毒败血症(金葡菌感染),2.中毒性大疱表皮松懈症,3.支气管肺炎,4.中毒性肝炎。给予新青Ⅱ,先锋霉素等治疗一周,病情恶化,左外耳道广泛坏死,皮损范围扩大,中心坏死、发黑、凹陷、胸腹部
Children, female, 8 years old. January due to fever, left ear swelling and pain with systemic lesions 10 days admitted. Physical examination: anemia, scleral mild yellow dye, left peripheral facial paralysis, left ear swelling, local ulceration, purulent secretions. The left hip 6 × 6cm size ulcerative mass, the right lower extremity scattered in red classes. Upper right lung can be heard and wet rales, liver ribs 3cm, quality, spleen ribs 2cm. Laboratory tests :: Hb 60g / L, RBC 2.0 × 10-12 / L, WBC 3.5 × 10-9 / L, N 0.80, L 0.20. Chest radiographs suggest bronchopneumonia. Left mastoid no obvious bone destruction. Liver function: jaundice index 12u, SGPT 80u. Cerebrospinal fluid is normal. Diagnosis: 1 sepsis (Staphylococcus aureus infection), 2 toxic epidermolysis bullosa, 3 bronchial pneumonia, 4 toxic hepatitis. Give Xinqing Ⅱ, cephalosporins and other treatment for a week, the disease deteriorated, extensive external necrosis of the left ear canal, the scope of lesions increased, the center of necrosis, black, depression, chest and abdomen