发烧、腰痛、腹痛、血尿的误诊与经历(国外英文资料).docVIP

发热、腰痛、腹痛、血尿的误诊与经验 Misdiagnosis and experience of fever, lumbar pain, abdominal pain, hematuria 2011-06-13 Yin hengqiang Medical records in this paper, Patient male, 25 years old, teacher. The patient died of fever, and was hospitalized on July 1, 1997, and was diagnosed with acute tonsillitis. The court give the intravenous drip of penicillin 8 million u/d, 2 d remission of fever, sore throat, but a persistent low back pain, abdominal pain, a matrix increased, accompanied by the naked eye hematuria. On the night of July 6, 1997, I was transferred to our hospital. The emergency room was treated with urinary tract infection and urinary calculi. The history of living: plain health, no history of tuberculosis. Before February, the symptoms of urination, urgency, and urinary pain were reported. Admission examination: T37.5 ° C, R 24 times/min, P 100 times/min, BP16/12 kPa (120/90 mm Hg). Shen zhi qing, acute pain and suffering, the skin of zhou body, the mucosa not see rash and the blood point. Facial blushing, pharyngeal and soft palate marked hyperemia, bilateral amygdala I ° enlargement. Heart, lung, did not see abnormalities, abdominal plain soft, liver, spleen, bottom left abdomen tenderness obviously, muscle tension, rebound tenderness, attacking bilateral renal area and pain, for, on the left side of the no swelling of lower limbs. Laboratory examination: hemoglobin 135g/L, white blood cells 10.2 times 109 / L, neutral 0.8, lymphoid 0.2; Urine routine: urine protein + + +, red cell 50/hp. The heart, lung and abdomen were not abnormal, and the abdomen was negative. Double kidney B: normal. Liver function: aspartate transaminase 162 U/L, alanine ammonia enzyme 180 U/L, total bilirubin 17.24 U mol/L, direct bilirubin 2.57 U mol/L, indirect bilirubin 14.67 U mol/L. Urobacterial cultures are negative. Kidney function: BUN 12.2 mmol/L, Scr 350 mumol/L, CO2 CP 20 mmol/L. Hospitalization: initial diagnosis of urinary tract infection after admission, left urinary calculi