摘要:
病例 患儿男,5岁,因"发热、巩膜黄染1天"入院.入院查体T 39.6℃,R 28次/min,P121次/min急性热面容,巩膜轻度黄染.辅助检查血常规WBC10.44×109/L,N88%,L8.4%,Hb127g/L,PLT179×109./L,CRP30.34mg/L,PCT≥10;肝功能ALB32.2g/L,ALT785U/L,AST385U/L,TBIL91.9umol/L, DBIL65.5umol/L, IBIL26.4umol/L;血氨66umol/l;FIB:6.29g/l;ESR 28 mm/h.肝炎全套,TORCH,EB病毒,补体,RF,ANA,抗双链DNA抗体,ASO均在正常范围.T淋巴细胞亚群:CD3+54.6%, CD3+CD4+19.6%, CD3+CD8+29.7%,CD3+/CD8+0.66.血培养阴性.考虑感染,给予头孢哌酮钠/舒巴坦钠和青霉素抗感染、保肝等治疗,体温仍呈39℃~ 40℃稽留热,持续抗生素治疗5d无效.