发热、腰痛、腹痛、血尿的误诊与经验（Misdiagnosis and experience of fever, low back pain, abdominal pain and hematuria）.docVIP

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发热、腰痛、腹痛、血尿的误诊与经验（Misdiagnosis and experience of fever, low back pain, abdominal pain and hematuria）.doc

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发热、腰痛、腹痛、血尿的误诊与经验（Misdiagnosis and experience of fever, low back pain, abdominal pain and hematuria）

发热、腰痛、腹痛、血尿的误诊与经验（Misdiagnosis and experience of fever, low back pain, abdominal pain and hematuria） Misdiagnosis and experience of fever, low back pain, abdominal pain and hematuria 2011-06-13 Yin Hengqiang, Wang Xinhua, Wu Hongchi Case history summary Patient male, 25 years old, teacher. Patients with fever and sore throat in July 1, 1997 admitted to hospital, the diagnosis of acute tonsillitis. The hospital received intravenous injection of penicillin 8 million u/d, 2D fever, sore throat, but persistent back pain, abdominal pain, paroxysmal intensified macroscopic hematuria. Transferred to our hospital on the evening of July 6, 1997. The emergency room received urinary tract infection and urinary calculi and was received in the medical ward. Is living history: previous health, no history of tuberculosis. In February before the emergence of frequency and urgency of micturition, painful urination and other symptoms. Physical examination at admission: T37.5 degrees C, R 24 times, /min, P 100 times, /min, BP16/12, kPa (120/90, mm, Hg). Lucid, acute pain tolerance, body skin, mucosa no rash and bleeding. Facial flushing, pharyngeal and soft palate obvious hyperemia, bilateral tonsils I degrees swelling. The heart and lungs were not abnormal, the abdomen was flat and soft, the liver and spleen were not big, the left lower abdomen was obviously tender, no muscle tension, rebound pain, and bilateral renal percussion pain. The left side was characterized by no swelling at both lower extremities. Laboratory examination: hemoglobin 135g/L, white blood cells of 10.2 * 109/L, neutral 0.8, 0.2 lymph; urine: urine protein of red blood cell 50/HP + + + +. There was no abnormal X-ray in the heart, lungs and abdomen, and the abdominal radiograph was negative. Double kidney B: normal. Liver function: aspartate transaminase 162 U/L, alanine transaminase 180 U/L, total bilirubin 17.24 mu mol/L, direct bilirubin 2.57 mol/L, indirect bilirubin 14.67 mu mol/L. Urine cultures were negati