【医学课件】结核病病例（英文版）.pptVIP

Cases Presentation Case HistoryCase 1:2y8m boy, fever, can’t walk, abdominal pain × 15ds, and progress × 3dsBorn and grown up in Guizhou province. Date of admittance: Mar 23th, 2012 History of present illness15ds ago, he couldn’t walk, developed abdominal pain, mild fever and cough.? obvious sweat, ? seizure/ personality changeTreated as lower limbs pain of unknown with Abx by outpatient doctor w/o improvement. Past medical historyHealthyBCG immunization? close contact active TBBirth History: normal Social history living condition is poor Socioeconomic status is lower Physical ExaminationHepatosplenomegaly, Babinski sign (+), decreased muscle tone and strength (3/6) of lower limbsChest: good air entry bilaterally, ? crackle/wheeze Family medical history: Parents: His farther had pulmonary TB in 2009 and been cured. Mother is healthy.No sibling What’s your possible diagnosis?Lower limbs palsy of unknownIntracranial infection?Guillain-Barre Syndrome?Intracranial space-occupying?Transverse myelitis? InvestigationCBC: Hb 96, WBC 10.2 N 69%, Plt 420PPD: pendingBiochemistry: normalSerology for CP, MP and Legionella: all +ve TB Antibodies: (-)CSF analysis: cell 2/μl, protein:1364.2 ( ), AFB (-). Mar 24th, 2012CT scan: Normal An oval sheet opacities at precordium, suggesting CT scanMar 24th, 2012May be a tumor?Neuroblastoma? Mediastinal multiple lymph node calcificationMar 24th, 2012 Thoracic vertebra tuberculosisMar 24th, 2012Cold abscess formation Cold abscess formation Mar 24th, 2012 What is your diagnosis ?Pulmonary TBThoracic vertebra TBCold abscess formation Case 2Case History:10 years girl, vomiting x 6dBorn and grown up in Suburban of Jinhua City, Zhejiang Province, parents are healthy. Date of admittance: Jun 8, 2011 History of present illness6 d ago, She developed vominting, 1-2times/d, no fever and cough.? obvious sweat, ? seizure/ personality change, lost weigh for last 4 wks (BW:19.5kg)Treated as Vomiting of unknown, possible acute gastritis with A