A 28 year-old female was admitted to our hospital because of “fever and cough for 10 days”.
10 days ago, the patient began to have fever (peak temperature 38.0℃) and cough after catching cold. She had no sputum, dyspnea, chest pain and chill. She went to the local hospital 9 days ago, and blood test showed the white blood cell count was normal, chest X-ray showed “pneumonia in the right upper lobe”. She was treated with cefuroxime for 4 days and levofloxacin for 3 days. However, the symptoms had no change. She came to our hospital yesterday, and white blood cell count was 11170/mm3, N 86.4%, chest X-ray still showed “shadow in the right upper lung”. She was admitted to our hospital for further diagnosis and treatment. She had no nausea, vomiting and weight lose. Her sleep and appetite were normal. Her stool and urine were normal too.
Past history: She had 5×4cm subcutaneous abscess with tenderness in left lower limbs without any causes 2 weeks ago. The abscess was excided and drainage. There was nothing else abnormal in the case history review. She had no history of drug allergy.
Personal history and family history were nothing special.
Physical Examination:T37.9℃, P90/min, R20/min, BP110/70mmHg. The patient was well developed and moderately nourished. She was mentally normal and cooperative in the examination. There was 5×4cm subcutaneous abscess with red and tenderness in the left lower limb. Drainage pledget was inside. There was no rash, jaundice and purpura on the skin, and the lymphnodes were not palpable. Her head, eyes, nose, ears and mouth were normal. The neck was soft, and no venous engorgement. Thyroid glands were not palpable. The trachea was in midline. The chest and respiratory movements were symmetrical. No abnormal breath sound. The heart rate was 90/min, regular. No pathological heart murmur. No pericardium friction sound was heard. Abdominal wall was soft without tenderness. The liver and the spleen were not palpable, and there was no shifting dullness. No edema in her lower extremities.
Laboratory tests:
Blood routine test: WBC 8.1×109/L, N 70.2%, Hgb 129g/L, Plt 192×109/L
ESR: 97mm/hr
Urine routine test: normal
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