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NEJM：“甜甜圈”样病变-病例报道

2019-03-07 xing.T 网络

咽喉疼痛发热链球菌
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“甜甜圈”样病变为红斑性丘疹，中心苍白，可能存在于软腭和硬腭上。这些病变的存在表明之前发生过A组链球菌咽炎相关的临床症状。

患者为一名健康的9岁女孩，因咽喉疼痛和发热而诊所就诊。

她的体温为38.5°C，体格检查显示颈部淋巴结肿大，悬雍垂肿胀，扁桃体增大，硬腭和软腭上都有“甜甜圈”样病变（如图A和B所示）。A组链球菌的快速抗原检测试验为阳性，咽喉样本培养证实为A组β-溶血性链球菌。



“甜甜圈”样病变为红斑性丘疹，中心苍白，可能存在于软腭和硬腭上。这些病变的存在表明之前发生过A组链球菌咽炎相关的临床症状。

该患者接受口服阿莫西林治疗10天，无并发症，症状恢复。

原始出处：

Akira Kobayashi,et al.“Doughnut” Lesions.N Engl J Med 2019;https://www.nejm.org/doi/full/10.1056/NEJMicm1810556

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    2019-03-12 183****7028

    学习

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    2019-03-11 183****7028

    学习

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    2019-03-09 183****7028

    学习

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    2019-03-07 laoli

    谢谢分享，学习了

    0

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    2019-03-07 明月清辉

    谢谢分享，学习了

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=362535, encodeId=46403625355f, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/iaAVWEsIJUkA1ITy3uL0lhHUhyaJibWgFtH4KbJuaLbY2WUK33jgCFyoZ8Eqx7eE7hCuZhytc1C5GRrfjVXN8lYg/0, createdBy=fcb82149579, createdName=183****7028, createdTime=Tue Mar 12 21:07:14 CST 2019, time=2019-03-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=362414, encodeId=084e36241496, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/iaAVWEsIJUkA1ITy3uL0lhHUhyaJibWgFtH4KbJuaLbY2WUK33jgCFyoZ8Eqx7eE7hCuZhytc1C5GRrfjVXN8lYg/0, createdBy=fcb82149579, createdName=183****7028, createdTime=Mon Mar 11 07:02:58 CST 2019, time=2019-03-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=362336, encodeId=367a36233695, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/iaAVWEsIJUkA1ITy3uL0lhHUhyaJibWgFtH4KbJuaLbY2WUK33jgCFyoZ8Eqx7eE7hCuZhytc1C5GRrfjVXN8lYg/0, createdBy=fcb82149579, createdName=183****7028, createdTime=Sat Mar 09 21:17:11 CST 2019, time=2019-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=362204, encodeId=b21a362204ec, content=谢谢分享，学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLC1BMzZWdMSPQWuib6BtQGicK8ygGBM6YakpfkRc67soFSuKbZr86enL1KggQZEZbgWSeicJibafmYfQ3AibicIHMwwicmDShfRFvvI38/0, createdBy=272a110164, createdName=laoli, createdTime=Thu Mar 07 19:00:33 CST 2019, time=2019-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=362183, encodeId=1a77362183ea, content=谢谢分享，学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Thu Mar 07 09:30:01 CST 2019, time=2019-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=362178, encodeId=336d3621e899, content=很好的学习机会, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/04/12/cd30eefc465f70dc4dad89bd57479781.jpg, createdBy=02be2318568, createdName=一天没事干, createdTime=Thu Mar 07 08:29:07 CST 2019, time=2019-03-07, status=1, ipAttribution=)]
    2019-03-07 一天没事干

    很好的学习机会

    0

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