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双重麻烦
Double Trouble


Christopher Smith ... 其他 • 2019.11.07

本刊的这一栏目中,某真实患者的信息按阶段(粗体)呈现给一名临床专家,后者对这些信息出回应,和读者分享相关背景信息及其推理(常规字体)。作者随后出评论。

 

一名51岁男性因持续4周的咳嗽伴发热、寒战、疲劳和关节疼痛到其初级保健医师处就诊。该患者最初咳出的是带血的痰,之后变成干咳。症状出现后不久,患者到急诊就诊,医师为其开出阿奇霉素。1周后,另外一名医师为其开出克拉霉素,用于治疗持续存在的症状。患者病情在接下来2周内未好转。患者自诉无鼻塞、咽喉痛、头痛、耳痛、呼吸困难、恶心、腹泻、排尿困难皮疹。





作者信息

Christopher Smith, M.D., Gurpreet Dhaliwal, M.D., Sanjay Saint, M.D., M.P.H., Evan A. Farkash, M.D., Ph.D., and Puneet Garg, M.D.
From the Veterans Affairs (VA) Ann Arbor Medical Center (C.S., S.S., P.G.) and the University of Michigan Medical School (C.S., S.S., E.A.F., P.G.) — both in Ann Arbor; and the University of California, San Francisco, School of Medicine and the San Francisco VA Medical Center — both in San Francisco (G.D.). Address reprint requests to Dr. Smith at the University of Michigan Medical School, F4323 UH S., 1500 E. Medical Center Dr., Ann Arbor, MI 48109, or at casz@med.umich.edu.

 

参考文献

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