Intern: Good morning, Dr. Zhang.

實(shí)習(xí)醫(yī)生：張醫(yī)生，您好！

Dr. Zhang: Good morning. Let’s make the morning ward round.

張醫(yī)生：你好！咱們查房吧。

Intern: Ok. This is a new patient who was hospitalized last night because of febrile convulsion. He is a two-year-old boy.

實(shí)習(xí)醫(yī)生：好的。這是一名昨天夜里新收的病人，因高熱驚厥入院，是個(gè)兩歲的男孩。

Dr. Zhang: How about his temperature? Have any antipyretics and sedatives been given?

張醫(yī)生：他的體溫情況如何？給過(guò)解熱藥何鎮(zhèn)靜抗驚厥藥了嗎？

Intern: His temperature is as high as 40.2℃, Aspirin has been given orally. The dose is 150mg.  And Sodium Luminal was given intramuscularly. The dose is 75mg. Drugs have already quieted him down.

實(shí)習(xí)醫(yī)生：他體溫高達(dá)40.2攝氏度，已給阿司匹林150mg口服及魯米那鈉75mg肌注，藥物已經(jīng)使他安靜下來(lái)了。

Dr. Zhang: Anything else?

張醫(yī)生：還給什么了？

Intern: also gave him some fluid, I mean. 500ml of 10% glucose solution with Vitamin C 1.0g by intravenous drip, and place an ice bottle on his forehead.

實(shí)習(xí)醫(yī)生：補(bǔ)了液，也就是，10％葡萄糖液加1克維生素C靜脈滴注，并在他前額加了冰袋。

Dr. Zhang: Well done. Pass me his medical record, please.

張醫(yī)生：干得好。請(qǐng)把他的病歷遞給我。

Intern: Here it is.

實(shí)習(xí)醫(yī)生：給您。

Dr. Zhang: Thank you. Let me see…present illness.

張醫(yī)生：謝謝。讓我來(lái)看看…說(shuō)說(shuō)現(xiàn)病史吧。

Intern: The boy had a fever the day before yesterday. With clear nasal discharge, mild cough, headache, sore throat, anorexia, vomiting and mild diarrhea. His parent regarded it as common cold, and gave him some Aspirin. The following day, Penicillin was given by intramuscular injection, with dose of 400,000 U each time, twice a day. It seems to have no effect.

實(shí)習(xí)醫(yī)生：這個(gè)孩子前天開(kāi)始發(fā)燒，伴流清涕，輕咳，頭痛，咽痛，食欲不振，嘔吐及輕微腹瀉。家長(zhǎng)認(rèn)為是感冒，服了阿司匹林。次日肌注青霉素40萬(wàn)單位，一日兩次，但沒(méi)有效果。

Dr. Zhang: Has he ever had history of febrile convulsion?

張醫(yī)生：他以前有高熱驚厥史嗎？

Intern: Yes. The attack occurs each time his temperature is over 39℃.

實(shí)習(xí)醫(yī)生: 有。每當(dāng)他體溫超過(guò)39攝氏度時(shí)，就會(huì)發(fā)生高熱驚厥。

Dr. Zhang: Is there an epidemic fever in his kindergarten?

張醫(yī)生：他們幼兒園有發(fā)熱流行嗎？

Intern: Yes, two-thirds of the children in his kindergarten have fever this week. They have the symptoms similar to his.

實(shí)習(xí)醫(yī)生：有。這周幼兒園里有三分之二的孩子都發(fā)燒了，癥狀與他相似。

Dr. Zhang: I see. Now let’s take a physical examination of him.

張醫(yī)生：我明白了?，F(xiàn)在就來(lái)給他體檢一下吧。

Intern: No abnormal signs except for redness and enlargement of his tonsils.

實(shí)習(xí)醫(yī)生：除了雙側(cè)扁桃體充血腫大外，無(wú)其他異常。

Dr. Zhang: No rashes?

張醫(yī)生：沒(méi)有皮疹嗎？

Intern: No.

實(shí)習(xí)醫(yī)生：沒(méi)有

Dr. Zhang: Any blood test?

張醫(yī)生：驗(yàn)過(guò)血了嗎？

Intern: Yes. White blood cell count shows WBC 4,000/mm3, N34%, L66%. May I think of this case as the infection of upper respiratory tract?

實(shí)習(xí)醫(yī)生：驗(yàn)過(guò)了。白細(xì)胞總數(shù)4000/mm3, 中性34％，淋巴66％。我可以考慮這個(gè)病例是上呼吸道感染嗎？

Dr. Zhang: Yes, but what’s the causative pathogen?

張醫(yī)生：可以。但病原是什么呢？

Intern: Upon analysis of clinical characteristics, laboratory and epidemic data, we can almost confirm the diagnosis of influenza. The causative pathogen is surely influenza virus, do you agree?

實(shí)習(xí)醫(yī)生：根據(jù)臨床特征，實(shí)驗(yàn)室及流行病資料分析，我們幾乎可以確診為流感了，病原當(dāng)然是流感病毒了，您同意嗎？

Dr. Zhang: Yes, I think so. It’ll be much better if we have the evidence about isolation of virus.

張醫(yī)生：同意，要是有病毒分離的依據(jù)就更完整了。

Intern: Do you think the prognosis of influenza is generally good?

實(shí)習(xí)醫(yī)生：您認(rèn)為流感的預(yù)后一般說(shuō)是良好的嗎？

Dr. Zhang: Generally speaking, yes, but it does no harm to keep an eye on the underlying problems, for example, brain damage, myocarditis, etc. Oh, it’s time for us to give our orders. Stop here.

張醫(yī)生：一般來(lái)說(shuō)，預(yù)后良好，但留心那些潛在的問(wèn)題是有益處的，如腦損害，心肌炎等，哦，我們?cè)撻_(kāi)醫(yī)囑了，就到這里吧。