Clinical problem-solving. Building a diagnosis from the ground up--a 49-year-old man came to the clinic with a 1-week history of suprapubic pain and fever.
Clinical problem-solving. Building a diagnosis from the ground up--a 49-year-old man came to the clinic with a 1-week history of suprapubic pain and fever.
复制标题
临床问题解决。
DOI：
10.1056/nejmcps055322
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发表时间：
2007
期刊：
影响因子：
--
通讯作者：
Kauffman,CarolA
中科院分区：
文献类型：
--
作者：
Watts,Brook;Argekar,Pushkar;Saint,Sanjay;Kauffman,CarolA
前言在这篇日志中，关于一个真实的病人的信息分阶段（黑体字）呈现给一个专家临床医生，他对信息做出回应，与读者分享他或她的推理（常规类型）。一位49岁的男性因耻骨上疼痛和发热1周来就诊。检查时，他的体温为38.1 ℃，但看起来很好。尿液分析显示每个高倍视野有大量白色细胞、两个红细胞和两个以上细菌。诊断为尿路感染，并口服加替沙星处方response.ResponseThe可能的原因，这个病人的疾病包括泌尿生殖系统的过程（如膀胱结石，尿路感染，或前列腺炎）或腹腔内的过程（憩室炎，阑尾炎，或局部脓肿），这可能会导致膀胱刺激。虽然细菌性尿道炎......
ForewordIn thisJournalfeature, information about a real patient is presented in stages (boldface type) to an expert clinician, who responds to the information, sharing his or her reasoning with the reader (regular type). The authors' commentary follows.StageA 49-year-old man came to the clinic with a 1-week history of suprapubic pain and fever. On examination, he had a temperature of 38.1°C but appeared well. A urinalysis revealed numerous white cells, two red cells, and more than two bacteria per high-power field. A urinary tract infection was diagnosed, and oral gatifloxacin was prescribed.ResponsePossible causes of this patient's illness include a genitourinary process (such as a bladder stone, urinary tract infection, or prostatitis) or an intra-abdominal process (diverticulitis, appendicitis, or a localized abscess), that can result in irritation of the bladder. Although a bacterial urinary tract . . .