男,29岁,瑶族,农民,住院号201534。因左耳流脓伴进行性头痛半月,呕吐一次,于1986年8月17日中午来急诊。患者于8月2日左耳开始流脓,伴同侧耳痛和头痛。8月10日头痛加重,在当地看过一次门诊,回家后出现呕吐,失眠,厌食,从此卧床不起。16日晚头痛剧烈而尖叫。左耳有反复流脓史。出生后即聋哑。体查:体温36.9℃(腋),脉搏78次,呼吸18次,血压180/100。神志淡漠,烦躁。消瘦,五官尚端正。双侧瞳孔3mm,对光反射存在。颈硬。心肺听诊正常。舟状腹。未引出病理反射。左耳:耳廓外形正常。耳轮脚见一瘘口,干净。外耳道内充满恶臭脓液。右耳未查。血常规:白细胞总数16200,中 Male, 29 years old, Yao nationality, farmer, hospitalization number 201534 Due to left ear pus with progressive headache for half a month, vomiting, at noon August 17, 1986 emergency. The patient started to have pus on the left ear on August 2, with ipsilateral earache and headache. August 10 increased headache, seen in a local clinic, go home vomiting, insomnia, anorexia, from bedridden. 16th night severe headache and screaming. Left ear repeated pus history. After birth, deaf and dumb. Physical examination: body temperature 36.9 ℃ (axillary), pulse 78 times, breathing 18 times, blood pressure 180/100. Feel indifferent, irritable. Weight loss, facial features are still correct. Bilateral pupil 3mm, the presence of light reflex. Hard neck. Cardiopulmonary auscultation normal. Boat-shaped abdomen. Did not lead to pathological reflex. Left ear: pinna shape normal. See a fistula mouth, clean. External auditory canal filled with foul pus. The right ear is not checked. Blood: total white blood cells 16200, in