女性患者48岁,住院号76501。因发热40天,黄疸20天于1981年10月4日入院。40天前(8月24日)因受凉后咽痛伴畏寒、高热在广医院用四环素静滴2天,全身发生弥漫性粟粒样充血疹,停药10天左右皮疹消退。9月18日因畏寒、发热、咽痛去门诊用庆大霉素静滴2天,热不退且于颈胸部出现皮疹及两肺散在干湿罗音,按“肺炎’用红霉素静滴治疗即出现恶心、呕吐及全身不适,次日发现小便深黄,巩膜皮肤黄染。查肝功能明显损害,又按“肝炎”治疗10天无效。因肥达氏反应有二次效价递增又疑诊“伤寒”用氯霉素试治5天,体温仍不退,黄疸继续加深,黄疸指数从20单位急骤上升至120单位。因诊断不明而转本院。既往有“湿疹”史。对染发液及发乳有过敏史。1981年1月口服四环素,半月前用过庆大霉素。入院体格检查:体温37℃,脉搏76次/分,血压90/60mmHg,全身皮肤、粘膜明显黄染,颈部见少 Female patient 48 years old, hospital number 76501. Due to fever for 40 days, jaundice 20 days in October 4, 1981 admission. 40 days ago (August 24) due to cold and sore throat with aversion to chills, high fever in the hospital with tetracycline intravenous infusion of 2 days, the whole body occurred diffuse miliary congestion rash, withdrawal 10 days or so the rash subsided. September 18 due to chills, fever, sore throat go to the clinic intravenous infusion of gentamicin for 2 days, eager to return to the neck and neck rash and scattered in both lungs wet and dry rales, according to “pneumonia” with erythromycin Intravenous treatment that nausea, vomiting and general malaise, the next day found deep yellow urine, scleral skin yellow dye .Check liver function was significantly damaged, according to the “hepatitis” treatment for 10 days is invalid.Because of Widal reaction with secondary titer Increased and suspected Suspected “cholera” Try chloramphenicol for 5 days, the body temperature still does not refuse, jaundice continues to deepen, jaundice index rose sharply from 20 units to 120 units due to unknown diagnosis and transferred to the hospital .Previous “eczema” history . Has a history of allergy to hair dye and hair milk. January 1981 oral tetracycline, gentamicin used half a month before admission Physical examination: body temperature 37 ℃, pulse 76 beats / min, blood pressure 90 / 60mmHg, body skin, mucous membrane Clear yellow dye, see less neck