论文部分内容阅读
患者男,23岁。发烧,体温38℃,脐周阵发性疼痛,水样大便每天6次左右,经用复方新诺明等药治疗两天,腹痛,腹泻消失,但每天下午仍有发烧,体温波动在37.5～38℃之间,同时伴有畏寒。8天后体温逐渐达39～40℃,全身肌肉酸痛无力,尤以四肢为甚。继之肿胀,疼痛加重病人难以忍受,曾转治几个医院,按“疟疾”,“伤寒”,“风湿性肌痛”等病治疗,高烧仍持续不退,四肢肿痛无明显好转。自发病来病人无呕吐、咳嗽、吐痰,无夜间盗汗及出血倾向。体检:T39℃,P100次/分,R:25次/分,BP:9/4.5kPa,全身皮肤及粘膜无出血点,黄染,瘀斑,四肢及胸背部有散在斑丘疹,腋下及腹股沟有10余个黄豆大小之淋巴结,活
Male patient, 23 years old. Fever, body temperature 38 ℃, umbilical weeks of paroxysmal pain, watery stool about 6 times a day, after treatment with cotrimoxazole and other drugs for two days, abdominal pain and diarrhea disappear, but still have a fever every afternoon, body temperature fluctuations in 37.5 ~ 38 ℃, accompanied by chills. After 8 days the temperature gradually reached 39 ~ 40 ℃, muscle weakness, especially in limbs. Followed by swollen, pain aggravated the patient unbearable, has been transferred to several hospitals, according to “malaria”, “typhoid fever”, “rheumatic myalgia” and other diseases, high fever continued unabated, no significant improvement in limb swelling and pain. Since the onset of patients with no vomiting, cough, spit, no night sweats and bleeding tendency. Physical examination: T39 ℃, P100 beats / min, R: 25 beats / min, BP: 9 / 4.5kPa, whole body skin and mucous membrane without hemorrhage, yellow dye, ecchymosis, scattered rash in limbs and chest and back, Groin has more than 10 soybean-sized lymph nodes, live