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患者男,45岁,外科医师。因发热、头痛、腰酸3天,颊面潮红1天伴尿量减少(300ml/d)于1992年3月2日入院。26天前该医师曾为流行性出血热患者因胃肠穿孔而剖腹探查,经回忆在手术时手套被针刺破,有血液渗入手套内。体检:T38℃,R、P、BP均在正常范围,面部潮红如酒醉貌,心肺听诊正常,腹平软,无压痛,肝脾未及。实验室检查:血小板83×10~9/L,找到异型淋巴细胞,BUN10.5mmol/L,Cr124.6μmol/L。尿蛋白++,RBC+,WBC+。血清EHFAb测定(RPHI法)1∶40,牙龈出血,
Male patient, 45 years old, surgeon. Due to fever, headache, backache 3 days, 1 day with buccal flushing decreased urine output (300ml / d) on March 2, 1992 admission. 26 days ago, the physician had exploited a laparotomy for gastrointestinal perforation in patients with epidemic hemorrhagic fever. Memories revealed that the glove was needle punctured during surgery and blood penetrated the glove. Physical examination: T38 ℃, R, P, BP are in the normal range, facial flushing such as drunken appearance, cardiopulmonary auscultation normal, abdominal soft, no tenderness, liver and spleen not yet. Laboratory tests: platelet 83 × 10 ~ 9 / L, found atypical lymphocytes, BUN10.5mmol / L, Cr124.6μmol / L. Urinary protein ++, RBC +, WBC +. Serum EHFAb assay (RPHI method) 1:40, bleeding gums,