恶性组织细胞病(恶组)临床表现多种多样,常易延误诊断。特别是当合并其他疾病时,更给本病的诊断带来一定的困难。笔者最近收治1例恶组合并伤寒,且以伤寒为首发表现,现报告如下。患者、男,33岁。既往健康。因持续高热30天,腹泻20天入院。查体:T40.2℃,P104次/分,热病容,浅表淋巴结不大。心肺正常。腹软,肝大,右肋缘下3cm,质软,脾于左肋缘下4cm,肝脾均有压痛。肠鸣音存在。入院后连续三次血培养及一次骨髓培养均示伤寒杆菌生长。骨髓像示感染刺激性骨髓像。诊断:伤寒(败血症型)。给予静滴氨基苄青霉素。每日8g,并口服复方新诺明,每日2g,治疗一周发热仍不退,逐改用氯霉素静滴,每日2 Malignant histiocytosis (evil group) a variety of clinical manifestations, often easy to delay diagnosis. Especially when combined with other diseases, but also to the diagnosis of the disease brought some difficulties. I recently admitted to a case of evil combined typhoid fever, and typhoid fever as the first performance, are as follows. Patient, male, 33 years old. Past health. Due to sustained high fever 30 days, 20 days admitted to hospital diarrhea. Physical examination: T40.2 ℃, P104 times / min, fever, superficial lymph nodes is not large. Cardiopulmonary normal. Abdominal soft, liver, right rib margin 3cm, soft, spleen in the left margin of the ribs 4cm, liver and spleen are tenderness. Bowel sounds exist. Three consecutive blood cultures and one bone marrow culture showed the growth of Salmonella typhi after admission. Bone marrow imaging showed irritating bone marrow. Diagnosis: typhoid (sepsis type). Give intravenous infusion of ampicillin. Daily 8g, and oral administration of cotrimoxazole, 2g daily, fever is still not treated for a week, by chloramphenicol intravenous infusion, daily 2