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近年伤寒临床表现有非典型化趋向,因而临床上对本病的诊断进行了较多探索。一、临床诊断典型伤寒的临床表现有持续发热、表情淡漠、相对缓脉、玫瑰疹和肝脾肿大等。但近年伤寒典型表现不多见,热型以不规则热和弛张热居多。玫瑰疹的阳性率低,有报道仅1.93％。过去伤寒以脾大居多,近年肝大多于脾大。表现淡漠不多见,白细胞减少不明显。大部分病例趋向轻型化,但亦有不少病例病情重、热程长。本病轻重与伤寒杆菌的毒力有关。由于伤寒临床表现的变迁,作为本病诊断线索的临床指征应适当放宽,以免误诊和漏诊。
In recent years, the clinical manifestations of typhoid fever atypical tendency, so clinically the diagnosis of the disease carried out more exploration. First, the clinical diagnosis of typical clinical manifestations of typhoid fever continued fever, apathy, relative slow pulse, roseola and hepatosplenomegaly. However, in recent years, the typical performance of typhoid fever rare, hot type to irregular heat and relaxation heat mostly. Rosemary positive rate is low, there are only 1.93% reported. In the past typhoid mostly spleen, most of the liver in recent years, splenomegaly. Indifferent indifference, leukopenia is not obvious. Most cases tend to be light-weight, but there are also many cases of serious illness, fever long. The severity of the disease and Salmonella typhi related. Due to the change of clinical manifestations of typhoid fever, clinical indications as the diagnostic clues to this disease should be appropriately relaxed to avoid misdiagnosis and missed diagnosis.