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暴发型伤寒国内很少报告。笔者遇一例符合暴发型伤寒并多器官损害,现报告如下。患者女性,26岁,农妇。因持续高热伴大量毕衄和便血七天,疑钩端螺旋体病,流行性出血热及恶性组织细胞病,于75年5月29日入院。检查:T39.3℃,P 130次,8P17.329/10.664kpQ(130/80mmHg)。神智清楚,急性热病容。球结膜无明显充血水肿,巩膜不黄,浅表淋巴结不大,未见玫瑰疹,四肢皮肤散在出血点。心率130次律齐,心尖Ⅱ级收缩期杂音,双肺(-)。肤平软,肝助下1.5cm,质中等,无触痛,脾未及。双肾区叩击痛(+)。腓肠肌压痛(+)。脑膜刺激征(-),未引出病理神经反射。化验:未梢血WBC 3 × 10~9/L(3,000/mm~3),N64％,
Domestic typhoid rarely reported. I met a case of fulminant typhus and multiple organ damage, are as follows. Patient female, 26 years old, peasant woman. Due to continued high fever with a large number of Bi and blood in the stool for seven days, suspected leptospirosis, epidemic hemorrhagic fever and malignant histiocytosis, on May 29, 75 admitted. Check: T39.3 ° C, P 130 times, 8P17.329 / 10.664 kpQ (130/80 mmHg). A clear mind, acute fever tolerance. Bulbar conjunctiva no obvious hyperemia and edema, sclera is not yellow, superficial lymph nodes is not large, no rose rash, limbs and skin scattered in the bleeding point. Heart rate 130 law Qi, apical systolic murmur, lung (-). Skin soft, liver help 1.5cm, medium quality, no tenderness, spleen is not. Kidney area percussion pain (+). Gastrocnemius tenderness (+). Meningeal irritation (-), did not lead to pathological reflex. Laboratory: WBC blood 3 × 10 ~ 9 / L (3,000 / mm ~ 3), N64%