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近年来由于伤寒疫苗的接种,早期抗生素、激素的广泛使用以及伤寒杆菌菌株的变异,使伤寒临床变异较大,非典型病例增多。临床上常常以长期不明原因发热而入院,容易误诊为其他的疾病。我科于1987年1月～1993年1月共收治发热病人1757例,其中经血、及/或骨髓培养阳性确诊为伤寒者共38例(2.2％),现将该38例有关资料分析如下。 临床资料 一、一般资料:最小年龄为4岁,最大年龄为71岁,其中20～40岁为26例,平均年龄为29.5岁,以年青人为多。男性26例,女性12例,男女之比为2.17:1。入院时间以秋冬季为多,共27例。入院时发热最长时间为65天,最短为3天,平均为25.5天。 二、临床表现:伤寒的典型特征多数不全或缺如,症状、体征复杂多样,典型表现与非典型表现相互夹杂,详见表1。
In recent years, due to the vaccination of typhoid fever, early antibiotics, extensive use of hormones and strains of Salmonella typhi strains, the clinical variation of typhoid fever, atypical cases increased. Clinically often long-term unknown causes of fever and admission, easily misdiagnosed as other diseases. Our department from January 1987 to January 1993 were treated a total of 1757 cases of febrile patients, of which menstrual blood and / or bone marrow culture positive were identified as typhoid fever in 38 cases (2.2%), the 38 cases of the relevant data are as follows. Clinical data First, the general information: the youngest age of 4 years old, the maximum age of 71 years, of which 20 to 40 years old was 26 cases, the average age of 29.5 years old, mostly young people. 26 males and 12 females, the ratio of male to female was 2.17: 1. Admission to more as autumn and winter, a total of 27 cases. The longest period of fever on admission was 65 days, the shortest was 3 days, with an average of 25.5 days. Second, the clinical manifestations: Most of the typical features of typhoid fever are incomplete or absent, complex symptoms and signs, typical and atypical manifestations mixed with each other, as shown in Table 1.