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1988～1991年间,我院曾有3例儿童狂犬病误诊为散发性脑炎,抢救治疗无效均死亡。为提高对本病的认识,吸取教训,避免误诊,总结报告如下。例1:男,4岁。因发热、兴奋多语3天,抽搐3次,经当地卫生院按高热惊厥治疗无效转来我院,以散发性脑炎于1988年4月10日收住院。查体:T38.9℃,P、R、BP正常。神志清,精神差,心肺未见异常,肝脾不大,病理反射未引出。血常规及CSF正常。入院后情感不协调,兴奋多语,当晚出现恐水、怕风、流涎、抽搐。追问病史,5个月前曾被狗咬伤右手食指,未注射过狂犬疫苗。确诊为狂犬病,抢救治疗无效,于住院第5天死亡。
From 1988 to 1991, 3 cases of childhood rabies in our hospital were misdiagnosed as sporadic encephalitis, and all died of rescue treatment. In order to raise awareness of this disease, learn lessons and avoid misdiagnosis, the summary report is as follows. Example 1: Male, 4 years old. Due to fever, excitement for more than three days, convulsions 3 times, according to the local hospital by fever convulsions invalid transfer to our hospital to sporadic encephalitis in April 10, 1988 admitted to hospital. Physical examination: T38.9 ℃, P, R, BP normal. Consciousness, poor spirit, no abnormal heart and lung, liver and spleen is not large, pathological reflex did not lead. Blood and normal CSF. Feel uncoordinated after admission, excited multilingual, fear of water that night, fear of the wind, salivation, convulsions. Asked history, 5 months ago had been bitten by a dog right index finger, not injected rabies vaccine. Diagnosis of rabies, rescue treatment ineffective, died on the 5th day of hospitalization.