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近年来伤寒一副伤寒的临床特点发生了变化,其原因与病原体的自然演变、预防接种、确诊前应用抗菌药物以及合并葡萄球菌感染等有关。抗菌药物的院外早期应用也是促成这些疾病呈轻型和症状不典型的原因。在临床特点的变化上特别值得注意的是,半数以上伤寒具有假性脑膜炎、谵妄、感染性精神病、脑炎和昏迷等神经-精神障碍;重型伤寒病初的症状可能是不典型的,或早期出现肠穿孔、肠出血、急性脱水、感染-中毒性休克等合并症。上述种种情况常常使早期诊断发生困难。当然,由于这些疾病的发病率下降,人们对其目前的特点不够熟悉也不应忽视。
In recent years, the clinical features of typhoid fever have changed. The reasons are related to the natural evolution of pathogens, vaccination, the use of antimicrobial agents before diagnosis and staphylococcal infection. Early out-of-hospital antimicrobial use is also contributing to the atypical appearance of these diseases. Of note for changes in clinical characteristics is the fact that more than half of the typhoid fever is associated with neuropsychiatric disorders such as meningitis, delirium, infectious psychosis, encephalitis and coma; symptoms at the beginning of severe typhoid fever may be either atypical or Early intestinal perforation, intestinal bleeding, acute dehydration, infection - toxic shock and other complications. The above situations often make early diagnosis difficult. Of course, because of the decline in the incidence of these diseases, people are not familiar with their current characteristics and should not be overlooked.