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本例有如下特点:一、少年男性、不规则高热3个月,可自动退热伴大量出汗;二、肝脾肿大,脾大呈进行性;三、病程很快恶化、出现颈部淋巴结肿大、黄疸、全身出血、抽搐、昏迷;四、常验室检查:全血细胞减少,乙型肝炎表面抗原1:32阳性,死前转氨酶一度升高,现结合病史应考虑下列诊断: 一、疟疾:本病可呈不规则热型,体温波动大,可自动退热伴盛汗及肝脾肿大,反复发作可贫血、黄疸,恶性疟疾严重者可发生抽搐与昏迷(脑型疟疾),本例病程3月,血片及骨髓穿刺涂片均未找到疟原虫,病程中出现淋巴结肿大、全身出血倾向等、不符合本
This example has the following characteristics: First, young men, irregular high fever for 3 months, can be automatically fever with a large number of sweating; Second, hepatosplenomegaly, splenomegaly was progressive; Third, the course of the disease deteriorated rapidly, there neck Lymph node enlargement, jaundice, systemic hemorrhage, convulsions, coma; Fourth, laboratory examination: pancytopenia, hepatitis B surface antigen 1:32 positive, elevated aminotransferase once, now combined with the history should consider the following diagnosis: one Malaria: The disease can be irregular heat type, body temperature fluctuations, can automatically heat with sweating and hepatosplenomegaly, recurrent anemia, jaundice, severe malaria may convulsions and coma (cerebral malaria) , The course of 3 months of this case, blood and bone marrow puncture smear were not found in malaria parasites, lymph nodes appear during the course of swelling, systemic bleeding tendency, etc., not in line with this