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患者男,60岁,护林员,长年深居山林。入院前3天突起畏寒发热,全身酸痛不适。无鼻塞、咳嗽等上呼吸道卡他症状。起病第2天在卫生室按感冒治疗,仍持续高热、乏力、腰痛、双眼胀而不适、恶心。发病条4天来诊收住院治疗。入院体检:T39.3℃,P92次/m,血压9.2/6.6kpa,双腋下可见散在出血点数个,双眼睑结膜充血,球结膜轻微水肿。项软、心肺无异常,肝脾未扪及,脐周有轻微压痛,无反跳痛,双肾区叩击痛阴性,束臂试验(+)。实验室检查:血红蛋白10克。白细胞总数15.2×10~9/L,中性粒细胞0.78,淋巴细胞0.22(异型淋巴0.02),血小板96×10~9/L,出凝血时间正常;尿蛋白(卅),红细胞1—3/HP,白
Male patient, 60 years old, ranger, for many years in the mountains. 3 days before admission, chills and fever, body aches and discomfort. No stuffy nose, cough and other upper respiratory tract symptoms of catarrhal. Day 2 onset in the clinic by the cold treatment, still continued high fever, fatigue, low back pain, dilated eyes and discomfort, nausea. The incidence of four days to receive admission treatment. Admission medical examination: T39.3 ℃, P92 times / m, blood pressure 9.2 / 6.6kpa, double armpits scattered blood spots visible, double eyelid conjunctival hyperemia, conjunctival minor edema. Item soft, no abnormal heart and lung, no palpable liver and spleen, mild umbilical tenderness, no rebound tenderness, perineal area percussion pain, beam arm test (+). Laboratory tests: hemoglobin 10 grams. The total number of leukocytes 15.2 × 10 ~ 9 / L, neutrophils 0.78, lymphocytes 0.22 (atypical lymphoid 0.02), platelets 96 × 10 ~ 9 / L, the clotting time is normal; urinary protein (卅), erythrocytes 1-3 / HP, white