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病历摘要患者女,46岁,农民。因间歇发热1年余于1991年2月10日入院。1年多前,无明显诱因突然高热,体温39.4℃,4天后住某县医院,注射青霉素、庆大霉素,发热如故,并渐渐出现头晕、乏力、腹胀,进一步检查发现肝脾肿大,白细胞减少,肥达氏反应(±),按伤寒治疗10天,体温不降,又试验性抗痨治疗2周无效转入我院。化验:血红蛋白(Hb)95g/L,白细胞(WBC)2.6×10~9/L,未见幼稚细胞。血小板(BPC)96×10~9/L。骨髓中网状细胞9％,考虑为反应性网状细胞增生。B超示胆管炎、胆囊多发结石。遂用头孢唑啉静滴,同时口服强的松40mg/天
Medical record Summary Female patient, 46 years old, farmer. One year due to intermittent fever in February 10, 1991 admission. More than a year ago, no obvious incentive for sudden high fever, body temperature 39.4 ℃, 4 days after living in a county hospital, injection of penicillin, gentamicin, fever as before, and gradually dizziness, fatigue, bloating, further examination found that hepatosplenomegaly, Leukopenia, Widal reaction (±), 10 days by typhoid fever, body temperature does not drop, and experimental anti-tuberculosis treatment 2 weeks invalid transferred to our hospital. Assay: hemoglobin (Hb) 95g / L, white blood cells (WBC) 2.6 × 10 ~ 9 / L, no naive cells. Platelets (BPC) 96 × 10 ~ 9 / L. 9% of the reticulocytes in the bone marrow are considered as reticulocyte hyperplasia. B ultrasound showed cholangitis, multiple gallstones gallbladder. Then cefazolin intravenous infusion, while oral prednisone 40mg / day