流行性出血热(EHF)有典型临床表现者不难诊断,然有些EHF患者仅以某一脏器损害为主或出现其他特殊性表现,此时易误诊。笔者在近4年里收治EHF264例,误诊7例。误诊为急性阑尾炎、急性菌痢、上消化道出血、急性肾盂肾炎各1例,急性黄疸型病毒性肝炎3例。现举例分析如下。 例1:女,37岁,因发热、右下腹痛4天,伴恶心呕吐、周身痛入院。查体:T37.5℃,P100次/min,R24次/min,Bp13/10kPa。全身皮肤粕膜未见出血点,球结膜轻度充血水肿,腹肌紧张,右下腹有压痛。两侧肾区有叩击痛。查血WBC20.2×10~9/L,中性0.78,淋巴0.22,血小板100×10~9/L,尿蛋白(+)。腹部B超无异常,诊断为急位阑尾炎。行阑尾切除术,术中见阑尾长5cm,轻度充血水肿,顺利切除阑尾。木后24小时尿量仅100ml,出冷汗。血压降至10～12/8～10KPa,胸部及两侧腋 Epidemic hemorrhagic fever (EHF) is not difficult to diagnose typical clinical manifestations, but some EHF patients with only one organ damage or other special performance, then misdiagnosed. In the past 4 years, I received EHF 264 cases, misdiagnosed in 7 cases. Misdiagnosed as acute appendicitis, acute bacillary dysentery, upper gastrointestinal bleeding, acute pyelonephritis in 1 case, acute jaundice virus hepatitis in 3 cases. The following is an example analysis. Example 1: Female, 37 years old, due to fever, right lower quadrant pain for 4 days, with nausea and vomiting, whole body pain hospitalized. Physical examination: T37.5 ℃, P100 times / min, R24 times / min, Bp13 / 10kPa. Whole body skin meal membrane no bleeding, conjunctival mild congestion and edema, abdominal muscle tension, right lower quadrant tenderness. Kidney area percussion pain on both sides. Check blood WBC20.2 × 10 ~ 9 / L, neutral 0.78, lymph 0.22, platelet 100 × 10 ~ 9 / L, urinary protein (+). Abdominal B-no abnormalities, the diagnosis of acute appendicitis. Line appendectomy, see the appendix length 5cm, mild congestion and edema, successful removal of the appendix. 24 hours after the wooden urine output only 100ml, a cold sweat. Blood pressure dropped to 10 ~ 12/8 ~ 10KPa, chest and axils on both sides