鉴别诊断 Rubin医生:本例平素健康的26岁男性是由于间歇发热而入院,其发热于入院前3个月回加尔各答探亲时开始出现。在探家期间,他照料过一位曾患急性发热性腹泻综合征的家属,该患者经服药控制疾病,几天后,患者与另一位曾照料患病家属的人均得病。其发病的初始症状是高热、寒战及身体多处疼痛。曾应用氨苄青霉素及随后应用氯喹对本病可能有或无影响。然后大约有1个月的间隔期。入院前3周患者回到美国,出现消耗性发热及腹泻,几天后消退。经过1周表面上恢复健康之后,反复发热,伴有类流感症状但无腹泻。入院时高热,脉率112/min,可闻收缩期杂音。实验室检查资料包括脓尿、贫血、白细胞计 Differential Diagnosis Rubin, MD: The 26-year-old man, normally healthy, was admitted to hospital for intermittent fever and fever started returning to Calcutta three months before admission. During his visit, he had taken care of a family member who had had an acute febrile diarrhea syndrome who was given medication to control the disease. A few days later, the patient became ill with another who had taken care of the sick relatives. The onset of the initial symptoms are fever, chills and multiple body pain. Ampicillin has been used and the subsequent application of chloroquine may or may not affect the disease. Then there is an interval of about one month. Three weeks before admission, the patient returned to the United States with consumable fever and diarrhea, which subsided in a few days. After 1 week of regaining health on the surface, it recurred repeatedly with symptoms of flu but no diarrhea. High fever on admission, pulse rate 112 / min, systolic murmur can be heard. Laboratory tests include pyuria, anemia, white blood cell count