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本例有以下临床特点,(1)持续发热40天,一般情况尚可,无恶病质表现;(2)黄疸阳性而无上腹纹痛,肝功能、转氨酶正常;(3)全身疼痛,臀部剧痛,局部无红、热、水肿;(4)肝脾轻度肿大;(5)血红蛋白、白细胞、中性粒细胞、血小板正常,明显核左移,有中毒颗粒;(6)胸片有广泛病变而无呼吸系统症状和体征。根据上述特点,本例不支持非感染性疾病如结缔组织病、血液病等,应考虑感染性的疾病有以下几种。 1.病霉性肝炎发热时间长,无恶心呕吐等消化道症状,转氨酶、肝功能正常,表面抗原阴性,可除外。 2.胆道感染无上腹部绞痛、压痛及反跳痛,不
This case has the following clinical features, (1) sustained fever for 40 days, the general situation is acceptable, no cachexia performance; (2) positive jaundice and no upper abnormity, liver function, aminotransferase normal; (3) general pain, buttocks Pain, local redness, fever, edema; (4) hepatomegaly mild enlargement; (5) hemoglobin, white blood cells, neutrophils, platelets normal, obvious nuclear shift left, poisoning particles; Extensive disease without respiratory symptoms and signs. According to the above characteristics, this case does not support non-infectious diseases such as connective tissue disease, blood diseases, etc., should consider the following infectious diseases. 1. Mycotic hepatitis fever for a long time, no nausea and vomiting and other gastrointestinal symptoms, transaminases, normal liver function, negative surface antigen can be excluded. 2. Biliary tract infection without upper abdominal cramps, tenderness and rebound tenderness, no