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一例48岁男性医生,在柬泰边境的抗氯喹及抗法西达恶性疟流行区为柬埔寨难民治病一个月,本人未服预防药。在回美国后两周发热。发病后7天入院,体温39.9℃。主诉间歇性头痛、恶心、呕吐、精神紊乱一周和无尿12小时。体检:有中度嗜睡和定向障碍,有对答反应。皮肤黄染,有扑翼样震颤。眼底及心肺正常。肝肋下12cm、软有触痛。脾未及。颈软,神经系正常。化验:血清电解质均低于正常。血清尿素氮、肌酐、总胆红质和直接胆红质各为101、6.8、9.4和4.7mg/dl。凝血酶原时间36%(60～130%为正常)。血氨正常。AKP、SGOT、SGPT和LDH分别为132、277、208和890u/l。
A 48-year-old male doctor, a month before the Cambodian refugees were treated in the anti-chloroquine and anti-Fastida epidemic areas along the Cambodian-Thai border, did not take preventive medicine. Two weeks after returning to the United States fever. Seven days after onset of admission, body temperature 39.9 ℃. Chief complaint of intermittent headache, nausea, vomiting, mental disorder for a week and anuria 12 hours. Physical examination: moderate drowsiness and disorientation, response to the response. Yellow skin, a flapping-wing tremor. Fundus and cardiorespiratory normal. Liver ribs 12cm, soft tenderness. Spleen not yet. Neck soft, normal nervous system. Laboratory: serum electrolytes were lower than normal. Serum urea nitrogen, creatinine, total bilirubin, and direct bilirubin were 101, 6.8, 9.4 and 4.7 mg / dl each. Prothrombin time 36% (60 ~ 130% is normal). Blood ammonia normal. AKP, SGOT, SGPT and LDH were 132, 277, 208 and 890 u / l, respectively.