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近年来散发性脑炎报道逐年增多,由于散发性脑炎尚无特异的诊断手段和严格的诊断标准,故往往造成误诊,误诊率可为4.0～32.5％。如颅内肿瘤、精神病、药物反应、结核性脑膜炎、脑血管疾病和多发性硬化均常误诊为散发性脑炎。我们遇及1例貌似散发性脑炎的伤寒并发蛛网膜下腔出血患者,现报告如下。患者,女,15岁,农民,1982年2月5日起感全身不适,畏寒,发热,精神差,纳减,腹胀,便秘。2月12日出现头痛,呕吐,反应迟钝。2月15日患者自言自语,同时出现遗尿和右下肢无力的症状。当地医院诊断为散发性脑炎,患者因治疗无效于2月20日转我院治疗。体检:T40℃,BP90/60,P100,患者神志恍惚,巩膜无黄染,皮肤粘膜未见出血点和皮疹,
Sporadic encephalitis reported in recent years increased year by year, due to sporadic encephalitis no specific diagnostic tools and strict diagnostic criteria, it is often caused by misdiagnosis, misdiagnosis rate of 4.0 to 32.5%. Such as intracranial tumors, mental illness, drug reactions, tuberculous meningitis, cerebrovascular disease and multiple sclerosis are often misdiagnosed as sporadic encephalitis. We met one case of seemingly sporadic encephalitis complicated by subarachnoid hemorrhage, are as follows. Patient, female, 15 years old, peasant, February 5, 1982 from the feeling of general malaise, chills, fever, poor spirit, reduction, bloating, constipation. February 12 headache, vomiting, unresponsive. On February 15th the patient himself said that there were symptoms of enuresis and weakness in his right lower limb. Local hospital diagnosis of sporadic encephalitis, patients invalid due to treatment on February 20 to my hospital for treatment. Physical examination: T40 ℃, BP90 / 60, P100, patients with trance, scleral no yellow dye, skin and mucous membrane no bleeding and rash,