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流行性出血热(EHF)临床表现复杂,易被误诊。我院1986年1月～1987年4月共收治116例EHF患者,误诊8例,均经间接免疫荧光抗体(IFAT)检查证实。为提高对本病认识,报告如下: 1.因发热、右上腹痛误诊为急性胆囊炎:男性,46岁,发热、右上腹痛3天,B型超声胆囊肿大,化验白细胞16600/mm~3,诊为急性胆囊炎收入外科。次日血压下降至80/50mm Hg,尿少,经输液及血管活性药物治疗无效转入内科。查体:眼睑浮肿,睑结膜及软腭充血并有点状出血,右上腹压痛,莫非氏征阳性,化验血小板4.5万/mm~3,尿蛋白(++),第6病日IF AT滴1∶160,诊为EHF。按EHF常规治疗,右上腹痛3天后消失,B型超声胆囊缩小,继之进入多尿期,住院21天
Epidemic hemorrhagic fever (EHF) clinical manifestations of complex, easily misdiagnosed. A total of 116 patients with EHF were admitted to our hospital from January 1986 to April 1987, 8 were misdiagnosed. All patients were confirmed by indirect immunofluorescence antibody (IFAT). To improve understanding of the disease, the report is as follows: 1. Because of fever, right upper quadrant pain misdiagnosed as acute cholecystitis: male, 46 years old, fever, upper right abdominal pain for 3 days, B type ultrasound gallbladder enlargement, laboratory white blood cells 16600 / Diagnosed with acute cholecystitis income surgery. The next day the blood pressure dropped to 80 / 50mmHg, oliguria, transfusion and vasoactive drug therapy into the internal medicine invalid. Physical examination: eyelid edema, palpebral conjunctiva and soft palate congestion and a bit of bleeding, right upper quadrant tenderness, Moxi sign positive, laboratory platelets 4.5 million / mm ~ 3, urinary protein (++) 160, diagnosed as EHF. By EHF routine treatment, right upper quadrant pain disappeared after 3 days, B-mode ultrasound gallbladder shrink, followed by entering the polyuria, hospitalization for 21 days