病例介绍患者男性37岁因黄疸和贫血入院。患者身体一直好,至3个月前出现疲惫,伴以每日头痛,自项背放射过头顶至额部。饭后觉有胸骨下灼痛感,持续1～2小时,并有恶心。症状延至入院前2周,其时患者开始出现寒颤和发热,并有咳嗽,痰呈棕色,偶带血。某医师诊断为病毒感染并给予咳嗽糖浆。2天后,患者症状好转,但仍咳嗽。入院前6天患者又出现发热并有恶寒战栗。咳嗽加重,并在以后两天中常常呕吐。入院前5天别处就诊。胸部X光片显示右上叶前肺段实变;左肺清晰,未见胸腔积液。给予红霉素,阿司匹林和止吐剂。呕吐迅即消退。在以后的4天中有好几次在躯干和四肢出现无搔痒皮疹,为边界明显的红斑性斑丘疹圆斑,这种皮疹出现及消退均突然。入院前3天小便色深暗。次日其妻子发现患者黄疸。继续服用红霉素同阿司匹林,还加 Case description Male 37-year-old patient admitted to hospital for jaundice and anemia. The patient had been in good condition, exhausted to 3 months ago, accompanied by a daily headache, which had been radiated from the top to the forehead. I feel a sore throat burning after a meal, lasting 1 to 2 hours, and nausea. Symptoms were delayed until 2 weeks before admission, when patients began to shiver and fever, and cough, sputum was brown, even with blood. A physician diagnosed with a viral infection and given cough syrup. Two days later, his symptoms improved but he still coughed. Six days before admission, the patient developed fever and had aversion to chills. Cough worse, and often vomit in the next two days. 5 days before admission other treatment. Chest X-ray showed the right upper lobe anterior consolidation; left lung clear, no pleural effusion. Give erythromycin, aspirin and antiemetics. Vomiting quickly subsided. In the next four days, there were several times itchless rashes on the trunk and extremities, marked by erythematous maculopapular rachis on the border, which appeared suddenly and subsided suddenly. 3 days before admission urine dark color. The next day his wife found the patient jaundice. Continue to take erythromycin with aspirin, plus