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男患,33岁。因畏寒、发热伴头痛2天于1991年3月3日入院。查体:T40.1℃,P120次/分,Bp15/8kpa。神清,皮肤粘膜无黄染及出血点,颈软,心肺正常,腹软,肝脾未及,布氏征、克氏征、巴彬氏征(一)。WBC3×10~9/L,N0.60,L0.40。入院当晚呕吐3～4次,为胃内容物,解水样便2次。按“感冒”治疗,曾用激素,体温一度正常。5天后头剧痛、烦躁、呕吐,体温再次上升到39.2℃。巩膜皮肤出现黄疸,项强3指,肝助下2cm、质软、有触痛,脾未及,克氏征(+)。脑脊液外观黄色、混浊,压力74滴/分,潘迪氏试验(+++),WBC7.4×10~9/L,N0.95,L0.05,糖2.0mmol/L,氯化物190mmol/L,涂片未找到细菌。肥达试验两次阳性,血培养、
Male suffering, 33 years old. Due to chills, fever with headache 2 days in March 3, 1991 admission. Physical examination: T40.1 ℃, P120 beats / min, Bp15 / 8kpa. God clear skin and mucous membrane without yellow dye and bleeding points, neck soft, normal heart and lung, abdominal soft, liver and spleen not yet, Bu’s sign, Kirschner sign, Papin’s sign (a). WBC3 × 10 ~ 9 / L, N0.60, L0.40. On the night of admission vomiting 3 to 4 times, stomach contents, water samples will be 2 times. Press “cold” treatment, had used hormones, body temperature was normal. 5 days after the first pain, irritability, vomiting, body temperature rose again to 39.2 ℃. Scleral jaundice appears in the skin, 3 fingers strong, 2cm liver help, soft, tenderness, spleen, Kirschner sign (+). Cerebrospinal fluid was yellow, turbid, the pressure was 74 drops / min, Pandey’s test (+++), WBC7.4 × 10-9 / L, N0.95, L0.05, sugar 2.0mmol / L, chloride 190mmol / L, smear bacteria not found. Wada test twice positive, blood culture,