伤寒有其特殊发病规律及典型症状,近年来变异很大,致使早期诊断有一定困难。为了提高对不典型伤寒的诊断水平,本文拟结合未能早期确诊的病例进行分类讨论,并将近年之变异略加论述:第一类:以高烧、腹痛、白细胞增高等,急腹症为特征,初诊为肠穿孔腹膜炎,胆石症,胆道蛔虫症。病例:男性,20岁,于一周前发烧,自认为感冒,服 APC、黄连素等药,每天仍参 Typhoid fever has its own special pathogenesis and typical symptoms, great variation in recent years, resulting in early diagnosis has some difficulties. In order to improve the diagnosis of atypical typhoid fever, this article is intended to be combined with the cases of early diagnosis can not be classified discussion, and the recent variation of a little discussion: the first category: high fever, abdominal pain, leukocytosis, acute abdomen characterized , Initial diagnosis of intestinal perforation peritonitis, cholelithiasis, biliary ascariasis. Case: Male, 20 years old, had a fever a week ago, considered a cold, taking APC, berberine and other drugs, still daily