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脑病伴有局限性神经体征和意识改变是伤寒症少见的并发症,死亡率较高。本文报告伴有脑干损害临床特症的典型伤寒1例,其病变由于中脑和桥脑的急性弥散性脑脊髓炎(静脉周围脱髓鞘性大脑白质炎)所引起。患者男性,25岁,因间歇性发热一月入院。临床诊断为伤寒症。经磺胺增强合剂(Co-trimoxazole)治疗好转。在第11天再度发热,伴轻度毒血症和精神错乱。病情恶化,血培养有伤寒杆菌生长。48～72小时后发热和毒血症消退,临床症状改善。但次日病人迅速进入深昏迷,瞳孔固定,中等散大,心动过速;
Encephalopathy with limitations of neurological signs and changes in consciousness is a rare complication of typhoid fever, high mortality. This article reports a case of a typical typhoid associated with clinical features of brain stem damage that is caused by acute diffuse encephalomyelitis (demyelinating leukointethis) in the midbrain and pontine. Male patient, 25 years old, hospitalized for January due to intermittent fever. Clinical diagnosis of typhoid fever. Treatment with Co-trimoxazole improved. Re-fever on day 11 with mild toxemia and delirium. Exacerbations, blood culture with Salmonella typhi growth. 48 to 72 hours after fever and sepsis subsided, clinical symptoms improved. But the patient quickly into the deep coma the next day, the pupil fixed, medium and large, tachycardia;