例1,男,39岁,半年前患者劳动时左内踝被刺伤,曾在当地医院治疗数月,伤口不愈。查体:T37.8℃,左腹股沟扪及两个葫豆大之淋巴结,压痛,左内踝见6cm×6cm溃疡,肉芽组织高出皮肤约0.5cm,暗红色,呈菜花状,表面坏死发黑,恶臭,组织质脆,周围皮肤红肿,色素沉着,疑恶性溃疡。两次作溃疡病理活检,报告均为炎性肉芽组织。左胫骨正侧位X线片未见异常。创面分泌物涂片发现革兰氏阴性杆菌,细菌培养枸橼酸杆菌生长。选用敏感抗生素治疗效果仍不佳。准备手术修复创面。查血常规发现:Hb65g/L,RBC2.2×10~(12)/L,WBC17.1×10~9/L,N0.17,L0.83(含原始白细胞)。考虑白血病,作骨穿,骨髓报告证实为急性粒细胞性白血病。例2,女,17岁,一月前左小腿有一小疖,抓破后溃烂,溃疡日渐扩大,左小腿红肿。当地诊所 Example 1, male, 39 years old, six months ago when the patient was stabbed in the left medial malleolus, he had been treated in a local hospital for several months and the wound was unhealed. Physical examination: T37.8 ℃, the left groin palpable two gourd large lymph nodes, tenderness, see 6cm × 6cm ulcer left medial malleolus, granulation tissue about 0.5cm above the skin, dark red, cauliflower, surface necrosis black , Stench, crisp tissue, swelling around the skin, pigmentation, suspected ulcers. Two ulcer pathology biopsy, the report is inflammatory granulation tissue. Left lateral tibia is not abnormal lateral X-ray. Gram-negative bacilli were found on smear of wounds, and citrobacter grew on the bacteria. Selection of sensitive antibiotic treatment is still not good. Prepare surgery for wound repair. Blood tests found: Hb65g / L, RBC2.2 × 10-12 / L, WBC17.1 × 10 ~ 9/L, N0.17, L0.83 (including the original white blood cells). Consider leukemia, for bone wear, bone marrow report confirmed as acute myeloid leukemia. Example 2, female, 17 years old, a month before the left leg has a small claw, scratching broken ulcers, ulcers gradually expanded, left leg swelling. Local clinic