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恶性组织细胞病(简称恶组病)是一种网状内皮(单核-组织巨噬细胞)系统组织细胞异常增生的全身性疾病。此病临床表现多种多样,容易误诊。我们曾遇1例肠型恶组病误诊为慢性菌痢。为吸取教训,介绍如下。陆某,男,36岁。因间歇性发热伴腹痛、腹泻5月余,于1980年4月24日入院。患者于1979年11月初开始无明显诱因间歇性发热,体温高达40.0℃,腹痛,每日腹泻10余次,为黄色稀水便,偶带脓血,轻度里急后重感。经当地医院按“菌痢”治疗,稍好转。近10余日大便次数增加,有时为血便。入院检查:体温38.0℃,慢性病容,颌下可扪及两枚白果大小淋巴结。心肺听诊正常。肝肋下2.0cm,质软,光滑。脾肋下可触及,腹水征阴性。化验检查:血红蛋白10g,白细胞3,200,网织红细胞0.8%,血沉8mm/第1小时。粪常规:红细胞(++),脓细胞(+)。粪培养两次阴性。末梢血找红斑狼疮
Malignant cell disease (referred to as the evil group disease) is a reticuloendothelial (monocyte - tissue macrophages) systemic dysplasia of systemic diseases. The clinical manifestations of the disease varied, easily misdiagnosed. We have encountered a case of intestinal diarrhea misdiagnosed as chronic bacillary dysentery. To learn the lesson, the introduction is as follows. Lu Mou, male, 36 years old. Due to intermittent fever with abdominal pain, diarrhea more than 5 months, in April 24, 1980 admission. Patients in early November 1979 no significant incentive to intermittent onset of fever, body temperature up to 40.0 ℃, abdominal pain, diarrhea more than 10 times a day, for the yellow watery stool, even with sepsis, mild tenesmus. The local hospital by “bacillary dysentery ” treatment, slightly better. Nearly 10 days increased stool frequency, sometimes bloody stools. Admission examination: body temperature 38.0 ℃, chronic disease, submaxilla palpable two gingko size lymph nodes. Cardiopulmonary auscultation normal. Liver ribs 2.0cm, soft, smooth. Spleen ribs can be touched, ascites sign negative. Laboratory tests: hemoglobin 10g, leukocytes 3,200, 0.8% reticulocytes, erythrocyte sedimentation rate 8mm / 1 hour. Dung routine: red blood cells (++), pus (+). Fecal culture twice negative. Find the lupus erythematosus peripheral blood