患者男性,19岁,未婚。因畏寒、高热4天伴呕吐以“发热待查”入院。入院前4d无明显诱因畏寒、发热伴上腹胀痛,起病次日呕吐3次,无腹泻。经青霉素治疗,症状未缓解。体检:热病容,体温39.6℃,脉搏116次/min,未见皮疹及出血点,浅表淋巴结不肿大。心肺正常,肝脾均在肋下0.5cm处触及,质软,无触痛,中上腹有压痛,无肌卫及 Male patient, 19 years old, unmarried. Due to chills, fever 4 days with vomiting to “fever pending” admission. 4d before admission no obvious incentive chills, fever with abdominal pain, onset of vomiting 3 times the next day, no diarrhea. After penicillin treatment, the symptoms did not relieve. Physical examination: fever, body temperature 39.6 ℃, pulse 116 times / min, no rash and bleeding, superficial lymph nodes is not enlarged. Cardiopulmonary normal, liver and spleen are in the ribs 0.5cm at the touch, soft, no tenderness, tenderness in the abdomen, no muscle and Wei and