患者,男,54岁。因发热、皮诊4天于1993年2月21日入院。体检:T 39.5℃,P 100次/分,BP17/11kPa,一般情况好。皮肤粘膜无黄染及出血点。面部及四肢皮肤见淡红色的斑状丘疹,直径在1～2cm,有的融合成片,压之褪色,无破溃。浅表淋巴结未触及。咽部充血,扁桃体不大。胸骨无压痛,心肺未闻及异常。腹软,肝脾肋下未触及。四肢关节活动自如,关节无红肿。实验室检查:Hb 120～140g/L,WBC 17.5～26.1×10~9/L,N 0.86～0.91,PC 100～300×10~9/L,分叶核0.47,杆状核0.44,L 0.06,M 0.03.ESR 80～105mm/h,肝功正常。两次血培养及骨髓培养均未培养出细菌,肥达氏及外裴氏反应阴性。ANA及LEC均阴性,两次骨髓细胞形态学检查示感染骨髓像。腹部B超:肝、胆、脾、胰均正常。胸片:肺纹理增多。入院后出 Patient, male, 54 years old. Due to fever, 4 days of diagnosis and treatment was admitted on February 21, 1993. Physical examination: T 39.5 ℃, P 100 beats / min, BP17 / 11kPa, the general situation is good. Skin and mucous membrane without yellow dye and bleeding points. See the face and limbs pale pink patchy pimples, diameter 1 ~ 2cm, and some integration into a film, the pressure of fading, no ulceration. Superficial lymph nodes not touched. Throat congestion, little tonsils. Sternal no tenderness, heart and lungs did not smell and abnormalities. Abdominal soft, liver and spleen ribs did not touch. Joint activities freely limbs, joints without swelling. Laboratory tests: Hb 120-140 g / L, WBC 17.5-26.1 × 10-9 / L, N 0.86-0.91, PC 100-300 × 10-9 / L, lobular 0.47, rod nucleus 0.44, L 0.06 , M 0.03.ESR 80 ~ 105mm / h, normal liver function. Bacteria were not cultured in both blood culture and bone marrow culture, but negative in Widal’s and Pei’s. ANA and LEC were negative, two bone marrow cell morphological examination showed infected bone marrow. Abdomen B ultrasound: liver, gallbladder, spleen, pancreas are normal. Chest radiograph: increased lung markings. After admission