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患者女,28岁,1989年5月19日入院,高烧37.8—39.5℃,右颈部有一指头大小淋巴结,静点大量青霉素,热一直未退,收入院,体温39.6℃,伴有寒战,无腹痛、腹泻、胸痛、咳嗽头痛、呕吐等,右颈部可触及一黄豆大小淋巴结,1周前患口腔溃疡,入院后考虑感染,静点青霉素、先锋霉素、地塞米松,口服牛黄安宫丸等药物治疗,高热仍不退,做肥达氏,外裴氏检查2次,O、H甲,乙均为40倍阴性,O_(x19)320倍阳性,粒细胞在2.5×10~9～4.0×10~9/L,嗜酸细胞计数O,临床初诊伤寒不除外,经传染病医院会诊不支持伤寒、斑疹伤寒的诊断。血培养“无细菌生长”,在骨髓
The patient, 28 years old, was admitted to hospital on May 19, 1989 with a high fever of 37.8-39.5 ° C. There was a finger-sized lymph node in the right neck and plenty of penicillin in her stillness. She had never withdrawn and was admitted to the hospital with a temperature of 39.6 ° C. Abdominal pain, diarrhea, chest pain, cough headache, vomiting, etc., the right neck can reach a soybean-sized lymph nodes, oral ulcers 1 week ago, consider infection after admission, intravenous penicillin, cephalosporins, dexamethasone, oral Niuhuangan Gong Pills and other drug treatment, high fever is still not retreat, so fat Darth, Pei check 2 times, O, H A, B were 40 times negative, O_ (x19) 320 times positive, granulocytes in 2.5 × 10 ~ 9 ~ 4.0 × 10 ~ 9 / L, eosinophil count O, clinical initial diagnosis of typhoid is not excluded, the infectious disease hospital consultation does not support the diagnosis of typhoid and typhus. Blood culture “bacteria-free growth” in the bone marrow