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我院于1980年4月～1998年4月.收治经血、骨髓培养和血清学证实并确诊的伤寒共94例,误诊40例,误诊率42.55%,现对误诊原因进行分析.1 临床资料1.1 一般资料:男32例,女8例,年龄9～52岁.均为散发,病后7～22天确诊,全部病例治愈出院.1.2 临床表现:以不规则发热、乏力、纳差、腹痛腹泻、头痛、嗜睡、听力减退、表情淡漠、咳嗽为主要症状.主要体征为相对缓脉18例,玫瑰疹2例.肝大7例,脾大12例,肝区叩痛4例,肾区叩痛8例,双肺散在干湿罗音8例.急性起病27例,缓慢起病13例.1.3 实验室检查:白细胞总数少于 5 ×10~9/L33例,血小板减少8例,发现异常淋巴细胞8例,肥达氏反应全为阳性,血培养阳性9例,骨髓培养阳性12例,尿蛋白(+～++)22例,(+++～
Our hospital in April 1980 ~ April 1998. admitted to menstrual blood, bone marrow culture and serological confirmed and confirmed typhoid 94 cases, 40 cases were misdiagnosed, the rate of misdiagnosis was 42.55%, now misdiagnosis of the reasons for the analysis.1 clinical data 1.1 General information: 32 males and 8 females, aged 9 to 52 years were distributed, diagnosed 7 to 22 days after the illness, all patients were discharged.1.2 clinical manifestations: irregular fever, fatigue, anorexia, abdominal pain and diarrhea , Headache, drowsiness, hearing loss, apathy, cough as the main symptom.The main signs were relatively slow in 18 cases, rose rash in 2 cases, 7 cases of hepatomegaly, 12 cases of splenomegaly, 4 cases of percussion in the liver area, Pain in 8 cases, double lung scattered in wet and dry rales in 8 cases.Acute onset in 27 cases, 13 cases of slow onset.1.3 laboratory tests: the total number of white blood cells less than 5 × 10 ~ 9 / L33 cases, thrombocytopenia in 8 cases found Abnormal lymphocytes in 8 cases, Widal reaction were all positive, blood culture positive in 9 cases, bone marrow culture positive in 12 cases, urinary protein (+ ~ ++) in 22 cases, (+++ ~