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为提高对大肠杆菌败血症的认识和及时作出诊断,本文回顾性分析我院近年来经血培养证实为大肠杆菌败血症的病历.分析其中19例在血培养证实前的误诊情况:误诊为伤寒3例,急性胃肠炎3例,上呼吸道感染2例,流行性出血热1例,仅诊断出败血症的原发灶或迁徙灶者5例;由于仅注意到原发病而漏诊败血症者5例.由于本病缺乏特征性临床表现,故早期诊断有一定困难,再加上多数患者不发热,血白细胞不增高,未出现明显的呕吐、腹泻等,更易造成误诊,均应引起临床警惕.
In order to improve the understanding of Escherichia coli sepsis and make a timely diagnosis, this paper retrospectively analyzed the medical records of Escherichia coli septicemia confirmed by the blood culture in our hospital in recent years.Analysis of misdiagnosis of 19 cases before blood culture confirmed: 3 cases were misdiagnosed as typhoid fever, 3 cases of acute gastroenteritis, upper respiratory tract infection in 2 cases, 1 case of epidemic hemorrhagic fever, only the diagnosis of primary or migratory sepsis in 5 cases; only to pay attention to the primary disease and missed 5 cases of sepsis. The lack of characteristic clinical manifestations of the disease, so early diagnosis has some difficulties, coupled with the majority of patients without fever, white blood cells do not increase, no obvious vomiting, diarrhea, etc., are more likely to cause misdiagnosis, should cause clinical vigilance.