试题与答案

患者,男,28岁,持续高热10余天伴腹泻7天入院。患者两周前曾因头痛、咳嗽、发热来院

题型:问答题 案例分析题

题目:

患者,男,28岁,持续高热10余天伴腹泻7天入院。患者两周前曾因头痛、咳嗽、发热来院就诊,诊断为“上呼吸道感染”,治疗后好转。约一周后再次发热,体温升高达39~40℃,并出现腹胀、腹泻(25次/天),偶有黏液,无里急后重,右下腹隐痛,伴食欲差,恶心、呕吐,曾先后服阿莫仙、氟哌酸未见明显改善。

体检:体温39℃,脉搏120次/分,呼吸26次/分,血压100/60kpa。急性病容,轻度脱水貌,神志清。躯干背侧隐约可见3处米粒大小、压之褪色的淡红色皮疹。腹部略膨隆,轻度腹肌紧张,脐周压痛(+),反跳痛(-)。肝右肋下2cm,脾左肋下12cm,质中等。腹部移动性浊音(-),肠鸣音活跃。其余无异常。

实验室检查:血液检查示:中性粒细胞3.1×10/L,肥达氏反应1:320。粪便检查:粪便培养无致病菌。

对本病例作出诊断。写出诊断依据,并对临床表现作出相关解释。

答案:

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参考答案:对

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