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患者苏××,男,20岁,住院号73831。主因高热5天入院。体检:T39.3℃,咽部充血,扁桃体不大,全身浅表淋巴结未触及,心肺正常,肝脏未及,脾在左肋下可及2指,压痛(+)。化验:Hb13.5g,Pc17万,WBC9800,S35％,N40％,L9％,M2％,中幼粒4％,晚幼粒10％,肥达外裴氏试验:O(-)、H(-)、PA(-),PB1:40、OX_(19)1:320。临床诊断:1、斑疹伤寒。2、类白血病反应?经用四环素治疗后体温正常,脾脏回缩,但末梢血杆状粒细胞仍占28％,分叶核呈二叶,很少见到三叶,所有粒细胞均为成熟粒细胞的特点,核染色质粗而浓集,中性杆状核形态呈花生、哑铃、眼镜样。家系调查:5名成员中,除其父未见粒细胞异
Su Su × ×, male, 20 years old, hospital number 73831. The main reason for fever 5 days admission. Physical examination: T39.3 ℃, pharyngeal hyperemia, tonsil, systemic superficial lymph nodes not touched, normal heart and lungs, liver and spleen in the left ribs and 2 fingers, tenderness (+). Assay: Hb 13.5g, Pc 170000, WBC 9800, S 35%, N 40%, L 9%, M2%, medium 4%, late 10% ), PA (-), PB1: 40, OX_ (19) 1: 320. Clinical diagnosis: 1, typhus. 2, leukemia reaction? After treatment with tetracycline, normal body temperature, spleen retraction, but still accounted for 28% of peripheral blood stem cells, leaf lobes showed two leaves, seldom seen clover, all the granulocytes are mature The characteristics of granulocytes, nuclear chromatin thick and concentrated, neutral rod-shaped nuclear morphology was peanuts, dumbbells, glasses. Pedigree investigation: Among the five members, no granulocyte exception was found except for his father