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1 病史摘要 患者,女,38岁,教师。因畏寒、高热伴腹部膨隆3月余,院外疑诊恶性组织细胞病于1992年1月17日以发热待查收入我院。患者于1991年11月开始无明显诱因出现畏寒、发热,全日体温38℃～40.2℃;体温下降时伴大汗。无咳嗽、腹泻;无泌尿系症状;无鼻衄、牙龈出血。于沙市某医院就诊发现肝、脾肿大,按“胆囊炎”予青霉素、氨苄青霉素、甲硝唑治疗10余夭,体温不退转沙市一医院。查肥达氏反应阴性;血培养3次无细菌生长;B超示肝、脾肿大;骨穿(3次)示“反应性增生”(其中组织细胞1.2％,偶见异形、吞噬型)。两次血吸虫、环卵试验阳性,IHA(间接血凝抑制试验及乳胶试验)阴性。疑诊“血吸虫病”转江陵
1 history abstract patient, female, 38 years old, teacher. Due to chills, fever with bulging abdomen more than 3 months, out-of-hospital suspected malignant histiocytosis on January 17, 1992 with fever to be admitted to our hospital. Patients in November 1991 there was no obvious incentive chills, fever, the whole body temperature 38 ℃ ~ 40.2 ℃; body temperature drops with sweating. No cough, diarrhea; no urinary symptoms; no nose and throat, bleeding gums. Found in a hospital in Shashi liver, splenomegaly, according to “cholecystitis” to penicillin, ampicillin, metronidazole treatment of more than 10 days, the body temperature does not retreat Shashi a hospital. Cultures (3 times) showed “reactive hyperplasia” (1.2% of which cells, occasionally abnormal, phagocytic type) . Schistosoma twice, ring egg test positive, IHA (indirect hemagglutination inhibition test and latex test) negative. Suspected “schistosomiasis” to Jiangling