钩端螺旋体病的早期临床诊断探讨(附108例临床分析)

Early clinical diagnosis of leptospirosis: An analysis of 108 cases

对108例钩端螺旋体病作临床分析,并进一步探讨该病的早期诊断,提出:①有明确的流行病学资料;②典型的三症状三体征;③出现赫氏反应,用青霉素效果明显;④外周血白细胞和嗜中性粒细胞均升高,肾功能有一定损害;⑤凝溶或凝集试验阳性.以上有①+⑤或②+③+④者均可作出临床诊断.同时,需与夏秋季节常见急性热病鉴别.

108 cases of leptospirosis were analyzed and early diagnosis of the disease was also discussed. The results showed there were 1) definite epidemiologic data, 2) three typical signs(lymphadenetasis, conjunctival congestion and tenderness of gastrocnemius muscle) and symptoms(fever, aching pain and acratia), 3) Herxheimer's reaction, 4) increase of WBC and neutrophil in peripheral blood, and certain impairment of renal function and 5) positive reaction in agglutinationlysis or agglutination tests. The diagnosis may be made if there are 1) and 5) or 2), 3) and 4) in the cases. It should be differentiated from acute pyreticosis occurring in summer and autumn.