肠伤寒误诊126例的探讨

An Approach to Misdiagnosis of 126 Cases of Typhoid Fever

本文回顾近9年间被误诊的126例肠伤寒。本组病例曾被诊断为流行性乙型脑炎(重型)、系统性红斑狼疮、急性化脓性阑尾炎、急性细菌性痢疾、肠梗阻、上呼吸道感染以及其它18种病症。误诊的主要原因:(1)对本地区肠伤寒的新近疫情缺乏了解;(2)对现代肠伤寒的临床特点缺乏认识;(3)对肠伤寒的复杂而众多并发症欠熟悉;(4)对肠伤寒诊断的常规实验室检查方法甚显不足;(5)未能采用肠伤寒早期诊断的多项新技术。

One hundred and twenty six cases of misdiagnosed typhoid fever in past 9 years were reviewed. Their primary diagnosis included epidemic encephalitis B (severe type), systemic lupus erythematosus, acute suppurative appendicitis, acute bacillary dysentery, intestinal obstruction, upper respiratry tract infection and other 18 kinds of diseases. The main causes of misdiagnosis were considered as follows: 1) Lack of understanding the recent epidemic condition of typhoid fever in this area; 2) Lack of realizing the clinical characteristics of modern typhoid fever; 3) Not familiar with various complicated complications of typhoid fever; 4) Routine laboratory examination was not sufficient for the diagnosis of typhoid fever; 5) New technical methods were not employed for the diagnosis of typhoid fever in early stage.