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狂犬病是一种严重危害人类生命的疾病。该病潜伏期长短不一,病死率极高。死亡人数在法定传染病中的地位已跃居首位或第二位。其典型临床表现为特有的恐水怕风.咽肌痉挛,进行性瘫痪。我院近3年收治4例.其中3例因各种原因误诊。现就思维编差原因作如下分析。1 缺乏专科知识.过分注意常见病,多发病 例1,男性,34岁;因四肢乏力伴吞咽困难、畏寒,咳嗽4天入院。体检:神志清楚,饮水困难,兴奋,多语,四肢肌力正常。入院诊断:散发性脑炎,格林巴氏综合征。为协助诊断行腰穿,脑脊液常规及蛋白容量检查无异常改变。数小时后患者进一步出现恐水症状,追问病史,1个多月前曾被狗咬伤,请传染科会诊,确诊为狂犬病。
Rabies is a serious disease that endangers human life. The incubation period of the disease varies in length, high mortality. The death toll has jumped to the top of the list of notifiable infectious diseases. Its typical clinical manifestations of fear of fear of wind-specific. Pharyngeal muscle spasm, progressive paralysis. 4 cases were admitted to our hospital in recent 3 years, of which 3 were misdiagnosed for various reasons. Now on the basis of thinking difference made the following analysis. 1 lack of specialist knowledge. Over-attention to common diseases, multiple cases 1, male, 34 years old; due to weakness with swallowing difficulties, chills, cough 4 days admission. Physical examination: conscious, drinking water, excitement, multilingual, normal muscle strength. Admission diagnosis: sporadic encephalitis, Guillain-Barre syndrome. To assist in the diagnosis of lumbar puncture, cerebrospinal fluid routine and protein capacity check no abnormal changes. A few hours later the patient further symptoms of water scarcity, history, more than 1 month had been bitten by dogs, infectious disease consultation, diagnosed as rabies.