临床资料患者,男,45岁,农民。因发热7 d、全身散在红斑3 d,于2012年10月5日就诊。患者7 d前不明原因发热,体温高达39℃,伴畏寒、全身肌肉酸痛、疲乏无力、出汗、畏食;3 d前患者胸腹部出现粉红色斑疹,后蔓延到肩背部,不痒,无意中发现右大腿内侧一浅溃疡。患者居住在天津郊县,未到过我国西南和东南地域,发病前曾到野外务农。既往体健,无 Clinical data Patient, male, 45 years old, farmer. Due to fever 7 d, the whole body scattered erythema 3 d, on October 5, 2012 treatment. Patients with unexplained fever 7 days ago, body temperature up to 39 ℃, with chills, muscle aches and weakness, fatigue, weakness, sweating, fear of food; 3 days before the patient appeared pink and white spots on the chest and abdomen, spread to the back and shoulders, itch , Accidentally found a shallow ulcer on the inside of the right thigh. Patients living in the suburbs of Tianjin, have not been to the southwest and southeast of China, before the onset of farming to the outside world. Past physical health, no