以高热、幻觉为主诉的狂犬病首诊为颅内感染的临床特点
| 作者: |
1肖莉,
2熊明敏,
3郁可,
3侯群芳,
3潘先芳,
3陈琳,
3王庆松
1 成都市双流区第一人民医院(四川大学华西空港医院)神经内科，成都 610200 2 西藏自治区人民政府驻成都办事处医院放射科，成都 610041 3 西部战区总医院神经内科，成都 610083 |
| 通讯: |
王庆松
Email: wqs832001@sina.com |
| DOI: | 10.3978/j.issn.2095-6959.2021.09.038 |
摘要
回顾性分析2005年至2019年5例以高热、幻觉为主诉，以“颅内感染”为首诊而入院后临床确诊为狂犬病的患者的临床资料并文献复习。5例患者均以“感冒后高热，幻听、幻视”为主要临床表现，均在高热、幻觉出现后第3天死亡。该回顾研究提示“发热、幻觉”亦是与“恐水、恐风、恐声、恐光、咽肌痉挛、进行性瘫痪”等典型表现并列的狂犬病的主要临床症状，并且从5例患者在“高热、幻觉”出现后72 h后死亡来看，其可能是病情迅速恶化的预示。
关键词：
高热；幻觉；狂犬病；误诊；颅内感染；临床特点
Clinical characteristics of rabies patients with high fever and hallucination initially diagnosed as intracranial infection
CorrespondingAuthor: WANG Qingsong Email: wqs832001@sina.com
DOI: 10.3978/j.issn.2095-6959.2021.09.038
Abstract
The clinical data of 5 rabies patients from 2006 to 2019 were retrospectively analyzed and the literature was reviewed. All the patients complained of high fever and hallucination and were initially diagnosed as intracranial infection. The main clinical manifestations of 5 patients were “high fever, auditory hallucination and visual hallucination after cold”, and they all died on the third day after high fever and hallucination. This study suggests that fever and hallucination are also the main clinical symptoms of rabies, which are juxtaposed with “fear of water, wind, sound, light, pharyngeal spasm, progressive paralysis” and other typical manifestations. Five patients died 72 h after the appearance of high fever and hallucination, indicating that high fever and hallucination may indicate the rapid deterioration of the disease.
Keywords：
high fever; hallucination; rabies; misdiagnose; intracranial infection; clinical characteristics