摘要
目的探讨类狂犬病性癔病的临床特点及其与狂犬病的鉴别诊断要点。方法回顾性分析6例误诊为狂犬病的类狂犬病性癔病的临床资料。结果 6例均有犬咬伤史,伤后均及时对伤口进行处理并接种狂犬病疫苗。1-6个月后均无明显诱因出现恐惧、意识恍惚、失眠、口渴、恐水、咽喉紧缩症状,但无流涎、怕风和发热,其中2例饮水呛咳伴狂躁、哭闹不止、颜面潮红、表情痛苦。在我院（4例）及外院（2例）门诊误诊为狂犬病,入我院后经追问病史同时查狂犬病病毒抗体均阴性,6只攻击犬均健康且无异常表现,确诊为类狂犬病性癔病发作。经对症及暗示治疗,咽喉紧缩、恐惧、恐水等症状均缓解,出院。结论临床医师应注意类狂犬病性癔病与狂犬病的鉴别诊断,加强流行病学资料收集和病情观察,重视阳性体征并结合医技检查结果综合分析,以减少误诊。
Objective To explore clinical features of rabies-like hysteria and the key points of differential diagnosis.Methods Clinical data of six patients with rabies-like hysteria misdiagnosed as having rabies was retrospectively analyzed.Results All the six patients had been bitten by dogs,and were treated timely and injected with rabies vaccine. After 1- 6months,the patients had the symptoms of fear,consciousness,insomnia,thirst,hydrophobia and throat striction without obvious inducement and symptoms of salivation,dread of wind and fever. Two of them had bucking while drinking along with excessive crying,blushing and distress expressions. Four patients in our hospital and two patients in other hospitals were misdiagnosed as having rabies,and the rabies-like hysteria was confirmed after history inquiry,negative result of antibody against rabies virus,and the 6 aggressive dogs were healthy and no abnormal appearance was found. The symptoms of throat striction,fear,and hydrophobia were relieved after corresponding and suggestive treatments,and the patients were discharged. Conclusion Clinicians should pay attention to the differential diagnosis of rabies-like hysteria and rabies. Epidemiological data collection and disease observation should be enhanced,and the diagnosis should be made and combined with positive signs and auxiliary examination results in order to reduce the misdiagnosis rate.
出处
《临床误诊误治》
2014年第6期32-33,共2页
Clinical Misdiagnosis & Mistherapy
关键词
癔症
误诊
狂犬病
Hysteria
Misdiagnosis
Rabies
