A 26-year-old male patient presented with myalgia,headache and fever in both lower limbs for 5 days and macula for 2 days.He was suspected insect bites from reservoir activities 5 days ago.Physical examination showed T:38.2℃-38.5℃,vital signs stable.Multiple light red and dark red macules,patches and maculopapular rashes presented on the lower limbs,chest,abdomen and upper limbs,bean to finger size,circular and irregular shape,clear border,fast color,no escharb.He felt mild tenderness of bilateral ankle joint and gastrocnemius muscle.Laboratory examination:Weifer's reaction OX19 1∶160,mild liver function impairment.Diagnosis:endemic typhus.Anti-rickettsial treatment:oral doxycycline(0.2 g/d)combined with levofloxacin tablets(0.5 g/d),no fever from the day of administration.Eight days later,the patient's rash basically subsided,no joint pain and headache.
维普
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