题目内容

男性农民,30岁,5月中旬发病,起病急,发冷、发热,全身肌痛,5天后在某地医院诊断为败血症休克,经静脉补液及氨苄青霉素静脉滴注,次日血压正常,但病情加重,因呃逆、呕吐、尿少入院。体检:体温37.3℃,血压150/100mmHg,皮肤黏膜有瘀点,球结膜充血、水肿,心肺未见异常,肝大,肋下1.0cm,腰部有叩击痛。化验:白细胞50×109/L,中性粒细胞0.85,淋巴细胞0.15,血小板3×10/L,尿蛋白(++++)。最可能的诊断是()

A. 败血症并感染性休克
B. 钩端螺旋体病
C. 伤寒并溶血性尿毒综合征
D. 急性粒细胞性白血病
E. 肾综合征出血热

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