2）腸チフス・パラチフス

Typhoid Fever and Paratyphoid Fever

要旨　厚生労働省が2類感染症に指定している細菌感染症の腸チフス・パラチフスについて，特に腸チフスを中心に概説した．臨床像は腸チフスが重症であるが類似しており，いずれもニューキノロン製剤が奏功する．従来，腸チフスは終末回腸が好発部位とされてきたが，近年，右側結腸から左側結腸にかけて潰瘍性病変が発生することも明らかとなっている．重症度，病悩期間や治療の有無で消化管病変の程度に差はあるが，消化管病変の確認と病歴や血液検査所見を加味すれば本症を疑うことは困難ではない．

　Clinical features of typhoid fever and paratyphoid fever have been reviewed. Whereas the symptoms are more severe in typhoid fever, clinical features of the two infections are not obviously different. In both infections, quinolones are the choice of treatment. While the terminal ileum has been described as being the most frequent site of involvement, it has been recently reported that the colon also can possibly by affected by the micro-organisms. Although the degree of intestinal involvement varies according to the severity, confirmation of the intestinal damage, together with the histories and laboratory data, seems to contribute to the diagnosis of typhoid fever and help to determine what therapies should be applied.