病原性大腸菌腸炎（O18）の1例

Escherichia coli O18 Associated Colitis, Report of a Case

要旨　患者は74歳，男性．1995年8月13日，腹痛と頻回の下痢が出現．翌日，血便を伴うようになり当科入院．大腸内視鏡検査では肝彎曲部から横行結腸に著明な浮腫，発赤した粘膜，粘膜下血腫，縦走傾向の潰瘍を認め，注腸X線検査では上行結腸から横行結腸にかけて拇指圧痕像を認めた．肝彎曲部と横行結腸には縦走傾向の潰瘍もみられた．X線・内視鏡像および生検組織像からは虚血性腸炎との鑑別を要したが，内視鏡下生検培養の結果，病原性大腸菌O18を検出し，病原性大腸菌腸炎と診断した．抗生剤を投与し，約1週間で症状，検査成績とも改善し，その後施行した大腸内視鏡検査でも浮腫は消失し潰瘍瘢痕を認めた．

　A 74-year-old man was admitted to our hospital with the complaint of abdominal pain and frequent bloody diarrhea. Colonoscopy showed reddish and edematous mucosa, submucosal hematoma and ulceration in the proximal transverse colon. Barium enema examination also showed thumbprinting and longitudinal ulcer in the proximal transverse colon and ascending colons. Histological findings of the biopsy specimen taken from the ulceration suggested ischemic changes. Microbial culture of endoscopic biopsy specimens was positive for enteropathogenic E.coli O18. He was diagnosed as having E.coli O18-associated colitis. He recovered one week later under the treatment of an antibiotic agent, and subsequent colonoscopy revealed a scarred ulcer.