内視鏡的に経過観察しえた赤痢アメーバ症の1例

Amoebic Colitis Diagnosed with Biopsy, Report of a Case

　本邦では赤痢アメーバ症の発生頻度は減少の一途を辿り，“忘れられた感染症”とまで言われるほどになった．しかし，病態が軽症から重篤なものに至るまで様々であることや，他疾患との鑑別，殊に潰瘍性大腸炎との鑑別が困難な例が散見され，大腸疾患の鑑別診断上重要な疾患である．われわれは確定診断に1年以上も要した赤痢アメーバ症を経験したので報告する．

　A 49 year-old man with gastric ulcer was admitted to our hospital, complaining of bloody diarrhea for ten days. He had no history of being abroad. Barium enema study and endoscopic examination revealed multiple erosions and mucosal edema in the rectum and cecum in March 1979. Stool culture for Entamoeba histolytica and Shigella was negative. These findings were most suggestive of ulcerative colitis and then prednizolone and salazosulfapyridine were administered for forty six days. Endoscopic examination performed in May 1979 revealed multiple ulcers only in the cecum. After administration of these medicaments for one more month these ulcers healed. Since then he has been asymptomatic until he complained of abdominal distress in July 1980. Endoscopic examination performed then revealed multiple ulcers in the cecum again. The same medicaments were given for three months, but these ulcers did not heal. Biopsy specimen taken in October 1980 revealed Entamoeba histolytica, and immediately after then metronidazole was administered for ten day. These lesions were abolished and now no recurrence is noticed.