免疫不全状態でない高齢者のサイトメガロウイルス胃腸炎の1例

Cytomegalovirus Gastroenterocolitis in a Non-immunodeficiency Late: Elderly Man, Report of a Case

要旨　患者は83歳，男性．腰椎圧迫骨折にて入院し，第12胸椎の椎体形成術と第10胸椎から第1腰椎の後方除圧固定術を受けた．術後16日目から下痢，粘血便が出現したため当科を受診した．消化管内視鏡検査で直腸に単発の輪状潰瘍，胃幽門前庭部に打ち抜き様の大きな単発潰瘍を認めた．サイトメガロウイルス（cytomegalovirus ; CMV）感染症を疑い，胃の生検にてCMV感染症と診断した．本例は重篤な基礎疾患や免疫抑制剤・ステロイド剤の服用がなかった．抗ウイルス療法を行わず，胃と直腸の潰瘍は軽快した．本例は高齢者で免疫不全を認めなかったが，手術が誘因となりCMV胃腸炎を発症したと考えられた．

　An 83-year-old woman was admitted with compression fracture at the lumbar vertebra. She received vertebroplasty and posterior lumbar interbody fusion. From the sixteenth postoperative day, she had diarrhea and bloody feces. She received a medical examination in our hospital. Endoscopy showed a circular ulcer at the rectum and a giant excavated ulcer at the pyloric portion of the stomach. The biopsy from the stomach detected CMV（cytomegalovirus）infection. She was diagnosed as suffering from CMV infection. She was free of other severe diseases and didn't receive medications by immunosuppressive drugs and steroids. She was administered non-anti CMV therapy. We reported a case of CMV gastroenterocolitis with a gastric and a rectal ulcer in a non-immunodeficiency late elderly woman.