─最近注目される腸管感染症─クラミジア直腸炎

Chlamydia trachomatis Proctitis

要旨●クラミジア直腸炎は，いくら状・半球状小隆起が典型的内視鏡像とされるが，自験例では典型例が少なく，丈の低い隆起や隆起を伴わない例を認めている．自験例46例のうち初回内視鏡検査時に隆起性病変を認めた42例では丈の低い隆起を27例（58.7％），不整隆起を17例（37.0％），丈の高い隆起（典型例）を4例（8.7％）に認めた．隆起を伴わなかった4例（8.7％）では，びらん・アフタ，発赤の所見を認めた．クラミジア直腸炎では，半球状小隆起以外の内視鏡所見が認められることも多いと考えられ，診断に注意が必要である．

　The typical endoscopic view of Chlamydia trachomatis proctitis is known as “salmon roe-like rectal mucosa” or “semispherical nodules”. However, we observed an atypical view of Chlamydia trachomatis proctitis. Here we report these endoscopic findings. We studied 46 patients with a diagnosis of Chlamydia trachomatis proctitis infection.

　Many patients with Chlamydia trachomatis proctitis infection show atypical nodular lesions. In the first endoscopic examination of 46 patients, nodular lesions were observed in 42. “Short nodules” were observed in 27 patients（58.7%）, “irregular nodules” were observed in 17（37.0%）, and “semispherical nodules” were observed in 4（8.7%）. No nodule was observed in four patients（8.7%）at their first endoscopic examination, and “erosion”, “aphtha”, or “erythema” was observed in these patients.

　We believe that atypical endoscopic findings of Chlamydia trachomatis proctitis can be found in most patients, if carefully observed.