急激な意識障害で死亡し，脳膿瘍を認めた成人Eisenmenger症候群の一剖検例

An autopsy case of adult Eisenmenger's syndrome complicated with cerebral abscess

　今回，意識障害を主徴として来院した36歳のEisen—menger症候群で，剖検の結果，左前頭葉の2×3×2cmの膿瘍が左側脳室に穿破し，脳炎，髄膜炎が死因となった一症例を経験したので，若干の文献的考察を加えて報告する。

A 36 years old man was admitted to our hospital because of somnolence. He was acutely ill, with sign of cyanosis, however, no physical signs of left ven-tricular failure were revealed. The diagnosis of Eisenmenger's syndrome was convincingly made by the findings of electrocardiogram and chest x-ray, in spite of rather faint murmur not louder than one grade in lower left sternal border, and the diagno-sis of cerebral abscess was also suspected strongly because of psychotic disorder and generalized in-flammatory signs. On third hospital day the patient developed nuchal rigidity with fever of 38.6℃, the following day the patient rapidly lapsed into coma, and on fifth hospital day the patient died. Postmor-tem examination revealed large VSD of 2×4 cm in diameter with biventricular hypertrophy prepon-derance of right ventricle. In addition to this, ab-scess of 2×3×3 cm in size is demonstrated in white matter of the left frontal area, which perforat-ed into left lateral ventricle. Subsequently macro-scopic pathological findings of purulent encephali-tis and meningitis is revealed.