MumpsおよびHerpes Simplex髄膜炎と考えられる2成人例

TWO SUSPECTED ADULT CASES OF MUMPS AND HERPES SIMPLEX VIRUS MENINGITIS

緒言

　Wallgren^20）により提唱されたaseptic meningitisは発熱，頭痛をもつて急性に発病し，項部強直，kernig徴候をみとめ，髄液所見で細胞数増加，蛋白軽度増加，糖正常値を示し，髄液からの病原性細菌，真菌は陰性で，良性の経過をたどる症候群と考えられる。近年のウイルス学的，血清学的検索の進展とともに，それらの多くがウイルス性であることが明らかにされてきた。

　本邦におけるウイルス性髄膜炎は小児科領域からの報告が主で，Coxsackie，ECHO virusなどの腸管ウイルスによる流行例が多数散見される^{8）18）21）}。

　Two suspected adult cases of mumps and herpes simplex virus meningitis were presented in this report.

　Case 1, 34 years old male, noted swelling of the left parotis on July 22, 1966. A few days later, his right parotis was swelled with fever. Then he complained of severe headache and nausea, andentered to the hospital of the Institute of Medical Science. On admission there were slight stiffness of the neck, kernig sign, slight swelling and tenderness of both parotis and testis. CSF was normal pressure with pleocytosis (134 lymphocytes), total protein content of 37mg, and sugar 53mg/dl. He was recovered rapidly and discharged on Sept. 30. The serum CF titer for mumps virus (Enders' strain) was 256×(Aug. 18), 64×(Aug. 31), and 16×(Sept. 21).

　Case 2, 35 years old female, had acute onset with slight headache and pain in the throat on Feb. 2, 1967. After four days, she was admitted to the hospital of the Institute of Medical Science with the chief complaints of severe headache, fever 39°C, and nausea. She revealed acutely illness, moderate stiffness of the neck, and kerning sign without disturbance of conciousness. There was no stomatitis, and vesicle on her lips. CSF was normal pressure with pleocytosis (212 small lymphocytes), protein 132mg and sugar 42mg/dl. The culture of bacteria and fungus from the liquor were negative. Although she complained of double vision since March 19, her condition was recovered rapidly, and she was discharged May 10, 1967. The serum CF titer for herpes simplex virus (the isolated strain from herpetic keratitis) showed <16×(Feb. 10), 64×(Feb. 20), 64×(March 27), 256×(May 10), and <8×(June 10).