新生児クラミジア結膜炎8例の検討

Review of eight cases of newborn chlamydial conjunctivitis

要約　目的：新生児クラミジア結膜炎の臨床像と経過の報告。対象と方法：過去8年5か月の間に2診療施設を受診した新生児クラミジア結膜炎8例15眼を対象とした。男児4例，女児4例であり，全例が満期自然分娩であった。確定診断にはクラミジアPCR法または蛍光抗体染色法を原則として用いた。治療には主にフルオキノロン薬の点眼液または軟膏を用いた。結果：出生から眼脂などの症状発現までの期間は平均6日，症状発現から診断確定までの期間は平均20日であった。治療開始からクラミジアPCR法または蛍光抗体染色法の所見が陰性化するまでの期間は平均92日であり，治癒までの日数は点眼回数と有意差がなかった。結論：新生児クラミジア結膜炎では診断確定までに時間を要することが多い。治療では確実な抗菌薬の長期間にわたる局所投与が必要である。

Abstract.　Purpose：To report clinical features and course of newborn chlamydial conjunctivitis. Cases and Methods：This review was made on 15 eyes of 8 cases who were seen in two institutions during the past 8 years 5 months. The series comprised 4 male and 4 female infants. All were born full term by vaginal delivery. Diagnosis was made by fluorescent antibody staining or polymerase chain reaction. They were treated by topical fluoroquinolones. Results：Conjunctivitis became manifest at an average of 6 days after birth. It took an average of 20 days before diagnosis was confirmed after onset of symptoms. It took an average of 92 days of treatment before findings by fluorescent antibody staining or polymerase chain reaction became negative. Duration of treatment was independent of frequency of instillation. Conclusion：Prompt diagnosis of newborn chlamydial conjunctivitis is difficult. Long-term topical treatment by antifungal agent is necessary to achieve permanent cure.