不明熱を伴った眼トキソカラ症の1例

A case of ocular toxocariasis with episodes of idiopathic fever

要約　目的：原因不明の発熱を繰り返し，両眼のトキソカラ症が同時に生じた症例の報告。症例と所見：29歳男性が4週間前から原因不明の発熱，関節痛，全身倦怠感を3回繰り返し，左眼視力が0.1に低下した。眼底には孤立性の白斑が右眼，白色の隆起性病変が左眼黄斑部にあった。血清のToxocara CHEKとELISAが陽性で，眼トキソカラ症と診断した。左眼にトリアムシノロンのテノン囊下注射を行い，黄斑部の病変は縮小し視力は1.2に改善した。結論：眼トキソカラ症では発熱などの全身症状を伴うことがある。

Abstract.　Purpose：To report a case of bilateral ocular toxocariasis with episodes of idiopathic fever as the initial manifestation. Case and Findings：A 29-year-old male presented with visual acuity of 0.1 in the left eye. He had had three episodes of fever, pain in the joints, and lassitude in the last 4 weeks. Funduscopy showed a solitary white patches in the right eye and an elevated white lesion in the left macula. His serum was positive for toxocara by Toxocara CHEK and ELISA tests, leading to the diagnosis of ocular toxocariasis. The macular lesion in the left eye resolved following subtenon injection of triamcinolone with visual acuity improving to 1.2. Conclusion：Ocular toxocariasis may manifest signs of systemic involvement during the initial stage of the disease.