子宮頸管スクリーニング検査後に発症した新生児クラミジア結膜炎の2例

Newborn chlamydial conjunctivitis in two infants whose mothers had received cervical screening

要約　目的：出産前にスクリーニング検査を受けた母親から生まれた2例に新生児クラミジア結膜炎が発症した報告。症例：生後19日の女児と16日の男児に新生児クラミジア結膜炎が発症した。いずれも片眼に罹患し，主訴はそれぞれ血性眼脂，眼瞼腫脹と眼脂であった。両症例とも蛍光抗体染色とクラミジアPCR法でクラミジア抗原が陽性であった。1例の母親は妊娠34週目のスクリーニング検査では陰性，分娩後の検査では陽性であり，他の1例の母親は妊娠28週目のスクリーニング検査で陽性であり，クラリスロマイシンの投与を受けていた。結論：クラミジア感染についての出産前スクリーニング検査では，検査時期の再検討が望まれる。検査で陽性であった母体から出生した児には注意深い経過観察が必要である。

Abstract.　Purpose：To report 2 infants of newborn chlamydial conjunctivitis who were born from mothers who received cervical screening. Cases and Findings：Newborn chlamydial conjunctivitis developed in a male and female infant each. Both were unilaterally affected. Signs of conjunctivitis became manifest on day 19 and 16 respectively after birth. Both cases were positive for chlamydial antigen by fluorescent antibody staining and polymerase chain reaction. One mother was found negative when screened during 34 weeks of gestation and positive after birth. The other mother was found potisitive when screened during 28 weeks of gestation and was treated with clarithromycin. Conclusion：A modification seems necessary regarding screening for chalamydia during pregnancy. Due observation is advocated on infants born from mothers with a history of positive findings.