菌塊を形成した涙小管感染症の細菌学的検討

Microbiological features of lacrimal canaliculitis with formation of concretion

要約　目的：菌塊を形成した涙小管炎7例の起炎菌微生物の報告。対象と方法：手術により菌塊を摘出した涙小管炎7例を対象とした。年齢は60～83歳（平均70歳）で，男性1例，女性6例である。膿性分泌物または摘出した菌塊は嫌気培養または塗抹標本と病理組織標本のグラム染色を行った。結果：膿性分泌物の嫌気培養で2例が放線菌と同定され，塗抹標本のグラム染色で5例が放線菌と同定され，1例では病理組織から真菌感染が疑われた。放線菌の6例では，表皮ブドウ球菌や口腔連鎖球菌の混合感染があった。結論：菌塊を形成した涙小管炎では，嫌気培養だけでは放線菌の検出は困難で，塗抹または病理標本のグラム染色が起炎微生物の同定に有用である。

Abstract.　Purpose：To report microbiological findings in 7 cases of lacrimal canaliculitis with formation of concretion. Cases and Method：This study was made on 7 cases of lacrimal canaliculitis who received surgical removal of concretion. The series comprised one male and 6 females. Their age ranged from 60 to 83 years, average 70 years. Concretions or purulent discharge were examined by anaerobic culture or gram staining of pathological specimens. Results：Anaerobic culture of purulent discharge showed Actinomyces israelii in 2 cases. Infection by Actinomyces was proved in 5 cases by gram staining of scrapings. Fungus infection was suspected in one case by pathological examinations. Six cases of Actinomyces infection showed co-infection by oral Streptococci or Staphylococcus epidermidis. Conclusion：Anaerobic culture alone is not sufficient to identify causative organisms in lacrimal canaliculitis with formation of concretion. Additional examinations by gram staining of smear of discharges or pathological specimens may be useful.