水痘発症後の小児ぶどう膜炎の1例

Uveitis in a child following varicella

要約　目的：水痘の発症後に生じた汎ぶどう膜炎に治療が奏効した小児の報告。症例：9歳男児が視力低下で受診した。3週間前に水痘が発症し，皮疹が5日間続いた。発症と同時に左眼の充血と視力低下があった。所見：視力は右1.5，左0.7で，左眼に前房の炎症，硝子体混濁，網膜静脈の白線化，網膜滲出斑があった。急性網膜壊死に準じてアシクロビル点滴を開始した。2週間後に視力が1.5に改善し，バラシクロビル内服に切替えた。初診から3か月後には炎症性病変は鎮静化した。全経過中，右眼には病変はなかった。結論：水痘に続発した片眼性の汎ぶどう膜炎に対し，急性網膜壊死に準じた薬物療法が奏効した。

Abstract.　Purpose：To report a child who developed unilateral panuveitis following varicella infection. Case：A 9-year-old boy presented with impaired visual acuity in the left eye. He had suffered from varicella 3 weeks before that lasted for 5 days. The left eye became hyperemic with impaired visual acuity. Findings：Visual acuity was 1.5 right and 0.7 left. The left eye showed signs of iridocyclitis,vitreous opacity,sheathing of retinal veins,and retinal exudates. He was treated by intravenous infusion of acyclovir and peroral prednisolone similar to the guideline for acute retinal necrosis. Visual acuity improved to 1.5 2 weeks later and the treatment was switched to peroral baracyclovir. Intraocular inflammation subsided 3 months later. The right eye remained free of lesions throughout. Conclusion：Systemic treatment similar to that for acute retinal necrosis was effective for pediatric uveitis following varicella infection.