感冒様症状後に発症した眼窩筋炎の1例

A case of ocular myositis preceded by symptoms simulating influenza

要約　目的：感冒様症状後に発症した眼窩筋炎の症例を報告する。症例：43歳男性。咽頭痛，発熱などの感冒様症状の出現1か月後に眼痛と複視が出現した。所見と経過：両眼の結膜充血，浮腫，眼球運動障害，CT上，両眼4直筋肥厚を認め，眼窩筋炎と診断した。プレドニゾロン120mg/日の投与で速やかに眼所見は改善した。ステロイド漸減中に再発したが，増量により軽快した。結論：インフルエンザウイルス感染が眼窩筋炎の誘因となった可能性がある。眼窩筋炎は急性期にステロイド全身投与が著効するが，本症例のように両眼4直筋が罹患した場合は，再発の危険性が高く，ステロイドの漸減には注意が必要である。

Abstract.　Purpose：To report a case of ocular myositis following symptoms of influenza. Case：A 43-year-old male presented with diplopia and ocular pain. He had had fever and pain in the pharynx 6 weeks before. Findings：Corrected visual acuity was 1.0 right and 1.5 left. Both eyes showed chemosis and conjunctival injection. Both eyes were totally immobile and were vertically and horizontally displaced. Computed tomography showed thickening of all extraocular muscles. Laboratory data showed elevation of influenza virus B IgG titer and not IgM. The patient was given prednisolone at the daily dosis of 120 mg. Ocular pain disappeared the next day. Ocular motility almost normalized after 3 months of treatment. There has been no recurrence for one year until present. Conclusion：This case illustrates that ocular myositis may have been triggered by influenza virus that it may respond to systemic corticosteroid.