緑膿菌の二次感染による予後不良な麦粒腫の2例

Two Cases of Hordeolum with Poor Prognosis due to Secondary Infection of Pseudomonas Aeruginosa

緒言

　麦粒腫といえば，抗生物質の出現以前はかなり重篤な合併症や続発症も稀には見られたようである^1）が，現在では一般に予後の良好な疾患と考えられている。麦粒腫と診断が決まると医師も患者も一安心するのが普通であろう。

　しかし，ここに報告する2例は，一見単純な麦粒腫で始まつたが，緑膿菌の二次感染により良好な経過をとらずに，眼瞼の壊死脱落，角膜潰瘍，全眼球炎，眼窩蜂窠織炎といつた予想外の重篤な続発症状を惹起した例である。

　A 41-year-old male had been under treatment for acute myeloid leukaemia with systemic steroid and antibiotics for 2 weeks. Hordeolum developed in the right lower eyelid and resulted, two days later, in orbital phlegmone and severe restriction of ocular motility. Staphlococcus aureus and Pseudomonas aeruginosa was isolated from the pus so that topical and systemic treatment with Gentamycin was started on the 5th day of the disease. The inflammation further progressed to involve the orbit and the eyeglobe necessitating the removal of the eye due to panophthalmitis two weeks after onset of initial signs of the hordeolum.