単純ヘルペス脳髄膜炎にみられた壊死性網膜炎の1症例

A case of herpes simplex encephalomeningitis with necrotizing retinitis

　39歳の男性で，片限の壊死性網膜炎に脳髄膜炎と脳内出血を合併した症例を報告した。眼底病変は乳頭炎と黄斑部網膜に限局した小出血，浮腫で始まり，やがて網膜に濃厚な黄白色滲出斑と動脈炎の所見を生じ，閉塞性網膜動脈炎と壊死性網膜炎に進展した。脳病変は眼病変と同時に発生し，片側の側頭葉内側に出血をみた。ペアー血清で単純ヘルペスウイルスの補体結合抗体価に8倍の上昇をみた。以上の特徴から単純ヘルペスウイルスの感染が原因と考えられた。

A healthy 39-year-old man developed unilateral necrotizing retinitis and encephalomeningitis with intracranial hemorrhage.

Initially, papillitis, scattered retinal hemorrhages and retinal edema were seen at the posterior pole of the right eye. Brain lesions were revealed in the medial portion of left temporal lobe by computeriz-ed tomography.

Fundus changes rapidly worsened and necrotiz-ing retinitis developed. In the macula and at the peripheral retina, massive yellowish white exudates appeared, associated with remarkable sheathing and obstruction of the retinal artery.