単純ヘルペスウイルス結膜炎の臨床像

Clinical features of herpes simplex conjunctivitis

　単純ヘルペスウイルス（HSV）を結膜から分離できた66例において，その臨床所見をアデノウイルス（Ad）あるいはクラミジアトラコマティス（C．tr）が結膜から同じように分離培養できた78例，68例と比較検討して，次の結果を得た。

　1．HSV眼感染の64／65（98.5％）が片眼性であり，再発は30歳以上に12／14（85.7％）と多い。

　2．眼感染におけるHSVは全て1型であった。初感染と再発の比は8例：14例であり，再発の2例ではいずれも初感染と再発の際に分離した株の遺伝子型は同一であった。

　3．HSV特有の眼瞼，角膜病変を示さぬHSV結膜炎は10／22（45％）に認められ，clinical EKC中の頻度は3.6％であった。

We evaluated the clinical features of 66 patients with conjunctivitis due to herpes simplex virus (HSV). Isolation of HSV from the conjunctival smear was positive through culture with human embryonic kidney cell (HEK) or monkey kidney cell (MK) in all the cases. The findings were compared with those in 146 patients with conjun-ctivitis due to adenovirus (78 cases) or Chlamydia trachomatis (68) seen in the same clinic.

The conjunctivitis was unilateral in 98.5% of cases due to HSV, 27% in those due to adenovirus and 47% due to Ch. trachomatis. The age distribu-tion was 61 children vs. 66 adults for HSV, 67 adults vs. 78 seniles for adenovirus, and 56 newborns vs. 68 adults for Ch. trachomatis. The conjunctivitis was mild to moderate in 39% and 38% each for HSV, severe in 58% for adenovirus and moderate to severe in 35% and 49% each for Ch. trachomatis. The incidence of corneal infiltration was 38% for HSV, 78% for adenovirus and 6% for Ch. tra-chomatis. The HSV was of type 1 in all the cases in the series. The genome type was the same for recurrences of conjunctivitis in each of 2 cases.