受傷2日目に眼球運動障害を呈した重症マムシ咬傷の1例

A case of severe viper bite with impaired ocular motility on the following day

要約　目的：初期には軽傷と診断されたが，複視の出現に伴い重症化したマムシ咬傷の1例の報告。

症例：55歳の男性が左足をマムシに咬まれ近医に入院した。軽傷と判断され翌日に退院したが，退院後に受傷部の腫脹が悪化し複視も出現した。近医眼科を受診し当院を紹介された。

所見：左足関節付近に牙痕があり腫脹は左鼠径部に及んだ。右眼の内転障害と左眼の下直筋麻痺が認められた。重篤な合併症は出現せず症状は徐々に軽快した。受傷23日目には眼球運動障害は改善した。

結論：マムシ咬傷による眼症状の合併は重症化を示唆する因子として重要である。

Abstract　Purpose：To report a case of viper bite exacerbated with development of diplopia despite being diagnosed with minor injury in early phase.

Case：A 55-year-old man was bitten in the left foot by Gloydius blomhoffii and hospitalized. He was diagnosed with minor injury and discharged on day 2 after injury but his left leg swelled a lot and developed diplopia after discharge. He had examinations at the ophthalmological clinic and was referred to our hospital.

Findings：The bite site was near the left lateral malleolus. Left leg swelled a lot beyond groin. Medial rectus paresis in right eye and inferior rectus paresis in the left eye were affected. No fatal complications arose and the symptoms were gradually getting better. On day 23, no ocular motility disorder remained.

Conclusion：Ophthalmic complications with viper bite are important to predict advancing in severity.