熊肉摂取後に発症した旋毛虫症にぶどう膜炎を合併した2例

Two cases of trichinellosis with uveitis after eating bear meat

要約　目的：旋毛虫症に伴うぶどう膜炎を呈した2例を報告する。

症例：症例1は32歳の男性。熊肉を摂取後に発疹，筋肉痛，眼瞼浮腫，発熱が出現した。旋毛虫症の診断で，アルベンダゾールとプレドニゾロン内服が開始された。両眼の霧視を自覚し，前眼部炎症所見と散在する網膜出血，蛍光眼底造影検査で蛍光漏出を認めた。症例2は41歳の男性。熊肉の摂取から2週後に発疹，筋肉痛，発熱が出現し，アルベンダゾール内服が開始された。左眼の霧視を自覚し，硝子体中の細胞浸潤および網膜出血を認めた。2例とも1か月後の診察時に炎症所見および網膜出血の消退を認めた。

結論：眼瞼浮腫，ぶどう膜炎，皮疹，好酸球増多を認めた際には旋毛虫症も鑑別に考え，病歴聴取を行う必要がある。

Abstract　Purpose：To report two cases of uveitis with trichinellosis following ingestion of roasted bear meat.

Cases：A 32-year-old man presented with rash of skin, muscle pain, bilateral palpebral edema, fever and blurred vision in both eyes 2 weeks after eating bear meat. He was diagnosed as trichinellosis. Treatment with oral albendazole and prednisolone was started. With ophthalmological examination, cells in anterior chamber and retinal hemorrhages were observed in his both eyes. Fluorescein angiography revealed retinal vascular leakage. Another 41-year-old man presented with rash of skin, muscle pain, fever and blurred vision in his left eye 2 weeks after eating bear meat. He was diagnosed with trichinellosis. Oral administration of albendazole was started. Vitreous cells and retinal hemorrhage were observed in both eyes. In both cases, inflammation and retinal hemorrhage disappeared one month after first visit.

Conclusion：Trichinellosis is one of the causes of uveitis and palpebral edema. It is important to take history of raw meat consumption for diagnosing trichinellosis.