両眼に同時発症した周辺部角膜炎の1症例

A case of bilateral peripheral keratitis of simultaneous onset

　31歳男子の両眼鼻側角膜周辺部に，激しい眼痛が先行した後，潰瘍を伴った白色混濁が左右対称的に現れたが，消炎剤，ヘパリンなどの使用により急速に治癒に向かった症例を経験した。眼痛が出現する4日前に38℃近くまで発熱していたことや，結膜や眼瞼に細菌感染を疑わせる所見がなかったこと，結膜嚢細菌培養が陰性であったことなどから，上気道感染が関与した細胞毒によって角膜にもたらされた急性の免疫反応と考えられた。

A 31-year-old male sought medical advice due to bilateral ocular pain and lacrimation. He had con-tracted common cold with high fever 4 days before. We observed opacification with ulceration in the nasal peripheral cornea in both eyes. There were no signs of inflammation in the conjunctiva or the eyelid. Culture of conjunctival smear was negative. The corneal lesion healed after treatment with antiinflammatory medications and subconjunctival injection of heparin sodium for one week. It appear-ed that the corneal lesions were due to acute im-munological reaction triggered by cytotoxicity sec-ondary to infection of the respiratory tract.