涙小管炎9例の検討

Review of lacrimal canaliculitis in nine cases

　過去22か月間の涙小管炎の自検例9例を検索した。男性4例，女性5例であり，いずれも片眼性であり，左右差ないし上下差はなかった。罹病期間は4日から2年（平均205±266日），経過観察期間は3か月から13か月（平均8.2±3.8か月）であった。菌塊のグラム染色で，全例にグラム陽性桿菌が検出され，分枝のある糸状菌の集積が6例にあった。嫌気培養で8眼に菌が発育した。主な内訳は，Propionibacterium Propionicus 4株と，Actinomyces israelii 3株であった。涙小管内の菌塊の除去，抗菌薬による涙嚢洗浄，抗生物質の点眼で全例に治癒が得られた。

We reviewed 9 cases of lacrimal canaliculitis seen during the foregoing 22 months. All the cases were unilaterally affected. There was no definite difference between the right and left eye or between upper and lower canalicule. The duration of disease ranged from 4 days to 4 years, average 205±266 days. The follow-up period ranged from 3 to 13 months, average 8.2±3.8 months. Staining of concretions showed Gram-positive rods in all the 9 cases including gathering of branching filaments in 6 cases. Anaerobic culture showed bacteria in 8 cases including 4 strains of Propiniobacterium propionicus and 3 strains of Actinomyces israelii. Clinical cure was obtained in all the 9 cases following removal of concretions from the affected lacrimal canaliculus, irrigation of lacrimal sac with antibiocs, and instillation of antibiotics.