アデノウイルス4型結膜炎の臨床像

Clinical manifestations of adenovirus type 4 conjunctivitis

　アデノウイルス4型（Ad4）結膜炎45例（男性16例，女性29例）の臨床像を検討した。平均年齢は37.4±15.6歳であった。臨床所見の出現頻度は，自覚症状として結膜充血，流涙，眼脂が各100％，他覚所見として結膜濾胞100％，瞼結膜小出血60％，乳頭増殖98％，角膜炎38％，偽膜形成0％であった。また耳前リンパ節症は38％，その他の眼外症状は62％，家族内感染は27％にみられた。これらをAd3,Ad8と比較するとAd4結膜炎患者の平均年齢はAd3より高かった。臨床所見は角膜炎，偽膜形成が少なく，眼外症状が多い点がAd3と共通していたが，結膜炎の程度はAd3とAd8の中間であった。そしてAd4は咽頭結膜熱から流行性角結膜炎といった幅広い臨床像を呈した。

We reviewed the clinical features of 45 cases of adenovirus type 4 (Ad4) conjunctivitis. The series comprised 16 males and 29 females. The ages averaged 37.4±15.6 years. As clinical symptoms, all cases showed conjunctival hyperemia, lacrimation and ocular discharge. Clinical signs included follicles 100%, petechial hemorrhage 60%, papilla 98%, keratitis 38% and no pseudomembrane. Preauricular lymphadenopathy was present in 38%, other extraocular signs in 62% and history of family infection in 27% of patients. The average of age affected with Ad4 was higher than Ad3 and was similar to Ad8. Conjun-ctivitis was more severe in Ad4 than Ad3. Clinically, Ad4 conjunctivitis was similar to Ad3 in that the disease was less severe, keratitis and pseudomembrane were less frequent, and extraocular signs were more frequent than Ad8. Ad4 caused variable types of conjunctivitis including pharyngoconjunctival fever or epidemic keratoconjunctivitis.