ムコーズス中耳炎の4症例

Four cases of mucoid otitis media

Ⅰ　はじめに

　ムコーズス中耳炎はムコイド型肺炎球菌を起炎菌とし，成人に好発する難治性中耳炎である^1）。本疾患はほかの起炎菌による中耳炎に比べ，内耳障害や頭蓋内合併症を伴いやすいことが知られている^2）。このため，早期の診断と治療が必要であるが，発症初期には鑑別に苦慮することも少なくない。今回，われわれは成人に発症したムコーズス中耳炎4症例を経験したので，臨床経過を中心に文献的考察を加えて報告する。

　We reported four cases of mucoid otitis media,an aggressive and intractable middle ear infection caused by mucoid-type Streptococcus pneumoniae. The patients showed purulent otorrhea gushing out and rapidly-progressed moderately to severe mixed hearing loss. The definite diagnosis was made by bacteriological examination of otorrhea. They underwent surgical drainage,and received the administration of penicillin or carbapenem antibiotics as well as corticosteroids. One patient with meningitis was given γ-globulin. The disease successfully cured and the hearing loss markedly recovered in all cases. Clinical characteristics,diagnosis and treatment of mucoid otitis media were bibliographically reviewed.