鼻内所見の乏しい鼻性頭蓋内合併症の2例

Two Cases of Rhinogenic Intracranial Complications with Lack of Intranasal Findings

I．はじめに

　抗生物質が頻用されている現在鼻性の頭蓋内合併症は珍しくなり，実際その報告も数少ない。しかしいったん発症した場合は現在においても，的確な処置が早期になされなければ死亡率が約50％というきわめて致命率の高い疾患であり^1），迅速な診断と治療が必要となる。われわれは最近頭蓋内および眼窩内合併症を併発した例を含め，副鼻腔炎が原発巣と思われた非術後性の頭蓋内合併症を2例経験した。いずれも鼻症状，鼻内所見に乏しくCT検査により初めて鼻性と診断のついた症例であったため，受診に至る経過，治療，その後の経過について報告する。

Two cases of non-postoperative rhinogenic in-tracranial complications were reported: Patient 1 was a 25-year-old female with meningitis and right orbital phlegmon, and patient 2 was a 21-year-old male with a brain abscess. Initial signs in these patients were meningeal signs and high fever with slight intranasal findings. It was not until computed tomography revealed paranasal abnormalities that the diagnosis was made. With large doses of antibiotics, these patients were completely cured of intracranial complications through intervention by an early rhinological operation. We must bear in mind that like these patients, rhinogenic intracranial complications with lack of intranasal findings exist even today.