扁桃病巣感染と考えられる側頭骨骨髄炎

Osteomyelitis of the Temporal Bone Associated with Tonsillar Focal Infection

はじめに

　近年，扁桃を中心とする病巣性感染症の二次疾患で，骨変化を伴うものとして胸肋鎖骨間骨化症（ISCCO）が注目されている。病因についてはいまだ不明であるが，骨病変部の組織像では慢性骨髄炎または非特異的炎症を呈することが多い^1〜3）。今回われわれは側頭骨に病変を伴った慢性扁桃炎の2症例に扁桃摘出術を施行し，側頭骨骨髄炎症状の改善を得たので，若干の考察を加えて報告する。

Two cases of osteomyelitis of the temporal bone associated with tonsillar focal infection are repor-ted. A 33-year-old male had suffered from pustu-losis palmaris et plantaris (PPP) and pain of the temporal bone, which had often worsened after the acute tonsillitis. Another patient was a 23-year-old girl who had complained of a painful osseous mass in her anterior thoracic region and temporal bone, and also pyrexia. Following tonsillectomy, their symptoms improved. The histological studies of the tonsils were characterized by so-called focal small lacuner ulcers and periarteriolar fibrosis (onion-skin lesion) suggesting the probable cause of tonsillar focal infection.