放線菌感染による尿膜管の慢性炎症性肉芽腫の1例

A CHRONIC INFLAMMATORY GRANULOMA DUE TO THE ACTINOMYCOTIC INFECTION: A CASE REPORT

緒言

　放線菌症（Actinomycosis）はsystemic fungusinfectionで，非常に結核に類似し，通常いわゆる"sulfur granules"と呼ばれるものを産する嫌気性のfungusと，Nocardia Asteroidcsと呼ばれる好気性，抗酸性で，同じく"sulfur granulcs"を形成するfungusの2型に分けられ，臨床例では前者が90％占め，後者が10％を占めるが，Nocardiaasteroidesの多くは非病原性であるという^1）。

　この放線菌感染症は，口腔外科の領域では比較的よくみられ，また呼吸器および消化器の感染も散見される。しかし，泌尿性器系の感染は少ない。

A 66 year old male with the chief complaint of frequent urination, pain during micturition and lower abdominal pain at his first visit, showed abacterial hematopyuria by urinalysis. A thumb tip sized tumor from the dome to the posterior wall was found by cystoscopic examination which lead to the diagnosis of urachus tumor and surgery was performed. An infant first sized tumor, firmly adhesed to the peritoneum, resulted in extensive partial cystectomy including removal of umbilical and middle umbilical ligament and part of the peritoneum.