鼻症状を呈したEcthyma gangrenosumの1例

RHINITIS NECROTICANS ASSOCIATED WITH ECTHYMA GANGRENOSUM, A CASE REPORT

　Ⅰ．緒言

　ecthyma gangrenosumは，皮膚の壊疽性潰瘍であり，病巣からは緑膿菌，ブドウ球菌，連球菌が証明されることが多い^1）。本症の発現は単に細菌の直接の毒素作用によるのでなく，細菌を抗原とするアレルギー反応が関与するという説がある。甚しくなると発熱，全身障害，衰弱が加わり死亡することが多い^2）。

　著者らは最近，ecthyma gangrenosumの患者でnecrotizing rhilitisを生じた例を経験し，治療により治癒したのでここに報告する。

　A case of rhinitis necroticans associated with ecthyma gangrenosum is reported. The patient a boy, aged 13, complained of fever, swelling of the left cheek, left nasal blockage, prurulent nasal discharge and ulcers on the extremities.

　The x-ray examination revealed a clouding of the left maxillary sinus. The inferior turbinate of the same side showed swelling and areas of necrosis. Biopsy on the left turbinate reported necroticans; the etiology was underterminable. The ulcers of the extremities was revealed to be ecthyma gangrenosum. From the ulcers of the extremities, pseudomonas aeruginosa and staphylococcus epidermidis were identified.

　The left inferior turbinate was resected and the patient was given antibiotic therapy. The patient is, at present, doing well without any sign of recurrency.