足趾末梢循環不全をきたしたクラゲ刺傷

・クラゲは海洋生物による毒被害でもっとも多い原因生物である．

・クラゲ毒による傷害には疼痛や線状発赤，発疹，瘙痒感などの即時型反応と，壊疽や潰瘍形成，血管攣縮，四肢のチアノーゼ，深部静脈血栓症，視力障害，顔面浮腫などの遅延型反応がある．

・自験例はクラゲ毒による遅延型反応で下肢末梢動脈に血管攣縮が生じ，その結果，虚血に伴う足趾末梢循環不全をきたしたと推察した．

（「症例のポイント」より）

　

Jellyfish sting resulting in toes ischaemia

　

Hashimoto, Nana1）Nakata, Kaya1）Watanabe, Kosuke1）Takahashi, Misaki1）Niiyma, Shiro1）Fukuda, Hidetsugu1） 1）Department of Dermatology, Toho University Ohashi Medical Center Abstract

　

A 33-year-old woman visited our department for swelling in her right lower leg and cyanosis in her toes. She was swimming in shallow sea water in the Philippines and stung by a jellyfish 4 days before admission. Vascular spasm is one of the delayed type responses in jellyfish poisoning. We diagnosed the skin disorder as ischemia caused by vasospasm which delayed type response by jellyfish poisoning. The patient was treated with intravenous alprostadil (10μg/day)and heparin sodium (10,000 units/day)and at 12 days after stung by a jellyfish was almost fully recovered.