性行為感染症（STD）を含む感染性直腸肛門部病変

Infectious Anorectal Disease, Including STD (Sexually Transmitted Disease)

要旨　直腸肛門部の感染性病変は三大肛門疾患に比し多くはないが，注意しなければならない種々の病変がある．特に，直腸肛門部のSTDは最近増加傾向にあるにもかかわらず，わが国ではこれらの疾患に関する報告は少ない．そのため，日常診療において診断・治療に難渋する場合がある．筆者らの専門外来では合併症も含めると全症例中5.4％がこれらの感染症であった．疾患別頻度では真菌症が73.1％と最も多く，次いで尖圭コンジローマ11.8％，ヘルペス10.9％であった．アメーバ赤痢は2.4％，梅毒は1.5％と少数ながら認められた．また，AIDSの日和見感染症は2例であった．なお，STDの確認は必ずしも容易ではないが，真菌症を除くとその比率は高く，70％近くあることが判明した．

　Though infectious anorectal diseases, especially STD, are tending to increase recently, the mention of these lesions, including STD is very rare in this country. Consequently there are complicated cases of diagnosis and treatment. The overwhelmingly high-frequency disease is fungal infection (73.1％) followed by condyloma acuminatum (11.8％) and herpesvirus infection (10.9％) which are also relatively frequent among the infectious anorectal lesions encountered at our proctological clinic. Recently amebiasis as STD has been increasing noticeably in this country and condyloma lata as syphilis has not yet disappeared. While there is a lot of interest in anorectal diseases as opportunistic infections accompanying AIDS (acquired immunodeficiency syndrome) in the USA, there are a few reports of these in this country. We have encountered two cases of opportunistic infections recently.

　We were astonished at the results of research showing, in this county, the high frequency of contraction of condyloma acuminatum and amebiasis from same-sex partners and also at the high frequency of contraction of herpes during visits abroad.