感染性腸炎の診断・治療手順

Diagnostic Procedures and Treatment for Infectious Colitis

要旨　感染性腸炎の診断を進める場合，最も重要なのは臨床所見である．詳細な病歴から感染性腸炎との診断のみならず，疾患の絞り込みも可能である．これに糞便や血液を用いた細菌学・生化学的検査所見を加えることで，ほとんど感染性腸炎の確定診断が可能となる．USやCT，X線・内視鏡などの画像所見は，病変の部位，形状，配列などを分析することで潰瘍性大腸炎やCrohn病などの狭義のIBDとの鑑別に有用である．治療としては補液による脱水の補正と適切な抗菌薬の使用が重要であり，起因菌が不明の場合はニューキノロン系薬，またはfosfomycinの投与が推奨される．

　In order to make a differential diagnosis and obtain a precise diagnosis of infectious colitis, the evaluation of clinical findings is of most importance. A detailed disease history can help to narrow down the diagnostic possibilities and can lead to a precise diagnosis of infectious colitis. Definite diagnosis can be obtained by adding some tests such as bacterial examinations using stool or blood and biochemistry. By analyzing location shape and alignment of the lesions. Combination use of imaging study of ultrasound, CT scan, radiography or colonoscopy is useful for the differential diagnosis of infectious colitis from IBD. As for the treatment of infectious colitis, correction of dehydration by drip infusion and administration of adequate antibiotic drugs are the most important measures. If the disease-causing bacteria has not bean isolated, administration of newquinolone or fosfomycin is recommended as empiric therapy.