クラミジア直腸炎

Chlamydia Tracomatis Proctitis

要旨　クラミジア直腸炎は，最も頻度の高い性行為感染症の病原体であるChlamydia trachomatisの直腸感染により形成される感染性腸炎である．その内視鏡像はいわゆる“イクラ状粘膜"と称される，下部直腸優位の半球状小隆起性病変の集簇を特徴とする．診断には病変部擦過検体を用いた酵素免疫法（EIA法）や遺伝子検査法（PCR法）などが有効である．本疾患におけるクラミジア抗体検査は感度や特異度が低く，補助的診断として位置づけられる．抗菌薬の選択や投与期間については，症例ごと治療反応性を評価し検討する必要がある．性感染症という側面を考慮し，パートナーの診断，治療も同時に行うことが望ましい．

　Chlamydia tracomatis proctitis is infectious enteritis caused by rectal infection with Chlamydia trachomatis, one of the most common agents of sexually transmitted diseases. The pathologic finding of so-called “salmon roe-like rectal mucosa,” confluent semispherical bulges dominant in the lower rectum, is characteristic of the disease as viewed by endoscopy. Antigen detection（EIA analysis）and genetic testing（PCR analysis）from rectal swab samples are effective for diagnosis. Chlamydia antibody testing is the ancillary method of choice as it has low sensitivity and specificity in the diagnosis of the infection. The response to treatment of each patient should be evaluated to determine optimal antimicrobial drugs and treatment duration. Because of the nature of this sexually transmitted disease, it is recommended that the partner receive diagnostic tests and treatments at the same time.