縦走潰瘍を示しCrohn病と鑑別を要したカンピロバクター腸炎の1例

Campylobacter Enterocolitis with Longitudinal Ulcers that Need to be Differentiated from Crohn's Disease, Report of a Case

要旨　症例は25歳，女性．習慣性扁桃炎にて入院し，両側口蓋扁桃摘出術を受けた．術後4日目から発熱，腹痛，頻回の下痢が出現したため当科を受診した．血液検査で炎症反応の上昇，内視鏡検査で回盲弁に不整形の潰瘍，上行結腸からS状結腸に縦走配列する不整形小潰瘍と縦走潰瘍を認めた．Crohn病を疑ったが，便培養でCampylobacter jejuniが検出されたため，カンピロバクター腸炎と診断し，マクロライド系抗生剤の投与にて軽快した．縦走潰瘍を伴ったカンピロバクター腸炎は，文献的には報告がなく非常にまれであるため報告した．

　A 25-year-old woman was admitted because of ordinary tonsillitis and received bilateral tonsillectomy. From the fourth postoperative day she developed fever, abdominal pain and frequent diarrhea, as she was examined in our department. Laboratory examination reveled a rise in inflammatory reaction. Colonoscopy showed ulcers on the ileocecal valve and irregular small ulcers of the tendency to mountain traversing and longitudinal ulcers between the ascending colon to the sigmoid colon. We suspected Crohn's disease, lent the examination of fecal culture detected Campylobacter jejuni. The patient was there diagnosed as a case of Campylobacter enterocolitis and treated successfully by a macrolide derivative antibiotic. We reported a rare case of Campylobacter enterocolitis with longitudinal ulcers.