エロモナス腸炎の内視鏡像

Colonoscopic Findings of Aeromonas Enterocolitis

要旨●エロモナス腸炎は，Aeromonas属（主にAeromonas hydrophilaおよびAeromonas veronii biovar. sobria）による感染性腸炎である．水様性下痢や腹痛を起こすが，多くは軽度で自然に改善するため，一般的にはあまり認識されていない．しかし，下痢が長期間持続する患者や，免疫力の低下した患者では重症化することもあり，注意を要する．今回筆者らは下部消化管内視鏡を施行したエロモナス腸炎28例を対象とし，内視鏡像を後ろ向きに検討した．①上行〜横行結腸の帯状潰瘍，②下行〜S状結腸の縦走潰瘍，③直腸から連続する発赤・浮腫・粘膜粗糙・血管透見低下が特徴的と考えられた．特徴的な内視鏡像を参考にし，慢性例・重症例に注意しながら診療することが望ましいと考えられた．

　Aeromonas enterocolitis, mainly caused by Aeromonas hydrophila and Aeromonas veronii biovar sobria, produces watery diarrhea and abdominal pain. As the symptoms are relatively mild and self-limiting, it is generally not recognized. However, diarrhea sometimes persists for a long duration, and immunocompromised patients can become severely infected, therefore care is needed. We retrospectively studied 28 colonoscopic findings of patients with Aeromonas enterocolitis. The characteristic findings were as follows：1）girdle ulcer in the ascending to the transverse colon ; 2）longitudinal ulcer in the descending to the sigmoid colon ; and 3）diffuse loss of vascular appearance, hemorrhage, and friability of the mucosa continuous from the rectum. Therefore, in cases of chronic and severe diarrhea, referencing these characteristic colonoscopic findings could aid in the diagnosis of Aeromonas enterocolitis.