肺壞疽を伴いたる進行性壞疽性鼻炎追加補遺

　緒言

　鼻部から始まり漸時周囲組織を潰瘍壞疽に陥いれる顔面部の進行性壞疽性疾病患はKaufmann（1）が30才の男子に就いて始めて報告して以来Arndt（2）Erich（3）Quix（4）本邦に於ても大藤（5），金原（6），川名（7），遠山（8）森（9）其の他の諸氏に依つて報告せられ，敢て珍らしい疾患ではないが，其の名称は区々で，馬鼻疽類似症（5）特発性鼻壞疽（10）壊疽性鼻炎（4）（7）鼻性進行性潰瘍（8）馬鼻疽類似の進行性壊疽性鼻炎（9）鼻腔壞疽性炎（11），更に近年では進行性壊疽性肉芽腫（12）高熱進行壊疸性鼻潰瘍（13）等種々の名称が冠せられているが，依然として其の本態は不明で確立した治療法も無く，予後極めて不良な疾患である，私は近時此の疾患該当すると思われ，且其の症状の激烈な事，愚者の年齢が極めて少ない事等の点で珍らしい1例に遭遇したので此処に御報告し，従来の文献に追加したいと思う．

　SATO reports a case of progressi4e necrosis of the nose that led to death of the patient in spite of various treatments given. An infant girl aged 5 and one half months, following an attack of pneumonia, developed a nasal affection which consisted of malodorous discharges and crusting that was in appearance diphtheritic. This lesion progrssed to destruction of the septum. Microscopically the nasal secretion revealed spirochaetes, diplococci and diphteroids. Howevve, diphtheria toxin was not present by animal tests and the blood was negative for Wasserman. Despite the tests being negative diphtheria antitoxin as well as salvarsan were tried, but without effect. In the meanwhile the nasal lesion progressed steadily to include the nasal bones and the hard palate in its path of destruction to reach the oral cavity. Added to this condition there was another lesion, which, in the beginning of the illness, was a mere papule on the chest wall, that gradually enlarged forming thereby a considerable sized ulcer which finally penetrated the chest wall itself to expose the lung tissues. From the nature of the speed with which the disease progressed the author believes that it might be classified as progressive necrotic rhinitis.