GNBが起炎菌と考えられた急性扁桃炎10例

ACUTE FAUClAL TONSILLITIS DUE TO GRAM NEGATIVE BACILLI, A REPORT OF TEN CASES

　I．はじめに

　急性口蓋扁桃炎の起炎菌は，主として溶連菌，黄色ブ菌などのグラム陽性球菌である。

　グラム陰性桿菌では，インフルエンザ菌が小児で起炎菌になり得る可能性が指摘されている^1）2）。肺炎桿菌による急性扁桃炎もテキスト^3）に記載されているが遭遇することは少ない。緑膿菌による急性扁桃炎の報告はまだないようである^4）。1971年から1975年の5年間に緑膿菌あるいは肺炎桿菌による急性扁桃炎を10例経験したので，報告し種種ご教授をえたい。

　Ten cases of acute tonsillitis, which were considered to be caused by gram negative bacilli such as pseudomonas aeruginosa and/or klebsiella, were reported. Although gram positive cocci (GPC), in acute tonsillitis, are considered as the most important causative factor and GNB not, as that yet, the latter may produce acute tonsillitis as that of so-called opportunistic infections. In the reported 10 cases there were some ill conditions existing among the hosts. One case was subjected to a long-term administration of massive doses of antitumorigenic drugs and antibiotics. Two cases were under a prolonged period in the use of steroidhormones. In 7 cases antibiotics were administered for a prolong period which caused ecological alteration of tonsillar microflora.

　As pseudomonas aeruginosa and klebsiella are naturally resistant to antibiotics frequently used today, acute tonsillitis due to GNB may increase in future. For a definitive diagnosis of acute tonsillitis, throat cultures should be resorted to routinely. GNB infection must be suspected when the state of acute tonsillitis is not improved with-in 3 or 4 days after the administration of antibiotics.