EBウイルス感染による急性扁桃炎・口腔咽頭炎症例の臨床所見 Clinical features of acute tonsillitis and oropharyngitis associated with Epstein-Barr virus infection

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著者

    • 余田 敬子 YODA Keiko
    • 東京女子医科大学附属第二病院耳鼻咽喉科 Department of Otorhinolaryngology, Daini Hospital, Tokyo Women's Medical University
    • 荒牧 元 ARAMAKI Hajime
    • 東京女子医科大学附属第二病院耳鼻咽喉科 Department of Otorhinolaryngology, Daini Hospital, Tokyo Women's Medical University

抄録

口腔咽頭の炎症性病変の生検組織からEpstein-Barrウイルス (EBV) を検出した急性扁桃炎8例・口腔咽頭炎4例の臨床所見について検討した.血清EBV関連抗体価から, 扁桃炎症例の3例がEBV初感染で他の5例は非初感染, 口腔咽頭炎症例は全例非初感染で2例はEBV再活性化が示唆された.扁桃炎例の口腔咽頭所見はEBV初感染・非初感染に関わらずほぼ共通し白苔病変が特徴的であった.口腔咽頭炎例では口腔咽頭に点在するびらんやアフタなどの有痛性の粘膜病変を認めた.症状および経過は, 扁桃炎では入院を要するほどの重症例が多く, 口腔咽頭炎例には難治例や再発例がみられた.

To identify distinct clinical features of oropharyngotonsillitis caused by Epstein-Barr virus (EBV), we retrospectively reevaluated serological and clinical findings in 12 patients with 8 acute tonsillitis and 4 oropharyngitis revealing positive signals with EBER-ISH (<I>in situ</I> hybridization to detect EBV-encoded small nuclear RNA-1 and-2) in biopsy specimens.<BR>Three of the tonsillitis patients had primary infection with infectious mononucleosis (IM), and 9 had nonprimary infection. Two of the oropharyngitis patients with nonprimary infection were considered to present reactivated EBV infection.<BR>Characteristic exudation was noted in EBV-associated tonsillitis of both primary and nonprimary infection, while nonspecific mucosal lesions were observed in the oropharyngitis of nonprimary infection. Symptoms of acute tonsillitis were severe, whereas those of oropharyngitis were not serious, but prolonged. Most patients were young adults.

収録刊行物

  • 口腔・咽頭科 = Stomato-pharyngology

    口腔・咽頭科 = Stomato-pharyngology 13(3), 319-325, 2001-06-01

    日本口腔・咽頭科学会

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