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Abstract

症例1は6歳女児.インフルエンザ感染症初日に発熱しオセルタミビルを開始.第3病日,右下腹部に限局した圧痛が出現.腹部造影CTで糞石を認め急性虫垂炎と診断.保存的に加療し炎症反応と腹痛は改善した.症例2は5歳女児.第1病日に発熱と腹痛を認め,第3病日に鼻咽腔迅速検査でインフルエンザB型と診断しザナミビル吸入を開始.触診で右下腹部に反跳痛を認め,腹部単純CTで虫垂壁の肥厚と糞石を確認.急性虫垂炎の併発と診断し,第4病日に虫垂切除術を施行.切除虫垂に膿瘍を認め腹腔ドレーンを留置.第5病日に解熱し経過は順調であった.インフルエンザに伴う腹痛では感染に付随する腹痛と断定せず急性虫垂炎の可能性も考慮し腹部CTなどの画像検査を行うことが肝要である.

We report herein two pediatric cases of influenza virus infection associated with acute appendicitis. Patient 1 was a 6-year-old girl. She presented to hospital with a high fever and received oral administration of oseltamivir phosphate. On the third day from the onset, tenderness developed in the right lower area at McBurney's point. Abdominal enhanced computed tomography( CT) showed intestinal fecalith, and acute appendicitis was subsequently diagnosed. Antibiotic therapy was performed, and abdominal pain and inflammation data improved. Patient 2 was a 5-year-old girl. On the first day, abdominal pain developed. On the third day from the onset, influenza type B was diagnosed using rapid antigen testing of the nasal mucosa, and inhalation therapy was started with zanamivir. Rebound tenderness was seen in the lower right abdomen. Abdominal CT showed both hypertrophy of the appendix wall and intestinal fecalith, and influenza infection associated with acute appendicitis was subsequently diagnosed. On the fourth day, appendectomy was performed. Drainage treatment was required to prevent peri-appendicitis abscess. On the fifth day, the patient defervesced and, as for the progress, was favorable. When encountering influenza infection associated with abdominal pain, performing abdominal CT is important.

Journal

  • Dokkyo journal of medical sciences

    Dokkyo journal of medical sciences 41(2), 173-176, 2014-07-25

Codes

  • NII Article ID (NAID)
    110009815884
  • NII NACSIS-CAT ID (NCID)
    AA00629581
  • Text Lang
    JPN
  • Article Type
    journal article
  • ISSN
    0385-5023
  • Data Source
    NII-ELS  IR 
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