臨牀消化器内科 Vol.19 No.8(1-2)


特集名 感染性腸炎
題名 [総論]感染性腸炎疑い症例における一般診断法と注意点
発刊年月 2004年 07月
著者 五十嵐 正広 北里大学東病院消化器内科
著者 佐田 美和 北里大学東病院消化器内科
著者 小林 清典 北里大学東病院消化器内科
著者 吉澤 繁 北里大学東病院消化器内科
著者 勝又 伴栄 北里大学東病院消化器内科
【 要旨 】 急性の感染性腸炎を疑うおもな臨床症状は,腹痛,下痢,発熱,悪心・嘔吐などである.診断に当たっては,原因を推察できるような要領を得た問診が重要である.さらに,便の培養による原因菌の同定が必要である.その際,抗菌剤投与前に検体を採取することが大切である.慢性の感染性腸炎は,それほど頻度の高いものではない.しかし,内視鏡検査の対象となることが多いので各疾患の特徴を知り,生検像と併せた診断が有用である.また,血清抗体の検索によって原因菌やウイルス,原虫などを証明できるものもあり,診断の第一歩は可能性のある病変を疑って検索を進めることである.
Theme Infectious Enterocolitis
Title Note on Diagnosis of Possible Infectious Enterocolitis
Author Masahiro Igarashi Department of Gastroenterology, Kitasato University East Hospital
Author Miwa Sada Department of Gastroenterology, Kitasato University East Hospital
Author Kiyonori Kobayashi Department of Gastroenterology, Kitasato University East Hospital
Author Shigeru Yoshizawa Department of Gastroenterology, Kitasato University East Hospital
Author Tomoe Katsumata Department of Gastroenterology, Kitasato University East Hospital
[ Summary ] The diagnostic approach for cases suspected of being infectious entero-colitis was discribed. The main complains with acute infectious entero-colitis were diarrhea, abdominal pain, fever, nausea and vomiting. It was deemed important to ask patients about their condition, since the answers provided can help us diagnose their condition. Furthermore, the detection of conditions caused by bacillus cultures is necessary. It is important that stool cultures be examined before administration of antibacterial medications. However, chronic infectious entero-colitis was not seen to be a common disease. The main complains with chronic infection were diarrhea, abdominal pain, weight loss, unknown fever, appetite loss, etc. These conditions were indicated by endoscopic examination, therefore we should be know the particular endoscopic findings for such cases and histological examination with biopsy should be performed. Some viral, protozial and parasitic infections were detected by serological examination.
It is concluded that the first step in diagnosis is to suspect possible infectious entero-colitis.
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