臨牀消化器内科 Vol.19 No.8(2-5)


特集名 感染性腸炎
題名 [各論]Traveler's diarrhea
発刊年月 2004年 07月
著者 松下 秀 東京都健康安全研究センター多摩支所
著者 河村 真保 東京都健康安全研究センター微生物部
【 要旨 】 traveler's diarrhea (旅行者下痢症) は,開発途上国への旅行者が高頻度に罹患する重要な疾患の一つである.本疾患は特定の原因によるものを示すものではなく,一連の下痢を主徴とする臨床症候群を指すものである.種々の原因による下痢のなかでもとくに問題となるのは,各種腸管系病原菌による感染性の下痢症である.わが国における実態をみると,コレラ,細菌性赤痢など,防疫措置を必要とする二類感染症もかなりの例数認められるが,毒素原性大腸菌をはじめとする各種食中毒起因菌がその原因の大半を占めている.複数病原菌が同時に検出される混合感染例が多いことも特徴としてあげられる.診断の際は,海外旅行経験の有無の確認,細菌学的検査が望まれる.
Theme Infectious Enterocolitis
Title Traveler's Diarrhea
Author Shigeru Matsushita Tama Branch Institute, Tokyo Metropolitan Institute of Public Health
Author Maho Kawamura Department of Microbiology, Tokyo Metropolitan Institute of Public Health
[ Summary ] Traveler's diarrhea is an important disease that frequently is experienced when traveling in developing countries. This disorder is not associated with a specific etiology, but represents a series of clinical syndromes, involving diarrhea as the main sign. In particular, an important issue is infectious diarrhea related to various enteropathogenic bacteria associated with diarrhea symptoms related to various etiologies. In Japan, the incidence of class II infectious diseases that require countermeasures for preventing epidemiological spreading, such as cholera and bacillary dysentery, is relatively high. However, various food poisoning-causing bacteria, including enterotoxigenic Escherichia coli, comprise the highest percentage of etiological factors. Traveler's diarrhea is also characterized by a high incidence of mixed infection in which several kinds of enteropathogenic bacteria are simultaneously detected. For proper diagnosis, the fact that the patient has traveled abroad should be confirmed, and bacteriological examination should be performed.
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