Exanthematous Disease in Newborn Infants.
Copyright policy ) Kenichi Maruyama; Takenobu Koizumi;
Exanthematous Disease in Newborn Infants.
生後1ヶ月未満で発疹を認め, かつ体温異常, CRP弱陽性, 血小板減少の3つの条件のいずれかを認めることを診断基準とした新生児期発疹性疾患症例20例について臨床的検討を行った.対象の在胎週数は29-40週, 出生体重は1,084-3,320gであった.血小板数が経過中15×104/μl以下となっていたのは19例であった.7例でCRPが1.0mg/dl以上に上昇していた.細菌培養ではメチシリン耐性黄色ブドウ球菌 (MRSA) が6例で咽頭もしくは便から分離された.ウイルス分離を行った18例中1例でコクサッキーB4型ウイルスが分離された.近年, 本疾患の原因としてMRSAが産生する toxic shock syndrome toxin 1 (TSST-1) が報告されているが, 本疾患の症状はウイルス感染症に類似しており, TSST-1による発疹症を一つの疾患単位とするならば, 診断にあったてはTSST-1を産生するMRSAを証明すると共にウイルス感染など他の原因を除外する必要があると思われる.
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