上深頸部リンパ節炎を主症状とするクラミジア感染症について(第一報)

抄録

Trachoma, lymphogranuloma venereum and psittacosis are well known as human diseases caused by chlamydial infection. Between June 1979-April 1981 we treated 260 cases of a possible new infectious disease, of which the main symptom was upper deep cervical lymphadenitis, with increased CF titers of chlamydia.
The disease serologically was diagnosed by the following criteria. 1) CF titer of 1:16 at the first examination. 2) A greater than four-fold difference between twice or more sera and/or a serum increased CF titer of 1:16 during tetracycline therapy. 3) The CF titer of 1:8 of a patient with upper deep cervical lymphadenitis whose member of his family was diagnosed as contracting a chlamydial infection.
After the disease was diagnosed, the patients' chief complaints, symptoms and values of CF titers were analysed statistically.
The complaints were otalgia 101 (38.8%), cough 90 (34.6%), fever 38 (14.6%), swelling of upper neck legion 27 (10.4%), rhinorrhea 24 (9.2%), sore throat 24 (9.2%), otalgia on opening the mouth 15 (5.8%), epistaxis 10 (3.8%), cervical pain on rotating the neck 10 (3.8%), abdominal pain 9 (3.5%), diarrhea 7 (2.7%), general fatigue 3 (1.2%), vomiting 3 (1.2%), headache 2 (0.8%) and hemoptysis 1 (0.4%).
The symptoms were upper deep cervical lymphadenitis 260 (100%), nasopharyngitis 260 (100%), sinusitis 157 (57.7%), otitis media 15 (5.8%), bronchitis 14 (5.4%), splenitis 17 (6.5%), diarrhea 5 (1.9%), epistaxis 5 (1.9%), fever 4 (1.5%) and pneumonia 3 (1.2%).
Their highest chlamydial CF titers were from 1:8 to 1:2048. Numbers of the cases of CF titer were 41 (15.77%) of 1:8, 97 (37.31%) of 1:16, 87 (33.40%) of 1:32, 25 (9.62%) of 1:64 and 10 of above 1:128.
Serological studies for chlamydia were performed in 1982 by both National Institute of Health, Japan and the laboratory of Shionogi Pharmaceutical Co. Ltd. The studies revealed a high positive rate of psittacosis. 42 cases out of 317 acute respiratory infected patients who visited National Sagamihara Hospital (Kanagawa, Japan), between 1956-1958, were retrospectively serologically diagnosed as contracting psittacosis. The symptoms of reported cases of psittacosis in Japan are not as severe as reported cases in other parts of the world. There is great possibility that this chlamydial infected disease accounts for high percentage of reported psittacosis cases in Japan.
Psittacossis is a chlamydial infection rarely contracted by humans through exposure to avian species, However, 108 (41.5%) cases out of 260 did not have any contact with birds in this study. There is a high percentage of populations of positive chlamydial. CF titer. We concluded that the chlamydial infected disease exceeds our expectations in number.