Trachoma

Japanese: トラコーマ(英語表記)Trachoma
Trachoma

What kind of infection is it?

It is conjunctivitis caused by a microorganism called chlamydia. Trachoma is rarely seen in Japan, where the sanitary environment is good, but it is a common disease worldwide.

In areas where chlamydia is prevalent, such as Africa, the eastern Mediterranean, and Asia, repeated infections are common, leading to the development of trachoma. In Japan, soldiers were infected with trachoma during the Sino-Japanese War and returned home afterwards. Spread ( One million yen ) It is said that in the 1910s, the incidence of trachoma in Japan exceeded 20%.

In addition, there is also a type of conjunctivitis caused by chlamydia, called inclusion conjunctivitis, but please see the column for more information on this.

How symptoms manifest

Trachoma is divided into four stages:

Phase I

Symptoms appear after an incubation period of 5 to 12 days. The eyelids become swollen, the conjunctiva becomes congested and edematous, and mucopurulent fluid accumulates. Eye discharge ( Cancer ) (Eye discharge) appears. Eyelids ( Hard work ) The conjunctiva had mild papillary hyperplasia and Follicular ( Method ) (Small bumps) appear.

Phase IIa

The follicles grow larger and blood vessels from the conjunctiva invade the cornea (pannus). This stage lasts from about 3 months to 3 years.

Stage IIb

Bacterial infection occurs and papillary proliferation intensifies. Conjunctival infiltration also intensifies.

Phase III

Scarring ( Stamp ) The pannus begins to form and covers the cornea. Corneal ulcers are often a complication.

Phase IV

It can cause eyelashes to grow irregularly, entropion (the eyelid turns inward and the eyelashes damage the cornea and conjunctiva), dry eyes, and residual vision problems.

Testing and diagnosis

It can be roughly inferred from the medical history and symptoms.

Treatment methods

Please see an ophthalmologist. Sometimes surgery is effective.

Yoshikazu Shimomura

Source: Houken “Sixth Edition Family Medicine Encyclopedia” Information about the Sixth Edition Family Medicine Encyclopedia

Japanese:

どんな感染症か

 クラミジアという微生物による結膜炎です。衛生環境のよい日本では現在、トラコーマの発症はまずみられませんが、世界的には多い病気です。

 アフリカ、地中海東部、アジアなどのクラミジアの流行地域では繰り返し感染する機会が多く、トラコーマが発症するといわれています。日本では日清戦争時に、兵士がトラコーマに感染して帰国してから蔓延(まんえん)したといわれており、1910年代には日本のトラコーマ罹患率は20%を超したとのことです。

 なお、クラミジアによる結膜炎には封入体(ふうにゅうたい)結膜炎もありますが、これについてはコラムを参照してください。

症状の現れ方

 トラコーマは、以下の4病期に分類されます。

・第Ⅰ期

 5~12日の潜伏期間ののちに発症します。まぶたがはれ、結膜が充血してむくみ、粘液膿性の眼脂(がんし)(めやに)が出ます。眼瞼(がんけん)結膜には軽度の乳頭増殖と濾胞(ろほう)(小さなぶつぶつ)が現れます。

・第Ⅱ期a

 濾胞は大きくなり、結膜から角膜に血管が侵入してきます(パンヌス)。この病期は約3カ月から3年です。

・第Ⅱ期b

 細菌感染を合併し、乳頭増殖が強くなります。結膜の浸潤も強くなります。

・第Ⅲ期

 瘢痕(はんこん)形成が始まり、パンヌスが角膜をおおうようになります。角膜潰瘍を合併することが多いようです。

・第Ⅳ期

 まつ毛が乱生したり、眼瞼内反(まぶたが内側へまくれ込み、まつ毛で角膜や結膜が傷つく)、ドライアイになり、視力障害を残します。

検査と診断

 病歴と症状からほぼ類推することができます。

治療の方法

 眼科専門医を受診してください。時に手術療法が効果的です。

下村 嘉一

出典 法研「六訂版 家庭医学大全科」六訂版 家庭医学大全科について 情報

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