@article{oai:dmu.repo.nii.ac.jp:00000926,
 author = {村上, 敦史 and Murakami, Atsushi},
 issue = {1},
 journal = {Dokkyo journal of medical sciences},
 month = {Mar},
 note = {<目的>滲出性中耳炎の中耳滲出液中にしばしばエンドトキシンが検出される事から,グラム陰性菌の感染の既往が疑われている.一方,好酸球性中耳炎は既往歴に喘息,好酸球の関与は間違いないが,直接の病因はまだ明らかにされていない.近年,慢性副鼻腔炎の起炎微生物として真菌が注目されている.中耳における真菌の関与について検討することとした.<方法>好酸球性 (8 例) 及び,非好酸球性滲出性中耳炎 (12 例) の中耳滲出液,及び鼻汁を採取し,メセナミン銀染色を行ない観察した.一部は電子顕微鏡でも観察した.<結果>好酸球性中耳炎,非好酸球性滲出性中耳炎の中耳滲出液中に100%真菌菌糸を検出した.好酸球性中耳炎では8 例中7 例にCharcot-Leyden crystal (CLCs) を認めた.好酸球性中耳炎の鼓膜状態から重症度分類するとCLCs が多い程,鼓膜状態は良好であった.鼻汁中にも真菌菌糸は100%認められたが,CLCs が検出されたのは,好酸球性中耳炎症例での一例のみであった.<考察>中耳滲出液中にメセナミン銀による組織染色で真菌が存在することを初めて明らかにした.両疾患に真菌が関与している可能性は十分考えられ,特に好酸球性中耳炎では鼓膜状態の重症度分類すると,重症度が増すほどCLCs の数が減少するという今回の結果は,好酸球性中耳炎は病因として真菌が重要な役割を演じている事を示唆していると考えられた., Objectives)It is rare to detect the bacillus and the virus in the middleear effusion of otitis media with effusion. But the past ofinfection of Gram-negative bacteria is douted as the endotoxinis detected in the middle ear effusion. The direct etiologyof eosinopliloc otitis media is uncertain although thisdisease is sure to have the relation to eosinophilic leukocytebecause of the previous history of asthma or eosinopbilic sinusitis.(Methods)The middle ear effusions and nasal secretions were gathered,from 8 patients of eosinophilic otitis media and 12 patientsof otitis media with effusion. They were observed bylight microscope after staining of the methenamine silverand some of them were observed with the electron microscope.(Results)The fungal hyphae were detected by 100 % in both middleear effusions of eoisnophilic otitis media and otitis mediawith effusion. The Charcot-Leyden crystals (CLCs) weredetected by 7 middle ear effusions of 8 patients with eosinophilicotitis media.The more the number of CLCs was detected, the moreexcellent the prognosis was.Although the fugal hyphae were also detected in all nasalsecretions, CLCs were detected only one case of eosonophilicotitis media.(Discussion)Although it is uncertain whether fungus is detected innormal person's middle ear, the possibility that fungus takespart in the both disease is large. In the result that the numberof CLCs decrease by the increase of the severity of eosinophilicotitis media, fungus is thought to be one of theetiologies of eosinophilic otitis media as it is reported thatCLCs in the fungal infection with the increased eosinophilicleucocytes were frequently observed., 原著, Original},
 pages = {79--85},
 title = {中耳滲出液と真菌},
 volume = {38},
 year = {2011},
 yomi = {ムラカミ, アツシ}
}