- 泌尿器科紀要 (ISSN:00181994)
- vol.51, no.11, pp.737-740, 2005-11
2001年1月から3年間に受診した亀頭包皮炎189例を,化膿連鎖球菌を分離した47例(PYO群),他の細菌を分離した93例(B群),細菌の検出がない27例(NB群),不必要のため細菌検査をしない22例(N群)に分け,臨床像と感染経路を比較検討した.その結果,PYO群は他の3群に比べて,臨床症状の膿性分泌及び疼痛,症状出現前の性的接触が多く,潜伏期間及び発症から受診までの期間が短い傾向が見られた.PYO群では包茎のない症例を7例認めた.更に,2004年1月から1年間に化膿連鎖球菌による亀頭包皮炎11例に対してamoxicillinを使用した結果,全例で治癒が確認されたBetween January 2001 and December 2003, 189 adult patients with balanoposthitis were treated in my clinic. Swab culture from the affected lesion detected Streptococcus pyogens in 47 cases (PYO group), other bacterial species including Candida albicans in 93 (B group), no bacterial growth in 27 (NB group) and swab culture was not done because clinical symptom was trivial in 22 (N group). The PYO group had a significantly higher prevalence of purulent discharge (68.1%) and local pain (38.3%), compared to the B group (25.8% and 21.5%, respectively) or the NB group (33.3% and 11.1%, respectively). Phimosis was absent in 7 cases in the PYO group. The route of infection in the PYO group was considered to be predominantly via sexual contact (PYO group 78.7%, B group 52.7%, NB group 59.3%), especially through fellatio by commercial sex worker for the majority of the PYO patients. The latent period (from sexual contact to the onset of symptoms) was 3 days or less in 40.5% and 4 to 7 days in 35.1% in the PYO group, whereas it was more than a week or not remembered in the majority of the B and NB groups, disapproving the causal relationship with sexual contact in such cases. Treatment with tosufloxacin tosilate or amoxicillin was effective in most cases of streptococcal balanoposthitis. Our results suggest that Streptococcus pyogens is one of the causative organisms of sexually transmitted balanoposthitis.