糖尿病に伴った急性尿道海綿体炎の1例

Abstract

63歳で, 56歳時から糖尿病に対して内服治療を受けていた.排尿困難, 排尿時痛, 会陰部痛等が出現したため受診し, 触診上, 尿道海綿体に圧痛・硬結を認めた.CTで同部に低吸収域が認められ, MRIで膿瘍化所見を認めた.会陰部より尿道海綿体を穿刺して膿を吸引し, 起因菌はB群溶連菌であることが判明した.化学療法を開始すると共にドレナージを試みたが, 排膿できたのは僅かな量であった.1年後の現在, 会陰部痛はなくなり, 硬結も消退し, 排尿についても支障は認めていない

We report a case of acute spongiositis with diabetes mellitus. A 63-year-old man with a 7-year history of diabetes mellitus was admitted to our hospital complaining of perineal pain and pyrexia. Physical examinations revealed induration and tenderness of the corpus spongiosum, but no signs of rubor or erosion. A laboratory investigation showed leukocytosis (12, 000/microliter), an elevated level of C-reactive protein (3.38 mg/dl) and hyperglycemia (532 mg/dl). Pyuria and bacteriuria were absent. Magnetic resonance imaging (MRI) yielded abscess-like lesion of the corpus spongiosum. Culture of the aspirated specimen demonstrated B-hemolytic streptococci. Treatment with antibiotics and insulin resolved leukocytosis and tenderness of corpus spongiosum. He left the hospital on the 23rd day after admission and no evidence of recurrence of the spongiositis was found for 1 year after discharge.