㌟ᆺࢥࢡࢧࢵ࣮࢟࢘ࣝࢫឤᰁࡢ 1 ஙඣ ሗ࿌ ࣏࢝ࢪỈ①ᵝⓎ⑈㢮ఝࡢⓎ⑈ࢆ࿊ࡋࡓ ㌟ᆺࢥࢡࢧࢵ࣮࢟࢘ࣝࢫឤᰁࡢ 1 ஙඣ ༓ⴥ 1)ࠊஂ㛫ᮌᝅ 2)ࠊሀ⏣᭷Ᏹ 2)ࠊ᪥ୗዉ㒔Ꮚ 2)ࠊᯇཎᐜᏊ 2)ࠊ㕥ᮌ⳯⤮Ꮚ 2)ࠊ▼⏣ᬛஅ 2) 㔝ཱྀ㔛ᜨ 2)ࠊⰋ୍ 2)ࠊຍ㈡ඖ᐀ 2)ࠊ⏣⃝㞝స 2)ࠊ୰Ụಙ⩏ 2)ࠊ㈗⏣ᒸ⠇Ꮚ 2) ࠊ㣤⃝⌮ 3)ࠊ᪂ᐉ༤ 4) Ọᖾኵ 5) 1) ྎ་⒪ࢭࣥࢱ࣮ ◊ಟ་ ᑠඣ⛉ 2) ྎ་⒪ࢭࣥࢱ࣮ ᑠඣ⛉ 3) ྎ་⒪ࢭࣥࢱ࣮ ⓶⛉ 4) ᮌ⏫ᑠඣ⛉ࠊ5) Ọᑠඣ⛉ Ӑᢒ㘓ӑ ࡣ 5 ᭶⏨ඣࠋ⏕ᚋ 2 ᭶㡭ࡽࢺࣆ࣮ᛶ⓶⅖ࢆࢃࢀࢫࢸࣟࢻእ⏝ࡼࡿ⒪ࡀ⾜࡞ࢃ ࢀ࡚࠸ࡓࠋᙜ⛉ཷデ๓᪥ࡽయᖿ㒊ᑠୣ⑈ࡀฟ⌧ࡋࠊⓎ⇕ࡶຍࢃࡗ࡚ࡁࡓࡓࡵ㏆་ཷデࡋࡓࡇࢁࠊ࣏࢝ ࢪỈ①ᵝⓎ⑈ࢆࢃࢀᙜ⛉⤂ࠊධ㝔࡞ࡗࡓࠋධ㝔ࠊయᖿ㒊ࢆ୰ᚰỈ⑁ࢆక࠺ᑠୣ⑈ࡀከᩘㄆࡵࡽ ࢀࡓࠋ Ỉ⑁ෆᐜ≀ࡢ᳨ᰝ࡛ࡣࣄࢺ༢⣧࣊ࣝ࣌ࢫ࢘ࣝࢫᢠཎࡣ㝜ᛶ࡛ࠊ ⾑Ύᢠయ౯ࡶ᳨ฟឤᗘ௨ୗ࡛࠶ࡗࡓࠋ ➨ 5 ᪥ẕぶࡀⓎ⇕ࡋᅄ⫥Ỉ⑁ࢆక࠺ᑠୣ⑈ࡶฟ⌧ࡋࡓࡓࡵᡭ㊊ཱྀデ᩿ࡋࡓࠋࡇࡢⅬ࡛ᝈඣࢆ ᗘὀព῝ࡃデᐹࡋࡓࡇࢁཱྀ⭍ෆᑡᩘࡢ⢓⭷⑈ࢆㄆࡵࠊᡭᤸ࣭㊊ᗏࡶୣ⑈ࡀᩘಶᩓᅾࡋ࡚࠸ࡓࠋᝈඣ ࡢᢠࢥࢡࢧࢵ࣮࢟࢘ࣝࢫ A6 ᆺ㸦CVA6㸧ᢠయ౯ࡣ࣌⾑Ύ࡛᭷ពୖ᪼ࡋ࡚࠸ࡓࡇࡽࠊCVA6 ࡼ ࡿ㌟ᆺࢥࢡࢧࢵ࣮࢟࢘ࣝࢫឤᰁデ᩿ࡋࡓࠋࢺࣆ࣮ᛶ⓶⅖ࡀ࠶ࡿሙྜࠊᮏࡢࡼ࠺ CVA6 ឤᰁ࡛ࡶ࣏࢝ࢪỈ①ᵝⓎ⑈㢮ఝࡢⓎ⑈ࢆ࿊ࡍࡿࡇࡀ࠶ࡿࡓࡵࠊయᖿ㒊ࢆ୰ᚰỈ⑁ࢆక࠺ᑠୣ⑈ࡀከ Ⓨࡍࡿ࡛ࡣ㠀ᆺⓗ࡞ᡭ㊊ཱྀࡢྍ⬟ᛶࡶᛕ㢌⨨ࡁ࡞ࡀࡽ㚷ูデ᩿ࢆࡍࡍࡵࡿᚲせࡀ࠶ࡿࠋ ࣮࣮࢟࣡ࢻ㸸ᡭ㊊ཱྀࠊ㌟ᆺࢥࢡࢧࢵ࣮࢟࢘ࣝࢫឤᰁࠊࢥࢡࢧࢵ࣮࢟࢘ࣝࢫ A6 ᆺࠊ࣏࢝ࢪỈ①ᵝ Ⓨ⑈ࠊࢺࣆ࣮ᛶ⓶⅖ 㸦2013 ᖺ 11 ᭶ 23 ᪥ཷ㡿ࠊ2014 ᖺ 1 ᭶ 18 ᪥᥇⏝㸧 㸯 ึࡵ ⭸㛵⠇ࠊ⮌㒊ࡶฟ⌧ࡍࡿࡀࠊయᖿ㒊ࢆ୰ᚰⓎ⑈ ࣏࢝ࢪỈ①ᵝⓎ⑈ࡣࠊࢺࣆ࣮ᛶ⓶⅖࡞ࡢ ࡀฟ⌧ࡍࡿࡇࡣᑡ࡞࠸ 2)ࠋࡋࡋࠊ㏆ᖺᑠඣ࠾ ኚ㒊ࠊ≉㢦㠃ࠊయᖿᑠỈ⑁ࡀከⓎࡍࡿᝈ ࠸࡚ᡭ㊊ཱྀࡢ㌟ᆺࡢሗ࿌ࡀቑ࠼࡚ࡁ࡚࠾ࡾࠊࡑ ࡛ࠊࣄࢺ༢⣧࣊ࣝ࣌ࢫ࢘ࣝࢫ㸦HSV㸧ࡢ⮬ᐙ᥋✀ ࡢཎᅉ࢘ࣝࢫࡢ୍ࡘࡋ࡚ࢥࢡࢧࢵ࣮࢟࢘ࣝ 1)ࠋ୍᪉ࠊᡭ㊊ཱྀࡣᩥᏐ㏻ࡾࠊᡭ ࢫ A6 ᆺ㸦CVA6㸧ࡀ♧ࡉࢀ࡚࠸ࡿ 3)ࠋᅇᡃࠎࡣయ ࡼࡾⓎࡍࡿ ㊊ཱྀỈ⑁ᛶⓎ⑈ࡀぢࡽࢀࡿᝈ࡛ࠊࡁୗ⭣ࠊ 44 ᖿ㒊ࢆ୰ᚰ࣏࢝ࢪỈ①ᵝⓎ⑈㢮ఝࡢⓎ⑈ࢆ࿊ ྎ་⒪ࢭࣥࢱ࣮་Ꮫ㞧ㄅ Vol 4, 2014 ࡋࡓ CVA6 ࡼࡿ㌟ᆺࢥࢡࢧࢵ࣮࢟࢘ࣝࢫឤ ୖ᪼ࡋ࡚࠸ࡓࠋ⥲ IgE ࡣ 79.7IU/ml ࡛ࠊ≉␗ⓗ ᰁࡢஙඣࢆ⤒㦂ࡋࡓࡢ࡛ሗ࿌ࡍࡿࠋ IgE ᢠయ౯ࡣ༸ⓑ 6.14UA/ml㸦ࢡࣛࢫ㸱㸧ࠊ༸㯤 ࠊ∵ங 0.74UA/ml㸦ࢡࣛࢫ㸰㸧 ࠊ 1.53UA/ml㸦ࢡࣛࢫ㸰㸧 㸰 ࢝ࢮࣥ 0.42UA/ml㸦ࢡࣛࢫ㸯㸧࡛࠶ࡗࡓࠋࡲࡓࠊ 㸸5 ᭶ࠊ⏨ඣࠋ Ỉ⑁㒊᧿㐣ࡼࡿࣄࢺ༢⣧࣊ࣝ࣌ࢫ࢘ࣝࢫ ッ㸸యᖿ㒊ࡢⓎ⑈ࠊⓎ⇕ࠋ 㸦HSV㸧ᢠཎ᳨ᰝࡣ㝜ᛶ࡛ࠊHSV ᢠయ౯࠾ࡼࡧỈ ᐙ᪘Ṕ㸸∗ẕࡀⰼ⢊ࠋ ①ᖏ≧⑁⑈࢘ࣝࢫ㸦VZV㸧ᢠయ౯ࡶ㝜ᛶ࡛࠶ࡗࡓࠋ ᪤ Ṕ㸸⏕ᚋ 2 ᭶ࡽஙඣ‵⑈ࡀ࠶ࡾࠊࢺࣆ࣮ ᛶ⓶⅖ࢆࢃࢀ㏆་࡛ࢫࢸࣟࢻእ⏝⸆ሬᕸ୰ࠋ ⌧Ṕ ධ㝔๓᪥ࡢኪ㛫ࡼࡾయᖿ㒊⓶⑈ࡀฟ⌧ࡋࡓࠋ⩣ ᪥ 38ΥྎࡢⓎ⇕ࡶຍࢃࡗࡓࡓࡵ㏆་ࢆཷデࡋࠊ ࣏࢝ࢪỈ①ᵝⓎ⑈ࢆࢃࢀ࡚ᙜ⛉⤂ࠊධ㝔࡞ ࡗࡓࠋ ධ㝔⌧ య㔜 7250gࠊ⬦ᢿ 124 ᅇ/ศࠊయ 39.6Υࠋయᖿ 㒊ࢆ୰ᚰ⣚ᩬࢆక࠺୍㒊⓶ࡋࡓୣ⑈ࢆㄆࡵ ࡓࠋ 㸦ᅗ 1㸧ࠋ㤳ࡸᡭ㛵⠇࿘ᅖ࡞ࠊᒅ᭤㒊㏆ࡣ ࢺࣆ࣮ᛶ⓶⅖ࡢᡤぢࡶΰᅾࡋ࡚࠸ࡓࠋᥙឤࡀ ᙉࡃయືࢆㄆࡵࡓࠋᡭᤸ࣭㊊ᗏࡸཱྀ⭍ෆ᫂ࡽ࡞ Ⓨ⑈ࢆㄆࡵࡎࠋ྾㡢࡛ࡣ㍍ᗘ྾Ẽᛶႍ㬆࠶ࡾࠋ⭡ ⾲㸯 ධ㝔᳨ᰝᡤぢ 㒊ࡣᖹᆠ࣭㌾࡛⫢࠾ࡼࡧ⭁ࡣゐ▱ࡋ࡞ࡗࡓࠋ ධ㝔ᚋ⤒㐣 ධ㝔᳨ᰝᡤぢ㸦⾲㸯㸧 ධ㝔ࠊⓎ⑈ࡢᛶ≧ࡽ࣏࢝ࢪỈ①ᵝⓎ⑈ࢆ ⓑ⾑⌫ᩘࡣ 9200/Pl ṇᖖ⠊ᅖ࡛࠶ࡗࡓࡀࠊ⏕ ࠸ࢩࢡࣟࣅࣝࡢ⤒㟼⬦ᢞࢆ㛤ጞࡋࡓࠋධ㝔⩣᪥ Ꮫ᳨ᰝ࡛ࡣ CRP ࡀ 0.5mg/dl ࢃࡎୖ᪼ࡋࠊ ⓶⛉ࢆཷデࡋ⓶⑈㒊ࡢࢬࣀ࣮ࣝሬᕸࠊ ḟឤᰁண㜵┠ⓗ࡛ࢭࣇ࢛ࢳ࣒ࡢ⤒㟼⬦ᢞࡀ㛤 ጞ࡞ࡗࡓࠋධ㝔 3 ᪥┠ࡣゎ⇕ࡋࠊయᖿ㒊Ⓨ⑈ࡣ ῐ〓Ⰽࡢ⓶ࢆṧࡋ࡚ᾘ〣ࡋࡓࡀࠊᒅ᭤㒊ࡢ⓶⑈ࡣ ṧᏑࡋ࡚࠸ࡓࠋධ㝔 4 ᪥┠㸦➨ 5 ᪥㸧ẕぶࡀⓎ ⇕ࡋࠊྠẕぶࡢᅄ⫥Ỉ⑁ࢆక࠺ᑠୣ⑈ࡀฟ⌧ ࡋࡓࠋࡇࡢࡓࡵᗘᝈඣࡢཱྀ⭍ෆᡤぢࢆ☜ㄆࡍࡿ ᑠᩘࡢ⢓⭷⑈ࢆㄆࡵࠊᡭᤸ࣭㊊ᗏࡶᑠୣ⑈ࡀᩘಶ ᩓᅾࡋ࡚࠸ࡓ㸦ᅗ 2㸧ࠋ⮫ᗋᡤぢ࠾ࡼࡧ⤒㐣ࡽᡭ ㊊ཱྀࢆ࠸᳨ᰝࢆ⾜ࡗࡓࠋ ᅗ㸯 ึデࡢ⓶⑈ࠋయᖿ㒊ࡢࢺࣆ࣮ᛶ⓶⅖㒊ࢆ୰ᚰ ᑠୣ⑈ࡀከᩘㄆࡵࡽࢀࠊ୍㒊ࡣῐ〓Ⰽࡢ⓶ࢆకࡗ࡚࠸ࡓࠋ AST 75mU/ml, ALT 57mU/ml ㍍ᗘࡢ⫢㓝⣲ࡢ ␗ᖖࢆㄆࡵࡓࠋࡲࡓࠊCK ࡶ 240mU/ml ࢃࡎ 45 ㌟ᆺࢥࢡࢧࢵ࣮࢟࢘ࣝࢫឤᰁࡢ 1 ஙඣ ᅗ㸰 ➨ ᪥ࡢ⓶⑈ࠋᑠୣ⑈ࡀᡭᤸ࠾ࡼࡧ㊊ᗏᩘಶㄆࡵ ࡽࢀࡓࠋ ⾲ 2 ♧ࡍࡼ࠺ᢠ CVA6 ᢠయ౯ࡣ➨ 5 ᪥ࡣ 128 ಸ࡛࠶ࡗࡓࡀࠊ➨ 16 ᪥᪥ࡣ 4,096 ಸ ⾲㸱 㠀ᆺⓗ࡞Ⓨ⑈ࢆ࿊ࡋࡓᡭ㊊ཱྀ ࡢࡲࡵ ࣌⾑Ύ࡛ 32 ಸࡢୖ᪼ࡀࡳࡽࢀࠊCVA6 ࡼࡿᡭ ࡚Ⓨ⑈ࡢᙧែࡀᵝࠎ࡛ࠊฟ⌧㒊ࡸᗈࡀࡾࡶ␗࡞ࡗ ㊊ཱྀデ᩿ࡋࡓࠋ ࡚࠸ࡓࠋయ⾲㠃✚ࡢ 10%௨ୖࡢⓎ⑈ࡀ 61%ࡢᝈ⪅ ㄆࡵࡽࢀࠊⓎ⑈ࡢฟ⌧㒊ࡶᚑ᮶ࡢᡭ㊊ཱྀ࡛ࡳ ࡽࢀࡿᡭᤸࠊ㊊ᗏࠊ⮌㒊ࡢࠊཱྀ࿘ᅖࠊᅄ⫥ࡸ యᖿ㒊ࡶㄆࡵࡽࢀࡓࠋࡉࡽ 55%ࡢᝈ⪅࡛ࡣ⓶ ⅖ࢆ࠾ࡇࡋ࡚࠸ࡿ㒊୍⮴ࡋ࡚࣊ࣝ࣌ࢫᛶ‵⑈ ᵝࡢⓎ⑈ࡀฟ⌧ࡋࡓࠋࡋࡋࠊ࡞ࡐ CVA6 ࡀ⓶⅖ ⾲㸰 ࢥࢡࢧࢵ࢟㸫࢘ࣝࢫᢠయ౯ ࡢ࠶ࡿ㒊Ỉ⑁ᛶⓎ⑈ࡸࡧࡽࢇࢆዲⓎࡋ࡚ࡃࡿ ࡢࡘ࠸࡚ࡣࠊࡲࡔⰋࡃࢃࡗ࡚࠸࡞࠸ 3, 7)ࠋࡲ 㸱 ⪃ᐹ ᡭ㊊ཱྀࡣဗ㢌ኚᡭᤸ࣭㊊ᗏࡢỈ⑁ᛶⓎ⑈࡛ ࡓࠊỈ⑁ᛶኚࡀᾘ〣ࡍࡿࡇࢁᡭᤸࡸ㊊ᗏࡢ⾲⓶ 2)ࠋᆺⓗ࡞≧࠾ࡼࡧ 㞳ࡀ㉳ࡇࡗࡓࡾࠊ3㹼8 㐌ᚋ∎ࡀ∎ᗋࡽࢀ ≉ᚩ࡙ࡅࡽࢀࡿᝈ࡛࠶ࡿ ࡓࡾࡍࡿࡇ㸦Onychomadesis㸧ࡶ࠶ࡿ 3)ࠋ ⮫ᗋᡤぢࡣⓎ⇕ࠊཱྀ⭍ෆࡧࡽࢇࠊࡑࡋ࡚ᡭࠊ㊊ࠊ⮌ 㒊ࡢᙧᑠỈ⑁࡛࠶ࡿࠋ5 ṓᮍ‶ࡢࡇࡶዲⓎࡋࠊ ᮏ࡛ࡶⓎ⑈ࡣయᖿ㒊ࢆ୰ᚰᗈࡃㄆࡵࡽࢀࠊ ⣅ཱྀឤᰁࠊỈ⑁ᾮࠊ㣕ἓឤᰁ࡛ឤᰁࡍࡿࠋࢥࢡࢧࢵ ࡑࡢᙧែࡽࡣ HSV ࡼࡿ࣏࢝ࢪỈ①ᵝⓎ⑈ ࣮࢟࢘ࣝࢫ A16 ᆺ࢚ࣥࢸࣟ࢘ࣝࢫ 71 ࡢ 2 ࡘ ࡢ㚷ูࡀᅔ㞴࡛࠶ࡗࡓࠋࡋࡋࠊ⤒㐣୰ẕぶࡀ ࡀᡭ㊊ཱྀࡢ௦⾲ⓗ࡞㉳ᅉ࢘ࣝࢫ࡛࠶ࡿ 4-6)ࠋ ᆺⓗ࡞ᡭ㊊ཱྀࢆⓎࡋࡓࡓࡵࠊ࣌⾑Ύ࡛ࢥࢡࢧ ㏆ᖺࠊᡭ㊊ཱྀ࠾࠸࡚ࠊ㠀ᆺⓗ࡞⓶⑈ࡢฟ⌧ ࢵ࣮࢟࢘ࣝࢫᢠయ౯ࡢ ᐃࢆ⾜࡞ࡗࡓࡇࢁࠊᢠ ࡀሗ࿌ࡉࢀ࡚࠸ࡿࠋ≉ 2011 ᖺࡽ 2012 ᖺ CVA6 ᢠయ౯ࡢୖ᪼ࡀࡳࡽࢀ㌟ᆺࢥࢡࢧࢵ࣮࢟࢘ ࡅ࡚⡿㝣࡛ὶ⾜ࡋࡓᡭ㊊ཱྀ࡛ࡣ㠀ᆺⓗ࡞ ࣝࢫឤᰁデ᩿ࡋࡓࠋ௨ୖࡢࡇࡽࠊᮏ Ⓨ⑈ࢆ࿊ࡋࡓࡀከࡃࠊMathes ࡽࡢሗ࿌ࡼࡿ ࡢࡼ࠺⓶⅖࠶ࡿ࠸ࡣ‵⑈ࡢ࠶ࡿ㒊᪂ࡓ 㠀ᆺⓗ࡞ᡭ㊊ཱྀࡢᑠඣ 80 ࢆゎᯒࡋࡓ Ỉ⑁ࢆక࠺ᑠୣ⑈ࡀฟ⌧ࡋࡓሙྜࡣ࢚ࣥࢸࣟ࢘ ࡇࢁࠊࡑࡢ࠺ࡕ 17 ࡛ CVA6 ࡀ᳨ฟࡉࢀࡓ 6)ࠋࡑ ࣝࢫឤᰁࠊ≉ CVA6 ࡼࡿឤᰁࢆ㚷ูᝈ ࡢ≉ᚩࡣ⾲ 3 ♧ࡍࡼ࠺ࠊᚑ᮶ࡢᡭ㊊ཱྀẚ ࡋ࡚ᛕ㢌ධࢀ࡚࠾ࡃᚲせࡀ࠶ࡿࠋ ᅜ❧ឤᰁ◊✲ᡤࡽࡢሗ࿌ࡼࡿ᪥ᮏ࡛ࡣ 2011 ᖺ 2013 ᖺ CVA6 ࡼࡿᡭ㊊ཱྀࡀὶ⾜ ࡋࡓ 8)ࠋྠᮇ㠀ᆺⓗ࡞ᡭ㊊ཱྀࡀ」ᩘ ᙜ⛉ࢆཷデࡋ࡚࠸ࡿࠋࡑࡢ୰࡛ᕧ࡞ᡭᤸ࣭㊊ᗏࡢ 46 ྎ་⒪ࢭࣥࢱ࣮་Ꮫ㞧ㄅ Vol 4, 2014 of 100 cases. J Am Acad Dermatol. 2003; 49:198-205 2) Blattner RJ. "Hand, Foot, and Mouth" disease. J Pediatr. 1963;63:508-510 3) Mathes EF, Oza V, Frieden IJ, et. al,. "Eczema coxsackium" and unusual cutaneous findings in an enterovirus outbreak. Pediatrics. 2013;132:e149-157 4) Robinson CR, Rhodes AJ. Vesicular exanthem and stomatitis. Report of an epidemic due to Coxsacke virus Group A, Type 16. N Engl J ᅗ㸱 㠀ᆺⓗ࡞⓶⑈ࢆ࿊ࡋࡓᡭ㊊ཱྀࡢ ṓ ᭶⏨ඣࠋ Med. 1961;265:1104-1105 5) Khetsuriani N, Lamonte-Fowlkes A, Oberst S, ୖẁ㸸๓⬚㒊࠾ࡼࡧ⫼㒊୍㒊ῐ〓Ⰽࡢ⓶ࢆక࠺ᑠୣ⑈ࡀ ㄆࡵࡽࢀࡓࠋୗẁ㸸ᡭᤸ࠾ࡼࡧ㊊ᗏᕧ࡞Ỉ⑁ࡀほᐹࡉࢀ et, al; Centers for Disease Control and ࡓࠋ Prevention. Enterovirus surveillance--United States, 1970-2005. MMWR Surveill Summ. Ỉ⑁ࡀࡳࡽࢀࡓࢆ⤂ࡍࡿ㸦ᅗ 3㸧ࠋࡇࡢ 2006;55:1-20 ࡣ 2 ṓ 10 ᭶⏨ඣ࡛ࠊయᖿ㒊࣏࢝ࢪỈ①ᵝⓎ⑈ 6) Ho M, Chen ER, Hsu KH, et. al.. An epidemic 㢮ఝࡢⓎ⑈ࢆㄆࡵࡓࡀࠊᡭᤸ࣭㊊ᗏࡢỈ⑁ࡀ┠❧ of enterovirus 71 infection in Taiwan. Taiwan ࡗࡓࡇࡽᡭ㊊ཱྀࢆ࠸ࠊࢥࢡࢧࢵ࣮࢟࢘ࣝ Enterovirus Epidemic Working Group. N ࢫᢠయ౯ࡢ ᐃࢆ⾜࡞ࡗࡓࠋࡑࡢ⤖ᯝࠊᢠ CVA10 Engl J Med. 1999; 341:929-935 ᢠయ౯ࡀ 128 ಸ㝧ᛶ࡛࠶ࡗࡓࡀࠊᢠ CVA6 ᢠయ 7) Wollenberg A, Wetzel S, Burgdorf WH, et. al. ౯ࡣ 8 ಸᮍ‶㝜ᛶ࡛࠶ࡗࡓࠋࡇࡢࡼ࠺ࠊCVA6 Viral infections in atopic dermatitis: ௨እ࡛ࡶ㠀ᆺⓗ࡞ᡭ㊊ཱྀࢆ࿊ࡋ࡚ࡃࡿࡀ࠶ pathogenic aspects and clinical management. ࡿࡇࡀ♧၀ࡉࢀࡓࠋ J Allergy Clin Immunol. 2003;112:667-674 8) Infectious Diseases Weekly Report Japan 2013 ᖺ➨ 31 㐌㸦7 ᭶ 29 ᪥㹼8 ᭶ 4 ᪥㸧㸬 㸲 ⤖ㄒ ࣏࢝ࢪỈ①ᵝⓎ⑈㢮ఝࡢⓎ⑈ࢆ࿊ࡋࡓ CAV6 http://www0.nih.go.jp/niid/idsc/idwr/IDWR20 13/idwr2013-31.pdf㸸2013;15:1-36 ࡼࡿ㌟ᆺࢥࢡࢧࢵ࣮࢟࢘ࣝࢫឤᰁࡢஙඣ ࢆሗ࿌ࡋࡓࠋయᖿ㒊ࢆ୰ᚰỈ⑁ࢆక࠺ᑠୣ⑈ࡀ ㄆࡵࡽࢀࡿ࡛ࡣࠊ㠀ᆺⓗ࡞ᡭ㊊ཱྀࡢྍ⬟ᛶ ࡶᛕ㢌⨨ࡁ࡞ࡀࡽ㚷ูデ᩿ࢆࡍࡍࡵࡿᚲせࡀ࠶ ࡿࠋ ᮏࡢせ᪨ࡣᐑᇛ┴ᑠඣ⛉་Ꮫ⾡ㅮ₇ 㸦2013 ᖺ10᭶ ྎ㸧࡚Ⓨ⾲ࡋࡓࠋ 㸳 ᩥ⊩ 1) Wollenberg A, Zoch C, Wetzel S, et, al.. Predisposing factors and clinical features of eczema herpeticum: a retrospective analysis 47
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