顎放線菌症治療中に発症した急性出血性直腸潰瘍の1例

• Published in: 日本口腔外科学会雑誌 Vol. 65; no. 2; pp. 105 - 109
• Main Authors: 國定, 勇希, 佐々木, 朗, 奥井, 達雄, 長谷川, 利聡, 竜門, 省二, 伊原木, 聰一郎
• Format: Journal Article
• Language: Japanese
• Published: 社団法人 日本口腔外科学会 20.02.2019
• Subjects: 急性出血性直腸潰瘍; 抗菌薬起因性大腸炎; 顎放線菌症
• ISSN: 0021-5163; 2186-1579
• DOI: 10.5794/jjoms.65.105

Acute hemorrhagic rectal ulcer (AHRU) is a serious disease characterized by sudden onset, painless massive bleeding from a rectal ulcer. We report a case of AHRU that developed during treatment for mandibular actinomycosis.　The patient was a 79-year-old man. Osteomyelitis of the right side of the mandible developed after extraction of his right lower molar at a private dental clinic.　The swelling spread from the temporomandibular joint to temporal area. Incision drainage was performed and Actinomyces israelii was detected from pus.　Antibacterial treatment with benzylpenicillin was given to manage the right mandibular actinomycosis.　Indolent mass melena occurred 10 days after the antibacterial drug treatment. Lower gastrointestinal endoscopy revealed an ulcer in rectum with arterial bleeding. Surgical clipping was performed.　We diagnosed this case as AHRU caused by bedrest with the background of arteriosclerosis. Treatment with benzylpenicillin was continued for 2 weeks and followed by the administration of amoxicillin for 6 months.