Coccidioimycosis ndi matenda a fungal chifukwa cha Coccidioides immitis kapena Coccidioides posadaii , omwe amadziwika kuti "Valley Fever." Zimakhala zovuta kumadera a kum'mwera chakumadzulo kwa US, kuchokera ku Texas mpaka kumwera kwa California, komanso kumpoto kwa Mexico, Central America, ndi South America.
Ngakhale kuti coccidioimycosis imapereka mkati mwa mapapo (pulmonary), pamene imafalikira kupitirira mapapo (extrapulmonary) imaonedwa ngati matenda a Edzi ndi US Centers for Disease Control and Prevention (CDC).
Chiwerengero cha chiwerengero cha Coccidioimycosis
Malingana ndi CDC, kuchuluka kwa chiŵerengero cha anthu ku US ndi 44 anthu pa 100,000. Komabe, ambiri mwa mavotiwa amapezeka m'madera awiri (Arizona, California), komwe chiŵerengero cha anthu chikhoza kukhala chapamwamba kuposa 248 pa 100,000.
M'chaka cha 2011, CDC inayamba kuwonjezeka kawiri pa 22,000 ndi coccidioimycosis kuchokera ku 1998. Ku California kokha, chiwerengero chawonjezeka kuchokera pa 719 mu 1998 kufika pa 5,697 mu 2011.
Izi zikuti, pakati pa anthu omwe ali ndi kachilombo koyambitsa matenda a Edzi, chiwerengero cha chizindikiro cha coccidioidomycosis chachepa kwambiri kuyambira pakubwera kwa mankhwala ochepetsa antiretroviral (MAP) .
Njira Zotumizira
Coccidioides alipo m'nthaka kumene imatha kukhala ndi spores yomwe imakhala nayo nthawi yamvula. Matendawa amayamba chifukwa chowombera nkhunguzi, nthawi zambiri popanda munthu ngakhale kudziwa.
Mukalowa mkati m'mapapu, spores ikhoza kubala zina spores, zomwe zimayambitsa mitsempha yomwe imatha kuphulika ndipo imayambitsa kutupa mkati mwa bronchi. M'magulu otetezedwa ndi chitetezo cha mthupi-makamaka omwe ali ndi kachirombo ka HIV omwe ali ndi CD4 chiwerengero pansi pa maselo 250 / μL-izi zingachititse matenda oopsa a pulmona. Nkhuku zimatha kufalikira m'mapapo kupita m'magazi, kumene zimakhudza mbali zina za thupi.
Coccidioides safalitsidwa kuchokera kwa munthu ndi munthu.
Zizindikiro za Coccidioimycosis
Ambiri omwe ali ndi kachilombo sakhala ndi zizindikiro kapena zotsatira za matenda. Mwa omwe amachita, zizindikiro kawirikawiri zimadzipatula komanso zimakhala ndi zizindikiro monga chimfine monga:
- Fever
- Mutu
- Kukuda
- Kupweteka pachifuwa
- Kupuma pang'ono
- Chills
- Myalgia (kupweteka kwa minofu) ndi arthralgia (kupweteka pamodzi)
- Kutopa
Kuthamanga kumatha kukhalanso m'ma 25% a milandu. Nthaŵi zambiri chiphuphucho chimakhala chakumapeto kwenikweni, chomwe chikuyimiridwa ndi zofiira zofiira kwambiri zamtundu winawake kapena zizindikiro za mawonekedwe osasintha. Nthawi zina (pafupifupi 5-8%), matenda amatha kupita ku chibayo chophatikizika chomwe chimapezeka pakati pa anthu (CAP), chomwe nthawi zambiri chimatsimikiza mosasamala popanda mankhwala enaake oletsa fungal.
Komabe, kawirikawiri, coccidioimycosis ikhoza kukhala yayikulu kwambiri, ndipo imayambitsa kupweteka kwambiri ndi mitsempha m'mapapu. Mukatambasulidwa (mwachitsanzo, kufalikira kupyola m'mapapo), ikhoza kuwononga thupi,
- Zilonda zapakhungu ndi ziphuphu
- Zilonda zopweteka komanso zopweteka
- Matenda a mafupa
- Kutupa kwa mtima
- Zovuta zamakono zochokera mumtsinje
- Maningitis
Matenda a meningitis ndi omwe amawopsyeza kwambiri moyo wa coccidioimycosis. Ngakhale kuti chiŵerengero cha kufa kwa anthu onse ku US chimawerengedwa kuti ndi otsika (0.07%), kwa omwe ali ndi kachilombo ka HIV (CD4 pansi pa 100 cells / μL), imfa imakhala yaikulu kuposa 70% ngakhale ndi mankhwala oyenera.
Kuzindikira kwa Coccidioimycosis
Coccidioimycosis ikhoza kupezedwa ndi kuyesa kwakukulu kwa madzi a thupi, sputum, exudates (mwachitsanzo pus), kapena biopsies minofu. Kuzindikira kumatha kupangidwanso ndi PCR (polymerase chain reaction), yomwe imalimbikitsa DNA kuchokera ku zowonjezera za serological kutsimikizira Coccidioides matenda.
Kuchiza kwa Coccidioimycosis
Anthu omwe ali ndi mphamvu zodziletsa komanso omwe ali ndi kachilombo ka HIV (CD4 kuposa maselo 250 / μL), coccidioimycosis kawirikawiri amakhala odziletsa ndipo samafuna chithandizo china kupatula chisamaliro chothandizira.
Kwa iwo osowa chithandizo-kaya chifukwa cha zizindikiro zosalekeza kapena zizindikiro zowonjezereka za matenda othetsa malungo akuyesa kuti ndilo mzere woyamba kusankha.
Mwa izi, ketoconazole ndiyo njira yokhayo ya FDA yovomerezeka yotengera coccidioimycosis, ngakhale akatswiri ambiri lero ali fluconazole kapena itraconazole. (Chonde onani kuti ketoconazole, fluconazole, ndi itraconazole zimatsutsana pa nthawi ya mimba ndi kuyamwitsa.)
Kwa odwala kwambiri, antifungal amphotericin B imatengedwa ngati mankhwala osankhidwa. Amagwiritsidwa ntchito intravenously mpaka matendawa akuyendetsedwa, pambuyo pake m'kati mwa moyo oral prophylaxis ya ketoconazole, fluconazole kapena itraconazole.
Kwa odwala matenda a coccidioidal meningitis, amphotericin B ikhoza kutumizidwa mu intrathecally (mwachitsanzo mu malo omwe ali ndi ubongo kapena msana).
Kupewa Coccidioimycosis
N'zovuta kuteteza coccidioimycosis m'madera ovuta. Kuti chitetezo cha mthupi chitetezeke kwambiri, mankhwala opatsirana amathandizira kupewa matenda. Palibe katemera omwe alipo panopa. Ngati mumakhala malo ochepa ndipo mukhulupirire kuti muli pachiopsezo, pali zochepa zomwe mungachite:
- Valani maskiti pfumbi pamene mukugwira ntchito ndi nthaka, kapena madzi pansi kuti muchepetse bowa.
- Pewani kupita kunja kunja kwa mphepo yamkuntho kapena mphepo yamkuntho.
- Gwiritsani ntchito miyeso ya mpweya, monga fyuluta ya HEPA , ndikuyika zenera zodula zenera ndi zitseko.
- Ngati mukugwira ntchito pamalo omangako, valani masentikiti a N95.
Zotsatira:
Zachigawo za US za Kuletsa ndi Kupewa Matenda (CDC). "Kuwonjezeka Kwachidule Coccidioidomycosis - United States, 1998-2011." Kufa ndi Kukhumudwitsa Sabata Lamlungu (MMWR). March 29, 2013: 62 (12): 217-221.
Galgiani, J. "Coccidioimycosis." Journal ya Royal Society ya Tropical Medicine ndi Ukhondo. 2005; 41 (9): 1217-1223.
Pickering, L ;; Baker, C ;; Kimberlin, D; et al. "Coccidioimycosis." American Academy of Pediatrics, Buku Lofiira: 2009 Lipoti ku Komiti Yodwala Matenda Opatsirana. Elk Grove Village, Illinois; Kope la 28: 266-268.
Masannat, F. ndi Ampel, M. "Coccidioidomycosis kwa Odwala omwe ali ndi kachilombo ka HIV-1 mu Era ya mankhwala opatsirana pogonana." Matenda opatsirana pogonana. January 2010; 50: 1-7.
Zachigawo za US za Kuletsa ndi Kupewa Matenda (CDC). "Kuwonjezeka mu Coccidioidomycosis - United California, 2009." Kufa ndi Kukhumudwitsa Sabata Lamlungu (MMWR). February 13, 2009: 58 (5): 105-109.
Kutchulidwa: kok-si-dee-oh-my-KOH-sis
Komanso:
- Coccidioidal Granuloma
- Cocci
- "Fever California"
- "Nyanja Rheumatism"
- Matenda a Posadas Wernicke
- "Fungo la San Joaquin Valley"
Common Misspellings: coccidiomycosis