Matenda a Fungal Angalimbikitse Kulimbana ndi Matenda a Edzi
Matenda a cryptococcosis ndi matenda opweteka omwe amachititsa anthu oposa 16,000 padziko lonse tsiku lililonse kapena pafupifupi anthu miliyoni imodzi chaka chilichonse.
Kuchokera kwa cryptococcosis (yomwe imaphatikizapo cryptococcal meningitis) imayikidwa ndi US Centers for Disease Control and Prevention monga momwe HIV imakhalira . Pafupipafupi, cryptococcal meningitis ndi matenda omwe amapezeka kwambiri pakati pa anthu omwe ali ndi AIDS .
Pakufika kwa mankhwala opatsirana pogonana (ART) , chifuwa cha cryptococcosis chachepa kwambiri m'mayiko otukuka kuyambira m'ma 1990.
Komabe, kuchokera ku chiwonetsero cha padziko lonse, chiwerengero cha anthu omwe amafa chifukwa cha cryptococcal meningitis pakalipano ndiposa 625,000-ndipo chiwerengero chachikulu chikupezeka m'munsi mwa Sahara ya Africa, kumene anthu amafa pakati pa 50% ndi 70%.
Mosiyana, imfa chifukwa cha cryptococcosis ku US ndi mayiko ena otukuka ndi pafupi 12%.
Causal Agents
Cryptococcosis imayamba ndi bowa Cryptococcus neoformans ndi Cryptococcus gattii . Poyambirira, cryptococcosis inangotchulidwa kokha kwa C. neoformans , koma kafukufuku adachoka kale ndipo adziŵitsa madontho aŵiri a causative.
Pakati pa anthu omwe ali ndi kachilombo ka HIV, maulendo opitirira atatu pa cryptococcosis amapezeka mwa anthu omwe ali ndi CD4 chiwerengero chapansi pa 50 maselo / mL. Cryptococcosis sichipezeka kawirikawiri kwa anthu omwe ali ndi machitidwe a chitetezo cha mthupi.
Njira Zotumizira
Zimatulutsa kuti cryptococcosis imapezedwa ndi kutulutsa spores (basidiospores) ya C. neoformans kapena C. gattii .
Ngakhale kuti C. neoformans kawirikawiri imapezeka m'nthaka yomwe imakhala ndi zitosi za mbalame, makamaka njiwa, inhalation imaonedwa ngati njira yambiri ya matenda (mosiyana ndi kumeza mwangozi kapena kukhudzana ndi khungu).
Mosiyana ndi zimenezo, C. gattii nthawi zambiri sapezeka muzinthu zamagulu, koma mmitengo (kawirikawiri ndi eucalyptus). Bowawu amadziwika kuti akufalikira m'mabwinja m'munsi mwa mitengo.
Ngakhale cryptococcosis imachitika kawirikawiri zinyama, zinyama zonse ndi avian, matenda a nyama-kwa-munthu ndi osowa kwambiri. Kugonjera kwa munthu kwa munthu kumatchedwanso kuti ndi kosawerengeka.
Zizindikiro za Cryptococcosis
Zizindikiro za matenda a Crytococcal nthawi zambiri zimayambira patapita miyezi iwiri kapena 11 mutatha kuwonekera.
Matenda a cryptococcal amachititsa kuti odwala azikhala osakwanira, kapena amakhala ndi zizindikiro zochepa zapuma, osati zapadera. Odwala omwe ali ndi chifuwa cha cryptococcal nthawi zambiri amakumana ndi chifuwa, kupweteka pamtima, kutentha thupi kwambiri, malaise, ndi kupuma pang'ono. Nthaŵi zina, pangakhale kulemera, kutupa kwa mitsempha yam'mimba ( lymphadenopathy ), kupuma mofulumira ( tachypnea ), ndi mapulogalamu omveka m'mapapo (miyendo).
Ngati kachilomboka kakufalitsidwa pamapapo (extrapulmonary), nthawi zambiri imakhala mkatikati mwa mitsempha ya cryptococcal meningitis. Muzochitikazi, odwala angayambe kupezeka ndi zizindikiro zochepa monga mutu, malungo, kapena kusintha kwa maganizo (mwachitsanzo, kutaya mtima, kusasamala, kulephera).
Zizindikiro nthawi zambiri zimakhala zovuta pang'onopang'ono, kuwonjezereka pang'onopang'ono pakapita milungu ingapo.
Makhalidwe akuluakulu ndi aakulu a cryptococcal meningitis angaphatikizepo:
- Nsowa ndi kusanza
- Masomphenya obisika
- Chisamaliro kuunika
- Kumva kupweteka kapena kutayika
- Kuwonjezeka kwapopu
- Mutu wamphamvu
- Khosi lamtundu
- Kusintha kwa umunthu
- Kuvuta kulankhula, kuwerenga kapena kulemba
- Kusokonezeka kapena kutayika bwino
- Hallucinations
- Coma
Popeza zizindikiro zina zokhudzana ndi matenda a meningitis (monga khosi lolimba ndi kuzindikiritsa kuwala) sizimapezeka kwa odwala ambiri ndi cryptococcal meningitis, kudziŵa kuti vutoli nthawi zina limasowa, kuchedwa kuchipatala kwa milungu ingapo ngakhale miyezi mpaka kutuluka kwapadera zizindikiro.
Pambuyo pa mapapo ndi mitsempha yambiri yamkati, matenda a cryptococcal angasonyezenso pakhungu ngati zilonda, zilonda zam'mimba, mapepala, ziphuphu, ndi chiwerengero china cha zina zowonongeka. Zingasokonezenso matenda a adrenal, prostate, ndi machitidwe ena a ziwalo.
Kuzindikira kwa Cryptococcosis
Kusanthula kwa cryptococcosis kumathandizidwa ndi kuwonetsera zochitika zachipatala ndi matenda a symptomatology, ndipo zimatsimikiziridwa ndi kufufuza magazi, minofu, cerebrospinal, kapena madzi ena. Njira zogwiritsira ntchito zingaphatikizepo izi:
- Kuyeza kwa antiptococcal antigen ya magazi kapena cerebrospinal
- Kuyeza kwa microscopic ndi / kapena chikhalidwe cha minofu, magazi kapena cerebrospinal fluid
- Chikhalidwe cha bronchoalveolar kusamba kutsuka
Ngakhale chifuwa chimagwiritsidwa ntchito m'mapapu pakadwala matenda a pulmonary, potsirizira pake zimathandiza m'malo momatsimikizira.
Kuchiza kwa Cryptococcosis
Kwa odwala osadziletsa omwe ali ndi matenda osokoneza bongo kapena ocheperapo, crystonaalle (i-fluconazole, itraconazole) ikhoza kulamulidwa mpaka matenda opatsiranawo atha kukhazikitsidwa.
Pakadwala matenda aakulu, nthawi zambiri mankhwala amayamba ndi amphotericin B, nthawi zambiri kuphatikizapo flucytosine. Izi kawirikawiri zimatsatiridwa ndi chithandizo chamakono chokonzekera pogwiritsira ntchito mlingo wa mankhwala a antitifungal (kuphatikizapo kuyambitsa ART ngati wodwalayo asanalandire chithandizo).
Thandizo lokonzekera liyenera kupitilizidwa mpaka nthawi yomwe CD4 chiwerengero ili pamwamba pa maselo 100 / mL ndipo chiwerengero cha vutolo cha wodwalayo chimafufuzidwa nthawi zonse. Ngati CD4 ikugwera pansi pa zana 100, mankhwalawa ayambe kuyambanso kuti asatengenso matenda.
Ku US ndi maiko ambiri otukuka, zoyambirira (zoteteza) antifungal prophylaxis sizitsimikiziridwa, ngakhale kuyesayesa kwa antigen kusagwiritsidwe ntchito kungawonedwe kwa odwala pangozi yowonjezera kapena m'madera omwe ali ndi matenda aakulu.
Malankhulidwe:
- krip-to-kaw-KO-sus
- krip-to-KOK-ul i-nin-JYE-tus
Komanso:
- Crypto (slang)
- Crypotococcal matenda
Zotsatira:
Zachigawo za US za Kuletsa ndi Kupewa Matenda (CDC). "Zowonjezera A - AIDS Kufotokozera Malamulo." Atlanta, Georgia; idatsimikiziridwa mobwereza November 20, 2008.
Cogliati, M. "Global Molecular Epidemiology ya Cryptococcus neoformans ndi Cryptococcus gattii: An Atlas of Molecular Types." Scientifica. December 11, 2012. Nkhani ID 675213, masamba 23.
Del Valle, L. ndi Piña-Oviedo, S. "Matenda a HIV, ubongo ndi tizilombo toyambitsa matenda." Malire mu Bioscience. January 2006; 11 (1): 718-732.
Holmes, C ;; Losina, E ;; Walensky, R .; et al. "Kubwereza kwa matenda a anthu omwe ali ndi kachilombo koyambitsa matenda a HIV m'madera akumwera kwa Sahara ku Africa." Matenda opatsirana pogonana. 2003; 36 (5): 652-662.
Zachigawo za US za Kuletsa ndi Kupewa Matenda (CDC). "Cryptococcal meningitis: matenda oopsa pakati pa anthu omwe ali ndi HIV / AIDS." Atlanta, Georgia; zolemba CS21371B; idatsimikiziridwa pa October 2, 2012.
Chophimba, R .; Hajjeh, R; ndi Powderly, W. "Chiyembekezo choletsa cryptococcosis kwa anthu omwe ali ndi kachilombo ka HIV." Matenda opatsirana pogonana. August 1995; 21 (S1): 103-107.
Rhein, J., ndi Boulware, D. "Kulongosola ndi kusamalira cryptococcal meningitis kwa odwala omwe ali ndi kachilombo ka HIV." Nthenda ya HIV ya HIV. June 12, 2012; 2012 (4): 45-61.
Kanji, S .; Kakai, R .; ndi Onyango, R. "Cryptococcal meningitis pakati pa anthu omwe ali ndi kachilombo koyambitsa matenda a immunodeficiency amagwira chipatala chachikulu ku Kisumu, Western Kenya." Archives of Clinical Microbiology. 2011; 2 (12); pitani: 10: 3823/220.
Yokwanira, J .; Dismukes, W .; Dromer, F .; et al. Malangizo Othandizira Omwe Amagwiritsa Ntchito Zipatala Zothandiza Kulimbana ndi Matenda a Cryptococcal: 2010 Kusinthidwa ndi Infectious Diseases Society of America. " Matenda opatsirana pogonana. . 2010: 50 (3): 291-322.