Fungal Infection Inogona Kutarisana neAIDS Kurondedzera Kurwara
Cryptococcosis inogona kuuraya chirwere chinouraya chinokonzera vanhu vanopfuura 16 000 pasi rose zuva rimwe nerimwe kana anenge mamiriyoni evanhu gore negore.
Extrapulmonary cryptococcosis (iyo inosanganisira cryptococcal meningitis) inotsanangurwa neU.S. Centers for Disease Control uye Kudzivirira semamiriro ekujekesa AIDS . Kakawanda, cryptococcal meningitis ndiyo inowanzobatwa nehutachiona hwehutachiona hwehutano uye yechitatu inowanzosangana nevanhu vane AIDS .
Nekuuya kwesangano reraretroviral therapy (ART) , chirwere che cryptococcosis chakaramba chichiramba chiri munyika yakagadzirwa kubva pakati pemakore ekuma 1990.
Zvisinei, kubva munyika yose, nhamba yegore negore yevakafa inonzi cryptococcal meningitis ikozvino inopfuura 625 000-ine kupararira kwakanyanya kunowanikwa kuSouth Africa yeSahara, uko kuurawa kunofungidzirwa kuva pakati pe50% uye 70%.
Kusiyana neizvi, kufa nekuda kwekristptococcosis muUnited States uye dzimwe nyika dzakagadzikana dziri kusvika 12%.
Causal Agents
Cryptococcosis inokonzerwa nefungus Cryptococcus neoformans uye Cryptococcus gattii . Pakupedzisira, cryptococcosis yakanga inongororwa chete neC neoformans , asi kutsvakurudza kwakabva kune yakasarudzwa uye kwakananga zvose causative subspecies.
Pakati pevanhu vane HIV, vanopfuura katatu yematambudziko e cryptococcosis vanoratidzwa kune vanhu vane CD4 nhamba pasi apa 50 masero / mL. Cryptococcosis haigoni kuitika kune vanhu vane zvirwere zvekudzivirira zvirwere.
Modes of Transmission
Inotarirwa kuti cryptococcosis inowanikwa kuburikidza nekugadzirisa zvipembenene zvinobereka (basidiospores) zveC. Neoformans kana C. gattii .
Kunyange zvazvo C. neoformans inowanzowanika muvhu iro rine madonping shiri, kunyanya pigeon, inhalation ichiri kutaridzirwa senzira inotyisa yehutachiona (zvisingaenzaniswi nekunyangarika kana kusangana neganda).
Kusiyana neizvi, C. gattii kazhinji haigoni kuwanikwa mumhuka dzeshiri, asi panzvimbo yemiti (inowanzowanzo eucalyptus). Iyo fungus inozivikanwa kuti inopararira mumatombo ari pasi pezvigadziko zvemiti.
Kunyange zvazvo kucheptococcosis inowanzoitika mumhuka, zvose zvinokamhina uye mhirizhonga, zviitiko zvemhuka-kusvika-vanhu zvinotapukira. Vanhu-ku-vanhu kutapurirwa kunoonekwawo kushoma.
Zviratidzo zve Cryptococcosis
Kurapa kwezvirwere zveCrytococcal zvirwere zvinowanzotangira chero mwedzi miviri kusvika kune gumi mushure mekutsvaga.
Chirwere chinokonzerwa nemapulmonary cryptococcal chinowanzove chisingaoneki mune varwere, kana kuti chiripo nechepasi-grade, kwete-zvakananga kuporesa zviratidzo. Varwere vane cryptococcal pneumonia vanowanzova nechikwereti, marwadzo ekupfuva, pasi-gwara fever, malaise, nekupererwa kwemhepo. Mune zvimwe zviitiko, zvinogonawo kuve nekurema, kuputika kwema-lymph glands ( lymphadenopathy ), kukufema nokukurumidza ( tachypnea ), uye mapepa anonzwika mumapapu (rales).
Kana hutachiona huchiparidzirwa kunze kwemapapu (extrapulmonary), inowanzowedzera munharaunda yepamusoro yenheyo se cryptococcal meningitis. Muzviitiko izvi, varwere vangangotanga kupa nezvirwere zvishoma-zvakadai sepfungwa, fivha, kana kuchinja mune zvepfungwa (semuenzaniso, kurasikirwa kwekucherechedza, kusaziva, kutadza).
Zviratidzo zvinowanzova zvishoma pamusana pokutanga, kuwedzera kuwedzera zvishoma nezvishoma kwemavhiki mashomanana.
Unhu hwakanaka uye husingagumi zviratidzo zve cryptococcal meningitis zvinogona kusanganisira:
- Nausea uye kurutsa
- Chiratidzo chakasvibiswa
- Kunzwa kujekesa
- Kunzwa kuora mwoyo kana kurasikirwa
- Kuwedzera kwekunetseka kunokonzera
- Musoro wemusoro
- Stiff neck
- Unhu hunochinja
- Kuoma kutaura, kuverenga kana kunyora
- Kugumburwa kana kurasikirwa kwemascular coordination
- Hallucinations
- Coma
Sezvo zvimwe zvezviratidzo zvinosanganiswa nemakambo ekumhanya (zvakadai semitsipa yakaoma uye kunzwisisa kune chiedza) hazviitiki kune vanorwara vakawanda vane cryptococcal meningitis, kuziva kuti mamiriro acho ezvinhu dzimwe nguva inoshaikwa, kunonoka kurapwa kwemavhiki uye kunyange mwedzi kusvikira kubuda kwemaitiro zviratidzo.
Kunze kwemapapu uye pakati pehutachiona hwehutachiona, chirwere che cryptococcal chinogona kuratidzwa paganda sezvipembenene, zvipembenene, mapepa, masciti, uye nhamba ipi zvayo yezvimwe zvidimbu (kana zviduku). Inogonawo kukanganisa adrenal glands, prostate, nezvimwe zvirongwa zvegumbe.
Kuongororwa kwe Cryptococcosis
Kuongororwa kwe cryptococcosis kunotsigirwa nehutano hwemakiriniki ezviratidzo uye zviratidzo, uye yakasimbiswa nekuongororwa kweropa, mishonga, cerebrospinal fluid, kana zvimwe zvirwere mumuviri. Nzira dzekuongorora dzinogona kusanganisira:
- Cryptococcal antigen kuongororwa kweropa kana cerebrospinal fluid
- Kuongorora kwakanyanya uye / kana tsika yematumbu, ropa kana cerebrospinal fluid
- Tsika ye bronchoalveolar kushambidza kushamba
Apo chifukidzo che-x-rays chinogona kuzarura panzvimbo ino kana kupararira chinopinda mumapapu muzviitiko zvehutachiona hwehutachiona, pakupedzisira vanosigira panzvimbo pokusimbisa kuongororwa.
Kurapa kwe Cryptococcosis
Kune vanomunocompetent varwere vane chirwere chekushaya muviri kana kunyoro-to-moderate cryptococcal, chirwere che antifungal therapy (fluconazole, itraconazole) inogona kurongerwa kusvikira utachiona hwehutachiona hwagadziriswa.
Kana pane chirwere chakakomba, kurapwa kazhinji kunotanga naAmphotericin B, kazhinji pamwe chete ne flucytosine. Izvi kazhinji zvinoteverwa nehupenyu hunogara huchigadziriswa uchishandisa mushonga wezuva rega rerapiungal medication (pamwe nekutanga kweART kana murwere asati ava kurapwa).
Chirongwa chekuchengetedza chirongwa chinofanira kupfuurirwa kusvika panguva yakadai sokuti CD4 count inopfuura 100 masero / mL uye mutachiona hwehutachiona hwemurwere hunoramba huchidzivirirwa kuti urege kuonekwa. Kana CD4 inowira pasi pe100, kurapa kunofanira kutanga zvakare kuti kudzivisa kudzokorora kwezvirwere.
MuAmerica uye kune dzimwe nyika dzakabudirira, nheyo (preventionative) antifungal prophylaxis haina kukurudzirwa, kunyange kutarirwa kwepakutanga antigen kunogona kutarisirwa kune varwere pane ngozi yakawanda kana munzvimbo dzepamusoro wekutakura zvirwere.
Mashoko okufananidzira:
- krip-to-kaw-KO-sus
- krip-to-KOK-ul ini-nin-JYE-tus
Uyewo Anozivikanwa Se:
- Crypto (slang)
- Crypotococcal disease
Sources:
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