Zvinopfuura kungoita shingles
Varicella zoster virus (VZV) ine nzira dzakasiyana-siyana dzekuita kuti vanhu vatambure. Pakutanga, inongokonzera chickenpox. Kazhinji, kunyange hutachiona hahwubudi apo ruzha runopera. Pane kudaro, hutachiona hunopinda muchivande, ichirarira mumakamuri emagunha emakondomu ari pedyo nomugero wepelinha, kumirira mukana wokuita imwe kuonekwa.
Shingles ndeimwe yenzira dzinonyatsozivikanwa dzeVZV dzinodzoka kumativi maviri.
Utachiona hunodonha kunze kweganda rinenge rakachengetedzwa nejinga rimwe chete, zvichiita kuti kuve nekuputika kukuru. Kunyangwe mushure mekurumidza kuparara, kurwadziwa kunogona kupfuurira mune izvo zvinonzi postherpetic neuralgia.
Shingles inonyatsozivikanwa asi VZV dzimwe nguva inogona kutungamirira vasculitis, meningoencephalitis, myelopathy, retinal necrosis, vasculopathy, kana Ramsay Hunt syndrome. Zvose izvi zvinetso zvinogona kuitika musina kumhanya kana mwedzi mushure mekurumidza. Kuongorora kwema laboratory zvakadai sekuvapo kweVZV DNA kana masero asina kukwana mumagetsi e- cerebrospinal (CSF) anobatsira kana aripo, asi chirwere chinogona kuitika kunyange kana zviwanikwa zvisipo. Kunyange kana kliniki ichifungidzirwa, kurapwa kwezvirwere zvehutano zvinokonzerwa neVZV kunogona kunge kwakaoma.
Herpes Zoster
Herpes zoster, inonziwo shingles, ndeimwe yemhando dzakawanda kwazvo dzeVVV. Nemhaka yokuti inopa nekumhanya kwechimiro, vamwe vanhu havafungi sechirwere chepfungwa.
Zvisinei, kuputika kunopararira pane izvo zvinonzi kududzirwa kwemaermatomal , zvinoreva nzvimbo yeganda isingarangarirwi nedzimwe nerve midzi. Izvi ndechokuti iyo mizinga yegunha, kana ganglion, ndiyo iyo hutachiona yakaradzika kusvikira yawana mukana wekuita zvakare zvakare. Chaizvoizvo, magnetic resonance imaging (MRI) inogona kuratidza kukurudzira kwechikwata chinokanganisa.
Dambudziko racho rinorwadza zvikuru. Kurapa kune valacyclovir kwemazuva manomwe.
Postherpetic Neuralgia
Postherpetic neuralgia inowedzera kusimbisa chokwadi chokuti herpes zoster inonyanya kurwara neurological. Kunyangwe mushure mekurumidza kuparara, marwadzo pamusoro pemvura iyo inogona kuramba iripo. Kana ikadaro kwemwedzi inopfuura mitatu, kufungidzirwa kwe postherpetic neuralgia (PHN) inogona kuitwa. Chinhu chinonyanya kukosha chinokonzerwa nekugadzirisa PHN ndechezera, uye vanopfuura 30 muzana yevaya vanopfuura makore makumi matanhatu nemasere vachienderera mberi kukurudzira PHN. Chirwere chacho chinogona kunge chichibva nokuda kwechirwere chisingagumi nekuda kwehutachiona hwehutachiona huripo, sezvo masero asingagumi anokwidzika akawanikwa mune vanhu vane PHN yemakore maviri, uye VZV DNA nemapuroteni anowanikwa muropa revarwere vakawanda vane PHN. Vamwe varwere vakagadziridzwa nehutachiona hwehutachiona hwehutachiona, asi kurapwa ne IV acyclovir hakubvumirwi neChadya neDrug Administration (FDA), uye kune chido chekugadzirwa kwakanaka kwekliniki. Zvinogona kuva zvakaoma zvikuru kudzora marwadzo eFN. A tricyclic antidepressant, gabapentin, pregabalin kana lidocaine patches inowanzova iyo nzira yokutanga yerapi, inoteverwa ne opioid, tramadol, kana kuti capsaicin sechipiri kana kuti chetatu mishonga.
Kusanganiswa kwemishonga kunogona kuva yakakosha. Percutaneous peripheral nerve field stimulation, iyo inokurudzira mashizha emagetsi anoiswa pasi penzvimbo yekutambudzika kukuru, inogona kupawo zororo.
Zoster Sine Herpete
Chaizvoizvo, "zoster sine herpete" yaizoonekwa seperipepegia neuralgia, asi pakanga pasina kumbobvira kushanduka (herpete) kutanga. Chirwere ichi chinogona kuonekwa neanoripolisi muCSF. Zvimwe zvinokonzera kurwadziwa kwakanyanya, zvakadai sechirwere cheshuga chirwere kana chirwere chetsvo, chinofanirawo kutongororwa neongororo yeuropi. Kurapa kunosanganisira high-dose acyclovir, nekurapa marwadzo mufashoni yakafanana naFN.
Retinal N ecrosis
Kuvharirwa kweziso neVZV kunogona kukonzera kufambira mberi kwesero murufu rwetina. Izvi zvinokonzera kurwa pedyo neziso, pamwe nekusaona kwemaonero. Peripheral vision yakarasika kutanga. Apo chiremba anoongorora kuongorora fundoscopic vanogona kuona kupisa uye kuchenesa kwe retina. Zvimwe mavhesi, zvakadai seHSV uye cytomegalovirus, zvinogona kukonzera retinal necrosis. Kazhinji, izvi zvinowanikwa kune vanorwara neAIDS vane T-cell inowanikwa pasi (<10 masero / mm ^ 3). Mishonga inowanzo ne IV acyclovir, pamwe chete nesteroid uye aspirin. Intravitreal injections yeantiviral agents akashandawo.
Meningoencephalitis
Izwi rokuti meningoencephalitis rinoreva kuvhiringidzika kweuropi uye zvakapoteredza mishonga. Izvi zvinogona kukonzera misoro, kusanganisa kugadziriswa, uye zviratidzo zvepfungwa zvehutano kana zviratidzo zvakadai sekutambudzika kutaura noma kusimba pane rumwe rutivi rwemuviri. Izvi zvese zvinogona kuitika kunyange pasina bhutta rinotaura. MRI inogona kuratidza kukura kwemashuga akakomberedza uropi, uye kuputika kwechirwere kunogona kuratidza anti-VZV IgG uye IgM antibodies kana VZV DNA mu cerebrospinal fluid. Kurapa kunowanikwa ne-high-dose intravenous acyclovir katatu zuva nezuva kwemazuva 10 kusvika ku14.
Myelopathy
Kuita myelopathy kunoreva kukuvara kumutsipa wepelinha. Izvi zvinogona kutungamirira kukundikana kunofambira mberi kwemakumbo, pamwe nekushaya simba kana kusava nechirwere chechando uye maronda. MRI inogona kuratidza chiremera chikuru kana kurohwa mukati memutsipa wepelinha. Mucherechedzo wehutachiona hunogona kuratidza zvimwe zvakawanikwa zvinotarisirwa muVZV meningoencephalitis, ine anti-VZV antibodies kana VZV DNA. Sezvo neVZV meningoencephalitis, kurapwa kunowanikwa nepamusoro-dose intravenous acyclovir.
Vasculopathy
VZV inogona kukanganisa midziyo yeropa yeruropi uye nervous system, zvichiita kuti zvirwere zvakaoma zvezviratidzo zvinokonzerwa nekuderera kweropa. Izvi zvinogona kutungamirira kumusoro wepfungwa, kuchinjwa kwemagariro, uye kujekesa kweurouro zviratidzo nezviratidzo. MRI icharatidza zvipembenene zvinowanikwa pedyo nejena-white junction, kazhinji iri mukati mukati meuropi. Dzimwe nguva, VZV inogona kutarisa nguva yemazuva, iyo inokonzera nguva arteritis nekurasikirwa kwemaonero uye kurwadziwa pedyo neziso. Chirongwa cheCSF chakafanana neicho chinowanika mu meningoencephalitis kana myelopathy, uye kurapwa kunosanganisira high-dose IV acyclovir.
Ramsay Hunt Syndrome
Mukuwedzera kune dorsal root ganglia kumativi ose omukati, VZV inogona kunge yakanyarara mu ganglia yemakumbo emakumbo pamwe chete. Kana hutachiona huchiita zvakare mu cranial nerve ganglia, inogona kubudisa zviratidzo zvakasiyana siyana zvinozivikanwa seRamsay Hunt syndrome, izvo zvinogona kukonzera kushaya simba kwepamusoro kufanana neBell, uye zvimwe zviratidzo zvakawanda. Chiratidzo chekutanga cheRamsay Hunt chikafu chinoputika mukati memhemberero ye nzeve
Kudzivirirwa kweZvirwere Kurwaridzana
VZV inotarisana nevanhu vanosvika 90%. Chirongwa cheVZV chakaiswa muna 2006 kuti chidzivirire kuVZV reactivation. Ikoko chirwere ichi chinokurudzirwa kuvanhu vasingazivikanwi pamusoro pemakore makumi matanhatu kana kusina kumbove nekuitika kwemazuva ano. Pasinei nekubudirira kwayo, chirwere chacho hachina kushandiswa, uye kusawirirana kunoitika kuburikidza nedzinza uye madzinza zvakare zvakataurwa.
> Sources:
> Nagel MA, Gilden D. Murwere akaoma ane varicella-zoster virus chirwere. Neurology Clinical practice 2013; 3: 109-117