So saa ntontom yi betumi aka w’ahurututu nso? Momma yensua Histoplasmosis ho ade!

So woate yare bi a wɔfrɛ no ``Histoplasmosis'' ho asɛm pɛn? Ebia edin no bɛyɛ te sɛ nea ɛyɛ nwonwa kakra. Nanso ɛyɛ fungal yare a ebetumi aka yɛn ahurututu na ɛyɛ biribi a ɛsɛ sɛ yɛhwɛ yiye wɔ ho. Saa ntontom yi te asase mu, titiriw wɔ asase a nnomaa anaa akraman nsu wom mu. Sɛ yɛhome mfutuma a saa ntontom yi wom a, yenya saa yare yi.

Dɛn ankasa ne Histoplasmosis?

Sɛ yɛbɛka no tiawa a, histoplasmosis yɛ yɛn ahurututu mu yareɛ a ɛnam nwansena bi a wɔfrɛ no ``Histoplasma capsulatum`` (``Histoplasma capsulatum`` anaa ``H. capsulatum``) so na ɛba. Saa ntontom yi wɔ asase mu wɔ wiase mmeae pii, na abu so wɔ aman te sɛ Amerika. Wobetumi ahu saa ntontom yi wɔ yɛn Sri Lanka nso, titiriw wɔ asase a atwa akraman abodan, adan dedaw, ne nnomaa mfuw ho ahyia no mu. Ɛhyɛn yɛn nipadua mu bere a yɛhome mfutuma a fungal spores yi wom no.

So yare yi ahorow ahorow wɔ hɔ?

Yiw, histoplasmosis ahorow atitiriw pii wɔ hɔ. Nnuruyɛfo gyina bere tenten a woanya yare no ho sɛnkyerɛnne ne sɛ ebia atrɛw akɔ wo nipadua no afã afoforo so na ɛkyerɛ saa ahorow yi.

1. Ahurututu mu ntini mu yare a emu yɛ den

Eyi ne ɔyare mmoawa a ɛtaa ba. Nnipa a wɔanya fungus no mu bɛyɛ 10% nya sɛnkyerɛnne te sɛ ahurututu mu yare. Eyinom bi ne atiridiinini, ɔfe, ne ahome a ɛyɛ den. Nanso, sɛ wonya ɔyare mmoawa a ɛba fam a, ebia yare no ho sɛnkyerɛnne no nyɛ den na ɛbɛtra hɔ asram pii. Wɔfrɛ eyi sɛ subacute stage.

2. Ahurututu mu histoplasmosis a enni sabea

Eyi yɛ tebea a ɛtra hɔ kyɛ. Ɛtaa ba nnipa a wɔwɔ ahurututu mu nyarewa te sɛ emphysema anaa COPD (Chronic Obstructive Pulmonary Disease) mu. Ebia yare no ho sɛnkyerɛnne no bɛyɛ mmerɛw sen nea ɛyɛ hu no, nanso fifiri a ɛba anadwo ne ne mu duru a ɛso tew betumi aba. Nsɛnkyerɛnne no betumi atra hɔ asram pii, mfe pii mpo. Ebetumi ayɛ te sɛ nsamanwaw kakra. Sɛ wɔansa a, ahurututu no asɛe no bɛdɔɔso nkakrankakra.

3. Histoplasmosis a ɛtrɛw kɔ so

Eyi ne bere a H. capsulatum fungus no trɛw fi ahurututu mu kɔ nipadua no afã afoforo. Eyi taa ba nnipa a wɔn nipadua mu tumi a ɛko tia nyarewa no yɛ mmerɛw koraa, te sɛ wɔn a wɔanya HIV a ɛkɔ akyiri no so. Eyi betumi de sɛnkyerɛnne ahorow te sɛ ahome a ɛyɛ tiaa a ɛyɛ den, ɔbrɛ, mu duru a ɛso tew, ne honam ani akuru aba.

Nea ɛka ho no, histoplasmosis ahorow bi wɔ hɔ a ɛka amemene no (central nervous system histoplasmosis) ne nea ɛka aniwa (ocular histoplasmosis).

Histoplasmosis abu so dɛn?

Nokwarem no, wobu akontaa sɛ mpanyimfo a wɔte mmeae a ntontom `H. capsulatum` abu so anya saa fungus yi wɔ bere bi mu. Nanso, nnipa dodow no ara nnya yare no ho sɛnkyerɛnne biara.

Dɛn na saa ntontom yi yɛ yɛn nipadua?

Fa no sɛ, wohome saa `H yi. capsulatum` fungus a mfutuma wom. Afei ɛkɔ w’ahurututu mu tẽẽ. Ɛhɔ no, saa ntontom yi kɔ yɛn mogya mu nkwammoaa fitaa no mu na ɛsakra fi `nkuku` kwan so kɔ `mmɔkaw` kwan so a ebetumi anya ɔyare no.

Wɔ nnipa dodow no ara mu no, nkwammoaa a ɛko tia nyarewa a ɛwɔ nipadua no mu no sɛe ntontom no anaasɛ ɛyɛ nkataso soronko a wɔfrɛ no ``granulomas`` a ɛtwa ntontom no ho hyia na ɛmma ɛnhaw nipadua no. Ne saa nti, yenhu yare no ho sɛnkyerɛnne biara.

Nanso, ɛtɔ mmere bi a eyi betumi abɛyɛ yare:

• Sɛ wohome nwansena pii prɛko pɛ a, wo nipadua mu tumi a ɛko tia nyarewa no betumi ayɛ den, na ama woanya yare a ɛte sɛ atiridiinini na ayɛ den sɛ wobɛhome.
• Sɛ wowɔ ahurututu mu nyarewa te sɛ COPD a, saa ntontom yi betumi akɔ so asɛe w’ahurututu.
• Sɛ wo nipadua mu ahoɔden a ɛko tia nyarewa no yɛ mmerɛw (e.g., wɔn a wɔwɔ HIV anaa wɔn a wɔnom nnuru a ɛma nipadua no tumi ko tia nyarewa) a, saa ntontom yi betumi de wo nipadua mu nkwammoaa a ɛko tia nyarewa no adi dwuma de atrɛw akɔ wo nipadua no afã afoforo. Eyi betumi de nsɛnnennen a ɛde nkwa to asiane mu aba.

Dɛn ne histoplasmosis ho sɛnkyerɛnne ahorow?

Histoplasmosis ho sɛnkyerɛnne betumi ayɛ:

• Huraeɛ
• Ɛwa
• Fifiri a ɛrefifi
• Ɔhome a ɛyɛ den (dyspnea) .
• Koko mu yaw
• Tiyɛ (tiyɛ) .
• Ntini mu yaw
• Akisikuru kɔkɔɔ a ɛyɛ kurukuruwa wɔ nan ase (erythema nodosum) .

Nnipa a wɔwɔ cavitary pulmonary histoplasmosis a enni sabea nso betumi anya fifiri anadwo na wɔn mu duru so atew. Nea ɛho hia no, nnipa bɛyɛ 90% a wɔhome fungus H. capsulatum no nnya sɛnkyerɛnne biara, anaasɛ sɛnkyerɛnne no ankasa gyae.

Dɛn na ɛde yare yi ba?

Nea ɛde eyi ba ne ntontom bi a wɔfrɛ no ``Histoplasma capsulatum``. Sɛnea yɛadi kan aka no, ɛnam nsunsu mu nkwaboaa a wɔhome fi asase a saa ntontom yi wom mu so na ɛba. Saa ntontom yi nyin yiye wɔ asase a akraman nsu ne nnomaa nsu wom mu. Wohu wɔ wiase mmeae pii:

• Wɔ Ohio ne Mississippi Asubɔnten bon mu wɔ Amerika.
• Wɔ Amerika Mfinimfini ne Kesee Fam.
• Wɔ Afrika no.
• Wɔ Asia no.
• Wɔ Australia no.

Nnipa dodow no ara nnyare esiane sɛ wɔhome saa ntontom yi mu nti, nanso nnipa binom, titiriw wɔn a wɔhome ntontom no pii prɛko pɛ anaa wɔn a wɔwɔ akwahosan tebea horow bi no betumi anya yare no ho sɛnkyerɛnne.

Hena na ɔwɔ asiane kɛse mu ma eyi?

Sɛ w’adwuma anaa w’anigyede hwehwɛ sɛ wobɛkanyan mfutuma wɔ mmeae a saa ntontom yi pii wɔ no a, wowɔ asiane kɛse mu. Nhwɛso ahorow:

• Spelunking a wɔde di dwuma.
• Kuadwuma a wɔyɛ.
• Nkokɔ anaa nnomaa afoforo a wɔbɛtete wɔn.
• Adansi adan dedaw a wɔrebubu, adansi adwuma. Fa no sɛ, bere a woresiesie ofie dedaw bi a wɔmfaa nni dwuma mfe pii no, sɛ akraman wɔ ɔdan no atifi, na saa nsu no fra mfutuma no mu a? Asiane wɔ hɔ sɛ wohome a.

Hena na ɔwɔ asiane kɛse sɛ obenya histoplasmosis, sɛ́ ɛyɛ nea emu yɛ den anaasɛ enni sabea?

• Wɔn a wɔn nipadua mu tumi a ɛko tia nyarewa no ayɛ mmerɛw no fam. Nneɛma titiriw a ɛde eyi ba ne HIV a obi nya ne nnuru a ɛma nipadua no tumi ko tia nyarewa a wɔnom.
• Wɔn a wɔwɔ COPD anaa emphysema no fam.
• Wɔ nnipa a wɔadi boro mfe 55 ne nkokoaa a wonnii afe 1 fam.

Dɛn ne nsɛnnennen a ebetumi afi histoplasmosis mu aba?

Nsɛnnennen a anibere wom pii wɔ hɔ a ebetumi afi eyi mu aba:

• Akuru anaa nneɛma foforo a ɛsɛe ahurututu no.
• Fibrosing mediastinitis - Eyi yɛ akuru a ɛwɔ beae a ɛda ahurututu no ntam.
• `Ɔhome mu haw a emu yɛ den (ARDS)`.
• Central nervous system histoplasmosis - Sɛ fungus no trɛw kɔ amemene no mu a, sɛnkyerɛnne te sɛ amemene no mu ahonhon, tiyɛ, adwene a ɛyɛ basaa, ɛyɛ den sɛ obesusuw nneɛma ho, ne obubuafo betumi aba.
• Ocular histoplasmosis - Sɛ fungus no trɛw kɔ aniwa no mu a, ebetumi ayɛ basaa anaasɛ ɛbɛyera.
• Ɛtrɛw kɔ nipadua no afã afoforo te sɛ mmerɛbo, akyi berɛmo, nnompe mu ntini, ne honam ani.

Wobɛyɛ dɛn ahu yare yi?

Ebia oduruyɛfo bi bɛsɔ wo mogya, wo nsu, wo fĩ a efi w’ahurututu, nnompe mu ntini, anaa ntini bi a ɛka wo bi mu ahwɛ de ahu yare no. Wobetumi de saa nhwɛso ahorow yi adi dwuma de:

• Amammerɛ bi a ɛfa fungus `H. capsulatum` yɛ mmɔdenbɔ. Eyi ne ɔkwan a eye sen biara a wɔfa so hu histoplasmosis. Nanso, eyi betumi agye bere tenten, akosi adapɛn pii. Wɔ tebea horow a emu yɛ den mu no, ebia wo duruyɛfo no befi ase sa yare a ɔrentwɛn nea ebefi mu aba.
• Yɛrehwehwɛ mmɔkaw a ɛyɛ `H. capsulatum`.
• Wɔsɔ wo hwɛ sɛ ebia H. capsulatum ho sɛnkyerɛnne (antigens anaa antibodies) wɔ wo nipadua mu anaa.

Nea ɛka ho no, wɔyɛ koko mu X-ray anaa CT mfonini de hwehwɛ nsakrae anaa ɔsɛe a H. capsulatum de aba. Nhwehwɛmu ahorow a wo duruyɛfo de di dwuma no gyina histoplasmosis ko a wowɔ ne sɛnea wo sɛnkyerɛnne ahorow no mu yɛ den so.

Dɛn ne nhwehwɛmu ahorow a wɔde hu yare no?

X-ray ne CT scan akyi no, oduruyɛfo betumi afa nsu anaa ntini mu nhwehwɛmu de ahwehwɛ H. capsulatum ho sɛnkyerɛnne anaasɛ ɔde ayɛ no amammerɛ. Wobetumi afa akwan a edidi so yi so afa saa nhwɛso ahorow yi:

• Nsuo anaa ahurututu mu nhwehwɛmu : Woto nsuo gu kuruwa mu (nsuo mu nhwehwɛmu) anaasɛ woto nsuo gu nsuo afiri mu (nsuo mu nhwehwɛmu).
• Mogya mu nhwehwɛmu: Oduruyɛfo bi de ade bɛfa wo nsa so mogya bi.
• Biopsy : Wɔfa ntini ketewaa bi a wɔatwa mu anaasɛ wɔde ade na ɛfa ntini bi ho. Wɔ nnompe mu ntini mu nhwehwɛmu mu no, wogye nhwɛsode bi fi asen dompe no mu.
• Bronchoscopy : Oduruyɛfo de afiri a ɛyɛ tratraa a kanea wom (bronchoscope) bɛhwɛ w’ahurututu mu. Saa bere yi de, wobetumi ayɛ adeyɛ bi a wɔfrɛ no bronchoalveolar lavage (BAL). Eyi hwehwɛ sɛ wode nsu "hohoro" w'ahurututu mu mmeae nketenkete, boaboa nsu no ano, na wode kɔ lab ma wɔkɔsɔ hwɛ.

Ɔkwan bɛn so na wɔsa histoplasmosis?

Wɔde nnuru a ekum fungal sa histoplasmosis, sɛ ɛho hia a. Sɛ wowɔ yare no ho sɛnkyerɛnne a emu nyɛ den, enni hɔ bere tenten, na ɛnyɛ asiane kɛse sɛ wubenya ɔyare mmoawa a emu yɛ den a, ebia wo duruyɛfo besi gyinae sɛ ɔbɛtwɛn kakra ansa na wama wo nnuru ntɛm ara.

So aduru bi wɔ hɔ a edi mũ ma eyi?

Yiw, mpɛn pii no, wobetumi de nnuru a ekum fungal asa histoplasmosis wɔ nnipa a wɔn nipadua mu ahoɔden a ɛko tia nyarewa no mu yɛ den no mu. Ebia wo duruyɛfo bɛkyerɛw nnuru te sɛ:

• `Itraconazole a wɔde ma`
• Amphotericin B (AmB) a ɛwɔ nipadua no mu.
• `Corticosteroids` (Wɔde eyinom ma wɔ nsɛm titiriw bi mu, te sɛ nea wɔde bɛtew ɔfe so) .

Sɛ wɔansa wɔn yare a, dɛn na ɛba?

Sɛ wo nipadua mu tumi a ɛko tia nyarewa no reyɛ adwuma yiye na wunni tebea foforo biara a ɛhyɛ wo ase a, mpɛn pii no, histoplasmosis no ankasa betumi afi hɔ. Nanso, sɛ wɔansa a, ɛtɔ mmere bi a ebetumi atrɛw akɔ nipadua no afã afoforo, titiriw sɛ wo nipadua no mu tumi a ɛko tia nyarewa no ntumi nyɛ adwuma yiye a. Ebetumi nso asɛe ahurututu mu wɔ nnipa a wɔwɔ ahurututu mu tebea horow a ɛhyɛ ase no mu.

So wobetumi asiw histoplasmosis ano?

Sɛ wote beae a saa ntontom yi abu so a, ebetumi ayɛ den yiye sɛ wobɛkwati sɛ wobɛhome ntontom `H. capsulatum`. Bere a ɛrentumi nyɛ yiye sɛ wubesiw ano koraa no, nneɛma kakraa bi wɔ hɔ a wubetumi ayɛ de atew asiane a ɛwɔ hɔ no so:

• Kwati mmeae a mfutuma wɔ dɔte anaa baabi a nnomaa anaa akraman te.
• Sɛ w’adwuma anaa w’anigyede hwehwɛ sɛ wo ne asase a ebia H. capsulatum wɔ mu di nkitaho a, hyɛ N95 akataso. Ɛbɛsesa mframa a wohome no akodu baabi.

Sɛ minya histoplasmosis a, dɛn na metumi ahwɛ kwan?

Nea ɛba bere a woanya histoplasmosis no gyina sɛnea emu yɛ den ne sɛ ebia wowɔ tebea afoforo a ɛhyɛ wo ase anaa. Wɔ nnipa a wɔn nipadua mu tumi a ɛko tia nyarewa no yɛ papa na wɔn yare no ho sɛnkyerɛnne a emu nyɛ den fam no, ebia wo duruyɛfo besi gyinae sɛ "ɔbɛhwɛ na watwɛn" a ɔrennom nnuru. Sɛ wo nipadua mu tumi a ɛko tia nyarewa no yɛ mmerɛw anaasɛ woyare kɛse a, ebia ebehia sɛ wonom nnuru a ekum fungal anyɛ yiye koraa no afe biako.

Mpɛn pii no, ayaresa no di adapɛn 6-12 anaa nea ɛboro saa ma ahurututu mu histoplasmosis a emu yɛ den. Wɔ tebea horow a enni sabea anaasɛ emu yɛ den mu no, ebia ɛho behia sɛ wɔde nnuru a ekum fungal ma anyɛ yiye koraa no afe biako.

Hokwan ahorow bɛn na ɛwɔ hɔ sɛ obi benya nkwa wɔ yare yi mu?

Nnipa dodow no ara a wɔn nipadua mu tumi a ɛko tia nyarewa no yɛ papa (bɛyɛ 96%) no ho tɔ wɔn fi histoplasmosis mu bere a wɔsa wɔn yare no. Nanso, nhwehwɛmu ahorow bi kyerɛ sɛ nnipa a wɔn nipadua mu tumi a ɛko tia nyarewa no mu yɛ mmerɛw no mu dodow betumi ayɛ 25% kosi 37%. Ɛno nti na ɛsɛ sɛ nnipa a wɔn nipadua mu tumi a ɛko tia nyarewa no yɛ mmerɛw no hwɛ yiye titiriw no.

Mɛyɛ dɛn ahwɛ me ho?

Sɛ wo nipadua mu tumi a ɛko tia nyarewa no ayɛ mmerɛw, anaasɛ wowɔ COPD anaa emphysema a, ɛsɛ sɛ woyɛ nneɛma foforo de tew asiane a ɛwɔ hɔ sɛ wubenya histoplasmosis no so. Sɛ wote beae a H. capsulatum abu so a, bisa wo duruyɛfo sɛ ahwɛyiye titiriw bi wɔ hɔ a wubetumi ayɛ de abɔ wo ho ban anaa.

Bere bɛn na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn?

Sɛ wo yare no ho sɛnkyerɛnne te sɛ atiridiinini, ɔfe, ne ahome a ɛyɛ tiaa no ankɔ yiye wɔ dapɛn biako mu, anaasɛ sɛ bere kɔ so no, ɛyɛ kɛse a, kɔ oduruyɛfo nkyɛn. Sɛ wonam w’adwuma anaa w’anigyede so anya saa ntontom yi, anaasɛ woatu kwan akɔ beae bi a saa ntontom yi wɔ a, ka kyerɛ wo duruyɛfo .

Bere bɛn na ɛsɛ sɛ mekɔ Emergency Treatment Unit (ETU) ?

Sɛ wo nipadua mu tumi a ɛko tia nyarewa no yɛ mmerɛw na wowɔ ɔyare mmoawa ho sɛnkyerɛnne a, ɛsɛ sɛ wo ne oduruyɛfo kasa anaa wokɔ baabi a wɔhwɛ wɔn a wɔwɔ ayaresa a egye ntɛmpɛ mu ntɛm ara. Sɛ wowɔ sɛnkyerɛnne ahorow a emu yɛ den a, kɔ baabi a ɛbɛn wo a wɔhwɛ wɔn a wɔwɔ ayaresa a egye ntɛmpɛ mu. Nsɛnkyerɛnne a ɛtete saa no bi ne:

• Atiridiinini a ano yɛ den (bɛboro Fahrenheit 103/Celsius 40).
• Ɔhome a ɛyɛ den kɛse anaa mpofirim.
• Koko mu yaw.
• Sɛ wofe mogya a.
• Adwene a ɛyɛ basaa anaa adwene mu nsakrae afoforo.
• Akisikuru a ɛma obi ho kyere no.
• Kɔla bruu a ɛwɔ honam ani, anofafa, anaa nsateaa nnadewa mu (`cyanosis` - wei yɛ sɛnkyerɛnne a ɛkyerɛ sɛ oxygen sua wɔ mogya no mu).

Nsɛm bɛn na ɛsɛ sɛ mibisa oduruyɛfo no?

Ebia ɛbɛyɛ nea mfaso wɔ so sɛ wubebisa oduruyɛfo nsɛm te sɛ eyinom:

• So asiane kɛse wom sɛ menya histoplasmosis a emu yɛ den?
• Anamɔn titiriw bɛn na ɛsɛ sɛ meyɛ na ama asiane a ɛwɔ hɔ sɛ menya histoplasmosis no so atew?
• Nsɛnkyerɛnne bɛn na ɛsɛ sɛ mehwɛ yiye?
• Bere bɛn na ɛsɛ sɛ mekɔ baabi a wɔhwɛ wɔn a egye ntɛmpɛ?

Nea etwa to no, nneɛma a ɛsɛ sɛ wokae (Take-Home Message) .

Histoplasmosis yɛ fungal yare a ɛka w’ahurututu. Ebetumi ayɛ den sɛ wobɛkwati sɛ wote beae a saa ntontom yi nyin yiye a. Nanso nsɛm dodow no ara nyɛ aniberesɛm na ɛno ankasa siesie.

Nanso, sɛ wowɔ ahurututu mu yare anaasɛ wo nipadua no mu tumi a ɛko tia nyarewa no ayɛ mmerɛw a, asiane kɛse wom sɛ wubenya nsɛnnennen a emu yɛ den afi histoplasmosis mu. Enti, ɛho hia sɛ wo ne wo duruyɛfo bom yɛ nhyehyɛe bi de bɔ w’akwahosan ho ban na w’ani da hɔ wɔ sɛnkyerɛnne biara ho. Mma wo ho nnyɛ wo hu, awareness ne defense a eye sen biara!

` Histoplasmosis, fungal yareɛ, ahurututu mu yareɛ, Histoplasma capsulatum, nnomaa nsuo, bat nsuo, ahomegyeɛ a ɛyɛ den