Yɛn nyinaa ate "pneumonia" ho asɛm, ɛnte saa? Ebia yɛn mu binom ayɛ saa. Yɛtaa susuw ahurututu mu yare ho sɛ yare biako pɛ. Nanso nokwarem no, mmoawa ahorow pii wɔ hɔ a wobetumi de ahurututu mu yare aba. Ɛnnɛ yɛbɛka ahurututu mu yareɛ bi a ɛyɛ soronko kakra, na ɛbɛtumi ayɛ asiane ho asɛm. Wɔfrɛ eyi "Legionnaires' Disease." Ebia woante din yi ho asɛm, nanso ɛho hia sɛ wuhu ho asɛm.
Sɛ yɛbɛka no tiawa a, dɛn ne Legionnaires’ Disease?
Legionnaires’ Disease yɛ ɔyare mmoawa a ɛba w’ahurututu mu, sɛ yɛbɛka no pɛpɛɛpɛ a, ahurututu mu yare bi. Mmoawa bi a wɔfrɛ no Legionella na ɛde ba . Wunya yare no bere a wohome nsu nketenkete a mmoawa yi wom no.
Saa yare yi ka w’ahurututu titiriw. Nanso ɛtɔ mmere bi a ebetumi aka w’amemene ne w’adidi nhyehyɛe (dwensɔtwaa) nso. Yare ketewaa foforo bi wɔ hɔ a Legionella mmoawa yi de ba, a wɔfrɛ no Pontiac fever . Ɛnyɛ aniberesɛm te sɛ eyi, ɛba te sɛ atiridiinini na afei ɛkɔ. Nanso Legionnaires’ Disease betumi de nkwa ato asiane mu, enti ɛsɛ sɛ yɛhwɛ yiye wɔ ho.
Afei ebia woresusuw ho sɛ, "Nsonsonoe bɛn na ɛda ahurututu mu yare a ɛba daa ne Legionnaires' Disease ntam?" Nsonsonoe no wɔ ɔyare mmoawa a ɛde yare no ba no mu. Legionnaires’ Disease ba bere a ɔyare mmoawa bi a wɔfrɛ no Legionella hyɛn ahurututu mu no. Ɛwom sɛ ayarefo dodow no ara a wɔde wɔn kɔ ayaresabea no nya atiridiinini ne ɔfe de, nanso sɛnkyerɛnne afoforo te sɛ akisikuru ne adwenem naayɛ nso abu so wɔ saa yare yi mu.
Hena na ɔwɔ asiane kɛse sɛ obenya saa yare yi?
Nokwarem no, ɛwom mpo sɛ Legionella mmoawa wɔ nneɛma a atwa yɛn ho ahyia no mu de, nanso ɛnyɛ obiara a ɔhome no na obenya yare no. Sɛ yɛn nipadua mu tumi a ɛko tia nyarewa no mu yɛ den a, ɛbɛko atia saa mmoawa yi na abɔ yɛn ho ban. Nanso nnipa binom wɔ asiane mu sɛ wobenya saa yare yi sen afoforo. Ma yɛnhwɛ nnipa ko a wɔyɛ.
| Asiane kuw | Nkyerɛkyerɛmu a ɛnyɛ den |
|---|---|
| Nnipa a wɔadi boro mfe 50 | Bere a yɛrenyin no, nipadua no mu tumi a ɛko tia nyarewa no so tew, na ɛma ɛyɛ mmerɛw sɛ mmoawa bɛka yɛn. |
| Nnipa a wɔnom sigaret anaa wɔanom sigaret bere bi a atwam | Esiane sɛ sigaretnom sɛe ahurututu no nti, entumi nko ntia ɔyare mmoawa. |
| Nnipa a wɔn nipadua mu tumi a ɛko tia nyarewa no yɛ mmerɛw | Tebea horow te sɛ HIV, asikreyare, kokoram, asaabo anaa mmerɛbo mu yare, anaa nnuru bi (e.g., nnuru a ekum kokoram, steroid) betumi atew tumi a nipadua no wɔ sɛ ɛbɛko atia nyarewa no so. |
| Nnipa a wɔwɔ ɔhome mu nyarewa a enni sabea | Saa ɔyare mmoawa yi betumi aka nnipa a wɔwɔ ahurututu mu nyarewa te sɛ COPD (Chronic Obstructive Pulmonary Disease) anaa emphysema kɛse. |
| Nnipa a wɔde wɔn akɔ ayaresabea anaa wɔte nkwakoraa ne mmerewa afie | Nea enti a ɛte saa ne sɛ, tumi bi wɔ hɔ a mmoawa yi betumi anyin wɔ adan akɛse mu nsu nhyehyɛe mu. |
| Nnipa a wɔayɛ wɔn oprehyɛn nnansa yi | Nipadua no betumi ayɛ mmerɛw bere tiaa bi, titiriw sɛ wɔyɛɛ oprehyɛn wɔ aduru a wɔde kum nipadua no mu a. |
| Wɔn a wɔde akwaa foforo ma wɔn | Bere a wɔde akwaa foforo ahyɛ nipadua no mu akyi no, wɔma nipadua no nnuru a ɛma nipadua no tumi ko tia nyarewa na amma ampo akwaa foforo no. Enti, asiane a ɛwɔ hɔ sɛ obi benya ɔyare no dɔɔso yiye. |
Dɛn ne yare yi ho sɛnkyerɛnne?
Legionella ho sɛnkyerɛnne fi ase da adi wɔ nna abien kosi 14 akyi bere a ɔyare mmoawa no anya obi no. Ɛwom sɛ eyinom te sɛ ahurututu mu yare de, nanso nneɛma bi wɔ hɔ a ɛyɛ soronko.
- Atiridiinini a emu yɛ den:Mpɛn pii no, atiridiinini no tumi boro digrii Celsius 40 (104 Fahrenheit).
- Ɔfe: Ebia ebefi ase sɛ ɔfe a ɛyɛ dry. Ɛtɔ da bi a, mogya kakra betumi apue ne phlegm (hemoptysis).
- Ɔhome a ɛyɛ den: Ebia wobɛte nka sɛ wo home yɛ tiaa sɛ wobɔ mmɔden kakra (dyspnea) mpo a.
- Ntini mu yaw: Ɛyaw a emu yɛ den betumi aba nipadua no mu.
- Tiyɛ: Tiyɛ a emu yɛ den betumi aba.
Nea ɛka ho no, su afoforo pii wɔ hɔ a ɛyɛ soronko wɔ yare yi ho.
- Atiridiinini: Atiridiinini a ɛka ahurututu mu yare ho yɛ Legionnaires Yare no ho sɛnkyerɛnne titiriw.
- Ɔfe ne akisikuru: Ebia ɔfe bɛka yafunu a ɛyɛ yaw ho.
- Adwene a ɛyɛ basaa: Nsɛnkyerɛnne a efi amemene mu te sɛ adwene a ɛyɛ basaa, basabasayɛ, ne sɛnea wuntumi nkae baabi a wowɔ anaa bere a ɛyɛ no betumi aba.
Wubetumi ahu sɛ eyi yɛ sɛnkyerɛnne soronko koraa na anibere wom sen atiridiinini a ɛba daa.
Ɔkwan bɛn so na wɔde yare yi kɔ nnipa mu? Ade a ɛho hia sen biara!
Eyi ne ade a ɛho hia sen biara a ɛsɛ sɛ obiara hu. Legionnaires’ Disease nyɛ yare a ebetumi atrɛw afi onipa so akɔ foforo so. Wei kyerɛ sɛ wuntumi nnye no mfi obi a ɔwɔ bi ho a wowɔ, bere a ɔfefe anaa ɔfefe no. Ɛnam nneɛma a atwa yɛn ho ahyia so trɛw.
Legionella mmoawa fi awosu mu wɔ atare, atare, nsubɔnten, ne asase mu. Nanso wɔmfa ɔhaw pii mma yɛn bere a wɔwɔ saa mmeae no. Ɔhaw no fi ase bere a saa mmoawa yi kɔ nsu nhyehyɛe a nnipa ayɛ mu na wofi ase nyin ntɛmntɛm wɔ baabi a ɛhɔ yɛ hyew no.
Susuw mframa a wɔde yɛ adwuma (AC) a ɛwɔ ahɔhodan, adwumayɛbea, anaa ayaresabea kɛse bi mu ho hwɛ. Saa nhyehyɛe akɛse yi de nsu na ɛyɛ nwini. Ɔhyew a ɛwɔ saa nsukorabea ahorow no mu no yɛ baabi a mmoawa yi wo. Nsu nketenkete (nsu a wɔde mframa afra mu) a efi saa nsu no mu ba no betumi atrɛw wɔ ɔdan no mu nyinaa denam mframa a wɔde yɛ adwuma no so. Sɛ nkurɔfo home saa mframa no a, mmoawa no kɔ wɔn ahurututu mu tẽẽ.
Afei nso, ɛtɔ da bi a sɛ yɛnom nsuo anaa yɛhohoro yɛn ano a, sɛ yɛ "aspirate" nsuo bi wɔ akwanhyia mu, kyerɛ sɛ, sɛ ɛkɔ mframa kwan no mu a, sɛ mmoawa wɔ saa nsuo no mu a, ɛbɛtumi de ɔyareɛ aba.
Saa mmoawa yi taa hu wɔ:
- Nsu a ɛyɛ hyew: Saa mmoawa yi nyin yiye wɔ nsu a ɛyɛ hyew mu.
- Shower heads ne faucets: Titiriw bere a wode shower a wɔmfaa nni dwuma bere tenten bi redi dwuma no.
- Mframa a wɔde yɛ adwuma (AC) ne nsu nhyehyɛe wɔ adan akɛse mu: ahɔhodan, ayaresabea, adwumayɛbea akɛse.
- Nsu a wɔde siesie nneɛma: Nsu a wohu wɔ aguadidan akɛse mu.
- Humidifiers: Mfiri a ɛma mframa no yɛ nwini.
- Nnum:Ebetumi nso de aba, ɛntaa nsi koraa, denam mfutuma a wɔhome fi asase no mu bere a wɔreyɛ turo no so.
Ɔkwan bɛn so na wobetumi ahu yare no?
Sɛ wowɔ sɛnkyerɛnne ahorow a yɛaka ho asɛm wɔ atifi hɔ no a, wo duruyɛfo no bedi kan ahwɛ wo. Ɔsan nso bebisa w’akwantuo ho abakɔsɛm a woanya nnansa yi (e.g., so wotena ahɔhodan mu?), adwuma ho abakɔsɛm, ne ayaresa tebea foforɔ biara a ebia wowɔ.
Wɔyɛ nhwehwɛmu pii de si yare no so dua.
- Nsu ne ahurututu mu nhwehwɛmu: Eyi ne nhwehwɛmu a wɔtaa yɛ. Wobetumi asɔ wo nsu mu nhwɛsode bi ahwɛ sɛ ebia Legionella antigens wɔ hɔ anaa. Wobetumi nso afa wo nsu a ɛyɛ fĩ no bi na wɔayɛ mmoawa no amammerɛ.
- Mogya mu nhwehwɛmu: Mogya mu nhwehwɛmu hwehwɛ nnuru a ɛko tia mmoawa a wɔwɔ mogya no mu. Mogya mu nhwehwɛmu nso boa ma wohu sɛnea nipadua no akwaa (asaabo, mmerɛbo) reyɛ adwuma.
- Chest X-ray anaa CT scan: Saa nhwehwɛmu ahorow yi boa ma wohu tebea a ahurututu mu yare no te wɔ ahurututu mu ne baabi a atrɛw akodu.
- Bronchoscopy: Wɔ tebea horow bi a emu yɛ den mu no, wɔde afiri teateaa bi a mfoninitwa afiri ketewaa bi abata ho no fa hwene anaa ano no mu kɔ ahurututu no mu, na wɔfa nkwammoaa bi na wɔhwehwɛ mu.
- Thoracentesis: Sɛ nsu wɔ ahurututu no ho (pleural effusion) a, wɔde ade teateaa bi hyɛ koko no mu na woyi nsu no kakraa bi de hwɛ sɛ ebia ɔyare mmoawa bi wɔ hɔ anaa.
Ɔkwan bɛn so na wɔsa?
Asɛmpa no ne sɛ Legionnaires’ Disease yɛ nea wotumi sa koraa denam nnuru a ekum ɔyare mmoawa so , nanso ɛho hia sɛ wofi ase sa yare ntɛm ara sɛnea wubetumi.
Wɔtaa sa ayarefo yare denam ayaresabea a wɔde wɔn bɛkɔ so.
- Nnuru a ekum ɔyare mmoawa: Mfiase no, wɔde ma sɛ IV nnuru a ekum ɔyare mmoawa. Sɛ wo ho tɔ wo pɛ a, wɔdan wo kɔ nnuru a wɔde kum ɔyare mmoawa a wɔnom so. Nnuru a wɔde kum ɔyare mmoawa a wɔtaa de di dwuma ne Azithromycin, Levofloxacin, ne Doxycycline .
- Oxygen a wode bɛma: Sɛ ɛyɛ den ma wo sɛ wobɛhome a, wɔde oxygen foforo ma denam hwene mu afiri anaa akataso so.
- Mfiri a Wɔde Ma Mframa: Sɛ yare no mu yɛ den yiye na ahurututu no ntumi nyɛ adwuma ankasa a, wɔde ɔyarefo no kɔ Intensive Care Unit (ICU) na wɔde bata afiri bi ho na aboa no ma wahome.
Dɛn na ɛba bere a obi ho atɔ no akyi?
Sɛ wufi ayaresabea kɔ fie mpo a, ɛho hia sɛ wonom nnuru a ekum ɔyare mmoawa a wo duruyɛfo akyerɛw ama wo no nyinaa bere tenten no nyinaa. Eyi bɛboa ma ɔyare mmoawa no ho atew koraa.
Afei nso, egye bere kakra ansa na nipadua no ho atɔ no afi ɔyare a emu yɛ den saa no mu. Asram pii no, ebia wubehyia nea edidi so yi:
- Ɔbrɛ
- Nipadua mu yaw
- Kari pɛ wɔ ɔhaw ahorow mu bere a wonam no
- Ɔkasa mu a ɛyɛ den kakra
Sɛ saa sɛnkyerɛnne ahorow yi kɔ so a, wo ne wo duruyɛfo nka ho asɛm.
Nsɛnnennen a ebetumi afi yare yi mu aba
Sɛ wɔansa yare no bere ano anaasɛ yare no mu yɛ den yiye a, ɔhaw ahorow pii a ɛde nkwa to asiane mu betumi aba.
- Ɔhome a entumi nyɛ adwuma yiye: Ahurututu no ntumi mfa mframa pa dodow a ɛho hia mma mogya no. Wɔ eyi mu no, ɛbɛyɛ nea ɛho hia sɛ wɔde mfiri ma mframa fa mu.
- Acute kidney injury (AKI): Asaabo no ntumi nyi nneɛma fĩ mfi mogya no mu. Eyi hwehwɛ sɛ wɔde nnuru anaasɛ wɔde dialysis di dwuma.
- Amemene mu yare: Nsɛnkyerɛnne te sɛ adwene a ɛyɛ basaa ne ɔhaw a ɛma obi kari pɛ betumi ayɛ kɛse.
- Septic Shock: Ɔyare mmoawa no atrɛw wɔ mogya no mu nyinaa, na ama mogya mmoroso akɔ fam wɔ ɔkwan a ɛyɛ hu so, na akwaa ahorow no adi huammɔ.
- Rhabdomyolysis: Ntini no sɛe, na emu protein betumi aboaboa ano wɔ mogya no mu na asɛe asaabo no.
Saa nneɛma yi betumi ayɛ hu sɛ wobɛte. Nanso kae sɛ, sɛ wohu yare no ntɛm na wɔsa no yiye a, nnipa dodow no ara ho bɛtɔ wɔn koraa. Sɛ wɔansa a, asiane a ɛwɔ hɔ sɛ obi bewu no betumi ayɛ kɛse akodu 30% - 80%. Nanso sɛ wɔsa yareɛ yie a, asiane yi bɛtumi atew akɔ 5% - 10%.
Bere bɛn na ɛsɛ sɛ wokɔ oduruyɛfo nkyɛn? Bere bɛn na ɛsɛ sɛ wokɔ ETU?
Sɛ wowɔ Legionnaires’ Disease ho sɛnkyerɛnne ahorow, titiriw atiridiinini kɛse, ɔfe, ne akisikuru a, kɔ wo duruyɛfo nkyɛn ntɛm ara.
Afei nso, sɛ wotra ahɔhodan anaa ahɔhodan mu nnansa yi na amanneɛbɔ bi wɔ hɔ sɛ Legionnaires’ Disease retrɛw wɔ hɔ a, nyansa wom sɛ wo ne oduruyɛfo bɛkasa ahwehwɛ afotu, sɛ wunni sɛnkyerɛnne biara mpo a.
Sɛ wowɔ sɛnkyerɛnne a emu yɛ den a edidi so yi mu biara a, kɔ ayaresabea Emergency Department (ETU) a ɛbɛn wo a wonntwentwɛn wo nan ase.
- Atiridiinini a ano yɛ den yiye
- Ɔhome a ɛyɛ den kɛse
- Mogya a wɔfefe
- Adwene a ɛyɛ basaa, adwene mu basaayɛ, anaa kasa a ɛyɛ den
- Koko mu yaw a emu yɛ den
Nkrasɛm a Wɔde Kɔ Fie
- Legionnaires’ Disease yɛ ahurututu mu yare a emu yɛ den a ɔyare mmoawa Legionella de ba. Ɛnam nsuo nketenkete a mmoawa no wom a wɔhome so na ɛtrɛw.
- Eyi nyɛ ɔyare mmoawa mfi onipa biako so nkɔ foforo so.
- Nnipa a wɔadi boro mfe 50, wɔn a wɔnom sigaret, ne wɔn a wɔn nipadua mu tumi a ɛko tia nyarewa no ayɛ mmerɛw (te sɛ asikreyarefo ne wɔn a wɔwɔ kokoram) wɔ asiane kɛse mu.
- Atiridiinini a ano yɛ den, ɔfe, ɔhome a ɛyɛ den, akisikuru, ne adwenem naayɛ yɛ sɛnkyerɛnne ahorow a ɛtaa ba.
- Eyi yɛ yare a wobetumi de nnuru a ekum ɔyare mmoawa asa koraa, enti ɛho hia sɛ wɔhwehwɛ ayaresa ntɛm ara sɛnea wobetumi.
- Sɛ wowɔ sɛnkyerɛnne a emu yɛ den te sɛ ahome a ɛyɛ den sɛ wobɛhome, atiridiinini kɛse, anaa adwene a ɛyɛ basaa a, kɔ ayaresabea Emergency Treatment Unit (ETU) ntɛm ara.
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