Nocardiosis: So wunim sɛ mmoawa yi ahintaw asase no mu?

So woasusuw pɛn sɛ mmoawa bi wɔ hɔ a wobetumi ama yɛyare wɔ asase a yɛde yɛn nsa ka na yɛnantew so da biara no mu? Ebia ɛbɛyɛ wo nwonwa sɛ wobɛte eyi. Ɛnnɛ yɛrebɛka yareɛ bi a yɛntee ho asɛm kakra, nanso ɛho hia paa sɛ obiara hu ho asɛm. Wɔfrɛ eyi Nocardiosis wɔ aduruyɛ ho nyansahu mu. Eyi yɛ ɔyare mmoawa a mmoawa de ba. Mma ɛnhaw wo, yɛbɛka eyi ho asɛm akɔ akyiri na ɛnyɛ den.

Dɛn ne Nocardiosis? Sɛ yɛbɛka no tiawa a...

Nocardiosis yɛ ɔyare mmoawa bi a wɔfrɛ no Nocardia na ɛde ba. Wɔtaa hu saa mmoawa yi wɔ asase a atwa yɛn ho ahyia no mu, nneɛma a asɛe mu, ne mfutuma mu. Fa no sɛ asase a ɛwɔ yɛn akyi hɔ no.

Saa ɔyare mmoawa yi ka yɛn ahurututu, honam ani, ne ɛtɔ mmere bi a amemene no titiriw. Mpɛn pii no, saa yare yi ba bere a yɛhome mfutuma nketenkete a saa mmoawa yi wom, anaasɛ bere a saa mmoawa yi fa kuru bi a ɛwɔ honam ani kɔ nipadua no mu no.

Nea ɛho hia ne sɛ nocardiosis nyɛ yare a abu so kɛse. Ɛno kyerɛ sɛ ɛnyɛ biribi a obiara benya ntɛm. Nanso, sɛ ɛba, titiriw wɔ nnipa a wɔn nipadua mu tumi a ɛko tia nyarewa no ayɛ mmerɛw mu a, ɛtɔ mmere bi a ebetumi akum wɔn. Enti ɛho hia paa sɛ wohu eyi.

Saa yare yi abu so dɛn?

Nocardiosis yɛ ɔyare mmoawa a wɔntaa nhu koraa ankasa. Sɛ nhwɛso no, wɔ ɔman te sɛ Amerika mu no, nnipa 500 kosi 1000 pɛ na wɔbɔ amanneɛ afe biara. Nanso, wɔ nsɛm titiriw bi mu no, asiane no dɔɔso. Sɛ nhwɛso no, wɔahu sɛ nnipa a wɔayɛ wɔn koma foforo anaa ahurututu mu ntini foforo no mu 1% kosi 4% wɔ asiane mu sɛ wobenya saa nocardiosis yi. Ɛtɔ mmere bi a wɔbɔ nsɛm a ɛtete saa ho amanneɛ wɔ Sri Lanka nso, titiriw wɔ wɔn a wɔn nipadua mu tumi a ɛko tia nyarewa no yɛ mmerɛw no mu.

Dɛn ne Nocardiosis ho sɛnkyerɛnne ahorow?

Ɛsono yare yi ho sɛnkyerɛnne a egyina baabi a ɔyare no wɔ wɔ nipadua no mu so. Momma yɛnhwɛ sɛnkyerɛnne atitiriw a wohu no.

Nea ɛfa ahurututu ho (eyi ne nea abu so sen biara):

• Ɔfe (ɛtɔ mmere bi a, ɛwɔ ahurututu) .
• Koko mu yaw
• Ahome a ɛyɛ tiaa (ɛyɛ den sɛ wobɛhome bere a wobɔ mmɔden kakra mpo) .
• Huraeɛ
• Mu duru a wɔtew so a ntease biara nnim
• Anadwo fifiri a ɛba
• Ɔbrɛ kɛse a wɔte nka (eyi yɛ ɔbrɛ ho nkate a ɛkɔ soro da biara da) .

Nea ɛfa honam ani ho:

• Akuru anaa akuru a ɛwɔ honam ani
• Akuru (nodules) a ɛwɔ honam ani - Eyinom betumi ayɛ kɔkɔɔ, kɔkɔɔ, anaa tuntum asen honam ani a atwa ho ahyia no. Ɛtɔ mmere bi a, wotumi yɛ yaw.

Nocardia honam ani yareɛ te sɛn?

Fa no sɛ wowɔ kuru ketewaa bi wɔ wo honam ani na efĩ bi wɔ so. Sɛ Nocardia mmoawa yi kɔ mu a, ɛbɛyɛ kɔkɔɔ, ahonhon, na ebia akisikuru, na akisikuru bɛpue. Ɛtɔ mmere bi mpo a, ebetumi ayɛ akutu. Wɔ nnipa binom fam no, eyi betumi ayɛ yaw.

Sɛ ɔyare no trɛw kɔ amemene no mu a (eyi yɛ tebea a emu yɛ den kɛse):

• Tiyɛ (tiyɛ a emu yɛ den a ɛkɔ so daa) .
• Akisikuru ne ɔfe
• Tebea a nkwa nnim
• Adwene a ɛyɛ basaa (nhumu a ɛyera mpofirim, basabasayɛ) .
• Akisikuru ho sɛnkyerɛnne (akisikuru) .

Sɛ wowɔ saa sɛnkyerɛnne ahorow yi mu biako anaa nea ɛboro saa, titiriw sɛ wo nipadua mu tumi a ɛko tia nyarewa no ayɛ mmerɛw a, ɛho hia yiye sɛ wobɛhwehwɛ aduruyɛfo afotu ntɛm ara.

Dɛn na ɛde Nocardiosis ba?

Sɛ yɛbɛka no tiawa a, nea ɛde ba ne ɔyare mmoawa bi a wɔfrɛ no Nocardia. Saa mmoawa yi te asase mu wɔ wiase mmeae pii.

Ɔkwan bɛn so na saa mmoawa yi hyɛn yɛn nipadua mu?

Akwan atitiriw abiɛsa na ɛwɔ hɔ:

1. Ɛdenam mmoawa a wɔhome wɔ dɔte anaa mfutuma mu so: Sɛ yɛwɔ baabi a mfutuma wɔ a, nneɛma nketenkete a mmoawa yi wom betumi akɔ yɛn ahurututu mu.

2. Mmoawa a wɔfa nea wɔatwa anaa kuru a ɛwɔ honam ani no mu hyɛn mu: Fa no sɛ na woreyɛ adwuma wɔ turo mu na wo nsam nsɔe anaasɛ wotwaa ketewaa bi. Mmoawa no tumi fa asase no mu fi saa kuru no mu kɔ nipadua no mu. Sɛ nsu anaa dɔte a ɛho ntew kɔ kuru bi a ɛwɔ hɔ dedaw so nso a, ebetumi aba.

3. Ɛnam nnuruyɛ mfiri a efĩ wom so bere a wɔreyɛ oprehyɛn (eyi ntaa nsi koraa): Eyi ntaa nsi, efisɛ wɔma nnwinnade a ɛwɔ ayaresabea ahorow no ho tew yiye.

So yare yi tumi kɔ nnipa mu?

Dabi, nocardiosis nyɛ yare a wotumi de fi onipa biako mu kɔ foforo mu. Eyi kyerɛ sɛ wuntumi nnya bi mfi obi a ɔwɔ yare no a wo ne no bɛkasa, wo ne no abɔ, anaa wobɛbɛn no mu.

Hena na ɔwɔ asiane kɛse mu sɛ obenya Nocardiosis?

Mpɛn pii no, obi a ne nipadua no tumi ko tia nyarewa no ntaa mfa Nocardia mmoawa no yare, sɛ ɔhome anaasɛ ɛkɔ ne honam ani mpo a. Nea enti a ɛte saa ne sɛ yɛn nipadua no ahobammɔ nhyehyɛe no ko tia mmoawa no na ɛsɛe wɔn.

Nanso, nnipa a wɔn nipadua mu tumi a ɛko tia nyarewa no ayɛ mmerɛw no wɔ asiane kɛse mu sɛ wobenya saa yare yi. Nkwammoaa a ɛko tia nyarewa a ayɛ mmerɛw kyerɛ sɛ tumi a nipadua no tumi ko tia mmoawa a wɔde nyarewa ba no so tew.

Tebea atitiriw a asiane no betumi akɔ soro ne:

• Nnipa a wɔde akwaa titiriw bi asi wɔn ananmu: Titiriw wɔn a wɔde ahurututu anaa koma foforo ahyɛ wɔn mu (akwaa a ɛyɛ den a wɔde si ananmu).
• Nnipa a wɔde ntini mu nkwammoaa a wɔde si ananmu: titiriw wɔn a wɔanya ntini mu nkwammoaa a wogye fii obi foforo hɔ (allogenic stem cell transplant).
• Nnipa a wɔyare kokoram(Titiriw bere a wɔreyɛ kokoram ayaresa).
• Nnipa a wɔwɔ asikreyare.
• Nnipa a wɔanya HIV.
• Nnipa a wɔwɔ nyarewa a nipadua no tumi ko tia nyarewa anaa wɔn a wɔnom nnuru a ɛma nipadua no tumi ko tia nyarewa (nnuru a ɛtew tumi a yɛn nipadua no tumi ko tia nyarewa so).
• Nnipa a wɔwɔ ahurututu mu nyarewa a enni sabea, sɛ nhwɛso no, nyarewa te sɛ `COPD (Chronic Obstructive Pulmonary Disease)`.

Dɛn ne nsɛnnennen a ebetumi afi Nocardiosis mu aba?

Sɛnea yɛadi kan aka no, sɛ wɔansa eyi yiye a, ebetumi ayɛ aniberesɛm. Nsɛnnennen a ebetumi aba no bi ne:

• Ɔyare no trɛw fi ahurututu mu kɔ nipadua no afã afoforo: sɛ nhwɛso no, ɛkɔ amemene, mogya, honam ani, aniwa, asaabo, nnompe, anaa ntini mu.
• Ahurututu mu yare: Ɔyare a ɛba ahurututu mu.
• Ahurututu mu akisikuru: Akisikuru a ɛboaboa ano wɔ ahurututu no mu a ɛyɛ kurukuruwa.
• Sepsis: Eyi yɛ sɛnea nipadua no yɛ n’ade wɔ ɔyare mmoawa bi ho a ebetumi de nkwa ato asiane mu.
• Ɔhome a entumi nyɛ adwuma yiye: Ɔhome a ɛyɛ mmerɛw.
• Akwaa a entumi nyɛ adwuma yiye: Akwaa a ɛho hia wɔ nipadua no mu a entumi nyɛ adwuma yiye.

Saa nsɛnnennen yi mma obiara, nanso ɛsɛ sɛ nnipa a wɔwɔ akuw a asiane kɛse wom mu no hwɛ yiye titiriw.

Ɔkwan bɛn so na wohu sɛ obi anya Nocardiosis?

Nnuruyɛfo de nhwehwɛmu ahorow di dwuma de si so dua sɛ obi anya yare no. Nea ɛho hia titiriw ne sɛ wɔbɛhwehwɛ Nocardia mmoawa no wɔ nhwɛsode ahorow a wɔafa afi nipadua no mu no mu. Akwan pii wɔ hɔ a wɔfa so yɛ eyi:

• Biopsies of skin ulcers: Sɛ honam ani akuru bi wɔ hɔ a, wɔfa ntini ketewaa bi na wɔde microscope hwehwɛ mu, anaasɛ wɔma mmoawa no nyin (wɔyɛ no amammerɛ).
• Nsuo a wɔde yɛ ahurututu: Sɛ sɛnkyerɛnne bi wɔ hɔ a ɛfa ahurututu mu yare ho a, wɔbɛma nkurɔfo ayɛ wɔn ahurututu mu nhwehwɛmu.
• Bronchial alveolar lavage: Eyi hwehwɛ sɛ wɔde afiri bi a mfoninitwa afiri ketewaa bi wom bɛfa ahurututu no mu na wɔafa nsu bi afi hɔ akɔyɛ nhwehwɛmu.
• Biopsy a efi amemene mu akisikuru mu: Sɛ ɔyare no atrɛw akɔ amemene no mu na akisikuru bi ayɛ a, wogye nhwɛsode bi fi hɔ.
• PCR nhwehwɛmu: Eyi yɛ ɔkwan foforo a ebetumi ahu awosu mu nneɛma a efi mmoawa mu na ɛkyerɛ sɛ ɔyare mmoawa no anya bi.

Bio nso, wobetumi ayɛ koko X-ray anaa CT scan de ahwɛ sɛ ahurututu mu yare bi wɔ hɔ anaa.Wubetumi ayɛ.

So wobetumi asa Nocardiosis?

Yiw, eyi yɛ yare a wotumi sa, nanso ehia sɛ wohu no ntɛm na wɔsa no yiye.

Ayaresa titiriw ne nnuru a ekum ɔyare mmoawa . Oduruyɛfo no betumi akyerɛw nnuru a ekum ɔyare mmoawa biako anaa nea ɛboro saa a egyina sɛnea ɔyare no mu yɛ den ne ɔyare mmoawa no so.

Ade a ɛho hia sen biara ne sɛ wobɛnom nnuru a ekum ɔyare mmoawa yi ama ayaresa no nyinaa, sɛnea wo duruyɛfo akyerɛ wo no. Mpɛn pii no, ɛsɛ sɛ wonom nnuru yi bere tenten, bɛyɛ asram 6 kosi 12 . Ebia ɛsɛ sɛ nnipa binom, titiriw wɔn a wɔn nipadua mu tumi a ɛko tia nyarewa no yɛ mmerɛw koraa no nom aduru no bɛboro afe biako. Sɛ wo yare no ho sɛnkyerɛnne no ano brɛ ase mpo a, nnyae aduru no nom kosi sɛ wo duruyɛfo bɛka akyerɛ wo. Anyɛ saa a, sɛ wugyae kwan no fã a, ebia yare no bɛsan aba bio.

Ɛtɔ mmere bi a, sɛ ɔhome mu haw yɛ den a, wobetumi ama oxygen foforo anaasɛ wɔde afiri a wɔde home bɛka ho . Sɛ woyare paa a, ebia ebehia sɛ wotra ayaresabea hɔ kɔsa wo yare.

Biribi a ɛfa nnipa dodow a wowuwu ho...

Ebia eyi bɛyɛ te sɛ nea ɛyɛ hu, nanso ɛho hia sɛ wuhu. Nhwehwɛmu ahorow bi kyerɛ sɛ nnipa dodow a wowuwu wɔ nocardiosis ho no yɛ 15% kosi 40% . Wɔ tebea horow bi mu (e.g., nnipa a wɔn nipadua mu tumi a ɛko tia nyarewa no yɛ mmerɛw yiye, nnipa a wɔwɔ amemene mu yare), dodow yi betumi akɔ soro mpo. Nanso, eyi gyina nneɛma pii so, te sɛ sɛnea yare no mu yɛ den, baabi a ɔyare no kodu, ne ɔyarefo no nipadua mu ahoɔden a ɛko tia nyarewa no. Enti, ntɛm a wobehu na wɔasa no yɛ ade titiriw.

Bere bɛn na ɛsɛ sɛ wokɔ oduruyɛfo nkyɛn?

Sɛ wowɔ sɛnkyerɛnne bi a wususuw sɛ ebetumi ayɛ nocardiosis ho sɛnkyerɛnne a, kɔ oduruyɛfo nkyɛn ntɛm. Eyi ho hia titiriw sɛ wowɔ asiane akuw a yɛaka ho asɛm wɔ atifi hɔ no biako mu (sɛ nhwɛso no, wɔn a wɔde akwaa foforo ma wɔn, nnuru a ɛma nipadua no tumi ko tia nyarewa, anaa asikreyarefo).

Nsɛm bi a wubetumi abisa wo duruyɛfo:

• Nneɛma bɛn na metumi ayɛ da biara da de ahwɛ me ho?
• Nsɛnkyerɛnne bɛn na ɛsɛ sɛ mehwɛ yiye?
• Bere bɛn na ɛsɛ sɛ wokɔ baabi a wɔhwɛ wɔn a egye ntɛmpɛ?
• Bere bɛn na ɛsɛ sɛ mesan ba kɔhwɛ me bio?
• Ɔkwan bɛn so na mede saa aduru yi di dwuma pɛpɛɛpɛ?

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

Sɛ wowɔ sɛnkyerɛnne a emu yɛ den a edidi so yi mu biara a , kɔ baabi a wɔhwɛ wɔn a wɔwɔ yare a egye ntɛmpɛ ntɛm ara:

• Koko mu yaw a emu yɛ den
• Ɔhome a ɛyɛ den kɛse
• Adwene a ɛyɛ basaa anaasɛ adwenem naayɛ a ɛyera
• Nsɛnkyerɛnne a ɛkyerɛ sɛ obi anya akisikuru (akisikuru) .
• Kuru a ɛnsa na ɛyɛ kɛse na ɛyɛ kɛse
• Nkuru akɛse anaa akisikuru a ɛte sɛ kɔkɔɔ, bruu, ahabammono tuntum, anaa tuntum wɔ honam ani
• Nsu bi a ɛyɛ huam fi akisikuru no mu

Ɔkwan bɛn so na wobɛbɔ wo ho ban afi Nocardiosis ho?

Bere a yentumi nkwati eyi koraa no, nneɛma bi wɔ hɔ a yebetumi ayɛ de atew asiane no so:

• Sɛ wode dɔte anaa mfutuma yɛ adwuma (e.g. turoyɛ, kuayɛ) a, hyɛ nsateaa ne akatasoɔ. Eyi ho hia titiriw ma nnipa a wɔn nipadua mu tumi a ɛko tia nyarewa no ayɛ mmerɛw.
• Hyɛ ntade a ɛkata honam ani sɛnea wubetumi biara na amma woantwitwa anaa woanpirapira, titiriw bere a woreyɛ adwuma wɔ abɔnten no.
• Ma akuru biara a wɔatwitwa anaa nea abue wɔ honam ani no ho ntew na kata so (fa nnuru gu so na fa aduru a wɔde kyekyere honam ani).
• Hohoro wo nsa mpɛn pii, titiriw bere a woafi abɔnten aba anaa wode dɔte ayɛ adwuma awie no.
• Sɛ wunya kuru a, sa no ntɛm ara. Fa samina ne nsu hohoro no yiye, na kata so. Sɛ kuru no mu dɔ paa, sɛ mogya no nnyae, anaa sɛ efĩ anaa nneɛma foforo bi akyea kuru no mu na wontumi nyi mfi hɔ a, hwehwɛ aduruyɛfo afotu ntɛm ara.

Wɔ ayarefo a wɔde nipadua foforo ma wɔn fam no, ɛtɔ mmere bi a nnuruyɛfo di kan kyerɛw nnuru a ekum ɔyare mmoawa ma wɔn na wɔasiw nyarewa ahorow yi ano. Wo ne wo duruyɛfo nka eyi ho asɛm.

Awiei koraa no, nea ɛsɛ sɛ wokae (Take-Home Message) .

Nocardiosis yɛ ɔyare mmoawa a ɛntaa nsi, nanso ɛtɔ mmere bi a ekum nnipa. Ɛho hia sɛ wo ne wo duruyɛfo kasa fa ɔkwan pa a wobɛfa so abɔ wo ho ban afi ɔyare mmoawa yi ho, titiriw sɛ wo nipadua mu tumi a ɛko tia nyarewa no ayɛ mmerɛw anaasɛ woreyɛ akwaa foforo a.

Afei nso, sɛ sɛnkyerɛnne ahorow no da adi a, siesie wo ho sɛ wubehu ntɛm na hwehwɛ ayaresa ntɛm ara sɛnea wubetumi. Dodow a wohu yare no ntɛm no, dodow no ara na ɛda adi sɛ ayaresa no bɛyɛ yiye. Mommma yɛnnsuro, yɛnhwɛ yiye, na yɛmmɔ mmɔden sɛ yebenya apɔwmuden!

` Nocardiosis, Mmoawa yareɛ, Nyarewa a ɛfiri asase mu, Immunology, Honam ani yareɛ, Ahurututu mu yareɛ