Ua lohe paha ʻoe i ke 'fiva lolo' a i ʻole ka meningitis. Akā ua ʻike anei ʻoe hiki i kahi fungus ke hana i kēia ʻano weliweli? I kēia lā e kamaʻilio mākou e pili ana i kahi ʻano koʻikoʻi, akā ʻaʻole i ʻike nui ʻia. Ua kapa ʻia ʻo Cryptococcal Meningitis. He mea nui e makaʻala i kēia, ʻoiai inā he ʻōnaehana pale nāwaliwali kou.
I ka ʻōlelo maʻalahi, he aha ka Cryptococcal Meningitis?
ʻAe, e hoʻomaka kākou ma ka hoʻomaka. He ʻano hū ka Cryptococcus, ʻo ia hoʻi kekahi ʻano fungus. ʻAʻole pinepine kēia fungus e hōʻeha nui i kahi kanaka olakino a maikaʻi kona ʻōnaehana pale. Eia nō naʻe, inā nāwaliwali ka ʻōnaehana pale o kekahi, he manawa kūpono loa kēia fungus.
Aloha nui kēia haʻiki i ko kākou ʻōnaehana nerve, ʻoiai ka lolo a me ke kaula iwi kuamoʻo. No laila, pili pololei kēia maʻi i nā membrane pale e hoʻopuni ana i ko kākou lolo. Kāhea mākou i kēia mau membrane ma ke ʻano lapaʻau he 'meninges'. No laila, ke loaʻa kēia mau membrane i ka maʻi a pehu, kapa mākou ia he meningitis a i ʻole 'fiva lolo'. Ke hana ʻia kēia maʻi e ka haʻiki Cryptococcus, kapa mākou ia he cryptococcal meningitis .
Hoʻokumu ʻia kēia maʻi e ka piʻi koke ʻana o ke kaomi i loko o ka lolo. Hiki i kēia kaomi kiʻekiʻe ke hōʻino i nā ʻāpana like ʻole o ka lolo. ʻAʻole wale ia, akā i kekahi manawa hiki ke hōʻino ʻia nā maka a me nā pepeiao. ʻElua ʻano nui o nā fungi e hoʻoulu ai i kēia maʻi. ʻO lākou ʻo 'Cryptococcus neoformans' a me 'Cryptococcus gattii'. ʻO kēia mau mea, ʻo ke ʻano mua ka mea maʻamau.
ʻO wai ka mea i ʻoi aku ka nui o ka pilikia o ka loaʻa ʻana o kēia maʻi?
E like me kā mākou i kūkākūkā ai ma mua, he mea kūpono kēia haʻiki. ʻO ke ʻano kēia e kali ana a hiki i ka nāwaliwali o nā pale o ke kino, ʻo ia hoʻi ka ʻōnaehana pale maʻi, a laila hoʻouka.
ʻO ka mea nui, ma kahi o 85% o nā maʻi meningitis cryptococcal i loaʻa i ka maʻi HIV , no laila he mea kēia e hopohopo nui ai ka poʻe e noho ana me ka HIV.
Ma waho aʻe o ka maʻi HIV, aia kekahi mau maʻi ʻē aʻe e hoʻonāwaliwali ai i ka ʻōnaehana pale . Inā loaʻa iā ʻoe kekahi o kēia mau maʻi, he mea nui e makaʻala i kēia mau hōʻailona.
- Nā kānaka me nā maʻi e pili ana i ke koko (Nā maʻi koko)
- ʻO nā kānaka me nā maʻi hāʻule o ke kino, e like me ka hāʻule ʻana o ke ake
- Nā puʻupaʻa, ke akepaʻa, a pēlā aku.ʻO ka poʻe i hana ʻia i kahi hoʻoili kino a ke lawe nei i nā lāʻau immunosuppressive
- ʻO nā kānaka me nā maʻi immunodeficiency ʻē aʻe
- ʻO ka poʻe e hoʻohana ana i nā lāʻau lapaʻau immunosuppressive e like me nā steroids no ka manawa lōʻihi
Pehea e komo ai kēia ʻano fungus i loko o ko kākou kino?
Hoʻolaha ʻia kēia haʻalulu Cryptococcus ma ke kaiapuni ma ke ʻano he spores. He mea maʻamau lākou i ka lepo, nā ʻōpala manu (ʻoi aku hoʻi nā ʻōpala manu nūnū), a me ka lāʻau palaho.
No laila, ke hanu kākou, hiki i kēia mau spores ke komo i loko o ko kākou mau māmā . Akā, mai hopohopo, ʻaʻole ia e laha mai ke kanaka a i ke kanaka e like me ke anu maʻamau.
Ke komo kēia mau spores i ke kino o ke kanaka me kahi ʻōnaehana pale maikaʻi, luku nā hunaola pale i loko o nā māmā (alveolar macrophages) iā lākou. Eia nō naʻe, hana ʻia kekahi mea ʻokoʻa i loko o ke kino o ke kanaka me kahi ʻōnaehana pale nāwaliwali.
I ka ʻōlelo maʻalahi, eia ka mea e hana ʻia:
1. Komo nā spores fungal i loko o nā māmā ma o ka hanu ʻana.
2. Ma muli o ka nāwaliwali o ke kino, ʻaʻole hiki i nā hunaola pale i loko o nā māmā ke luku i kēia mau mea.
3. Mai laila mai, hele ka haʻiki i nā lymph node, kahi e māhele koke ai a hana i nā hunaola haʻiki he nui.
4. A laila, hele kēia mau pūnaewele fungal ma o ke koko a hiki i ka lolo a me ke kaula kuamoʻo.
5. Ma laila, hoʻomaka kēia mau pūnaewele e ulu i loko o nā membrane e hoʻopuni ana i ka lolo. Mālie, ʻike ʻia nā hōʻailona.
He aha nā hōʻailona o kēia maʻi?
Hoʻomaka mālie pinepine nā hōʻailona o ka meningitis cryptococcal. ʻAʻole paha ʻoe e ʻike koke i kahi ʻokoʻa nui. No laila he mea nui e makaʻala i kēia mau hōʻailona.
| Hōʻailona | He wehewehe maʻalahi |
|---|---|
| ʻEha poʻo | He ʻeha poʻo pinepine a koʻikoʻi hoʻi i pane ʻole i nā lāʻau ʻeha hoʻomaha maʻamau. |
| kuni | He kuni iki i hele pū me ka manaʻo o ka nāwaliwali. |
| Ka hiamoe nui a me ke kaumaha | Ke hiamoe mau nei, ʻaʻole makemake e hana i kekahi mea. |
| ʻĀʻī ʻoʻoleʻa | Paʻakikī ke kulou ʻana i ka ʻāʻī i mua, me ka manaʻo ʻoʻoleʻa. |
| Ka luaʻi a me ka luaʻi | Ka luaʻi a me ka ʻeha ʻole o ka ʻōpū. |
| Nā pilikia maka | ʻO ka paʻakikī i ka nānā ʻana i ka mālamalama (Photophobia), ka ʻike ʻana i ʻelua mau mea i ka manawa hoʻokahi (Diplopia), a me ka emi ʻana o ka ʻike. |
| Poho lohe | Ka nalowale o ka lohe ma nā pepeiao. |
| Nā hopu ʻana | Loaʻa nā ʻōhū ke ʻoi aku ka ʻino o ka maʻi. |
E hoʻomanaʻo, ʻo ke kanaka me ka ʻōnaehana pale nāwaliwali loa, e like me kekahi me ka maʻi HIV , ʻaʻole paha e hōʻike i kēia mau hōʻailona i ka wā mua. No laila, hiki ke lohi ka ʻike ʻana i ka maʻi. Hāʻawi kēia lohi i ka fungus i kahi manawa e ulu maikaʻi ai i loko o ka lolo a hoʻonui i ke kūlana.
Pehea e ʻike pono ai i ka maʻi?
Inā loaʻa iā ʻoe kekahi a ʻoi aku paha o kēia mau hōʻailona a pili ʻoe i kekahi o nā hui pilikia i ʻōlelo ʻia ma luna, e ʻike koke i ke kauka . He mea nui loa ia.
E nānā kāu kauka iā ʻoe a kānalua i ka maningitis. Inā ʻoe i ka pilikia, e noʻonoʻo pū lākou i ka hiki ke loaʻa i ka maningitis cryptococcal.
No ka hōʻoia ʻana i ka maʻi, hiki i kāu kauka ke hana i kahi puncture lumbar.Ua kapa ʻia ʻo ia he spinal tap. Mai hopohopo, ʻaʻole kēia he mea weliweli e like me ka manaʻo o ka poʻe he nui. Pili ia i ke kau ʻana i kahi nila lahilahi loa i loko o kou kua haʻahaʻa a lawe i kahi hāpana liʻiliʻi o ke wai e hoʻopuni ana i kou lolo a me ke kaula spinal (Cerebrospinal Fluid - CSF). ʻO kēia wai ka mea e hānai a hoʻomaʻū i kāu ʻōnaehana nerve waena.
A laila hoʻāʻo ʻia kēia hāpana CSF i loko o ka hale hana e ʻike ai inā loaʻa ka fungus Cryptococcus.
Eia kekahi, hiki i kāu kauka ke ʻōlelo aku i kahi CT scan a i ʻole MRI scan o ka lolo.
He mea weliweli maoli anei kēia maʻi?
ʻAe, he maʻi koʻikoʻi loa kēia, a he maʻi hoʻoweliweli hoʻi i ke ola. Inā ʻaʻole mālama ʻia, hiki iā ia ke hōʻeha nui i ka lolo. ʻO kekahi o nā pōʻino he mea hiki ʻole ke hoʻihoʻi ʻia.
Inā ʻaʻole mālama ʻia, hiki ke loaʻa nā maʻi hīkī, ka nalowale o ka ʻike, ka coma, a me ka make.
ʻOiai me nā lāʻau lapaʻau maikaʻi loa o ka honua, ʻo ka nui o ka make mai kēia maʻi ma waena o 15% a me 30% . Pono kēlā e hāʻawi iā ʻoe i kahi manaʻo o ke koʻikoʻi o kēia maʻi.
Pehea e mālama ʻia ai?
Hoʻōla ʻia kēia me nā lāʻau antifungal. Eia naʻe, ʻaʻole i pau kēia lāʻau i hoʻokahi a ʻelua paha lā. Hiki ke hala i nā mahina e ho'ōla piha ai.
ʻElua mau pahuhopu nui o ka mālama ʻana:
1. Ka mālama ʻana i ke kūlana olakino kumu: No ka laʻana, inā loaʻa iā ʻoe ka maʻi HIV, he mea nui e loaʻa ka lāʻau kūpono (antiretroviral therapy) a hoʻihoʻi i ka pale ʻana o ke kino.
2. Ka mālama ʻana i nā maʻi fungal: Hoʻohana ʻia nā lāʻau lapaʻau e like me Amphotericin B, Fluconazole, Flucytosine, a me Itraconazole no kēia.
Pono ʻoe e noho ma ka haukapila i nā pae mua o ka mālama ʻana. ʻO ka holomua o ka mālama ʻana e pili ana i ka wā mua o ka ʻike ʻia ʻana o ka maʻi a me ke ʻano o kou kūlana kumu.
No laila, inā ʻoe e pilikia ana i ka loaʻa ʻana o kēia maʻi, e makaʻala mau i nā hōʻailona mua. Inā he kānalua iki kou, mai kānalua e kamaʻilio me ke kauka . ʻO ka ʻike mua ʻana a me ka mālama koke ʻana ke ala maikaʻi loa e hoʻopakele ai i kou ola.
Leka Lawe-Home
- He maʻi fungal koʻikoʻi ka meningitis cryptococcal e hoʻopilikia ai i ka lolo.
- ʻO kēia ka mea maʻamau i nā poʻe me ka maʻi HIV, nā mea i loaʻa i ka hoʻoili ʻana o nā kino, a me ka poʻe me nā ʻōnaehana pale kino nāwaliwali ma muli o nā kumu ʻē aʻe.
- ʻO nā hōʻailona nui ka ʻeha poʻo pinepine, ke kuni haʻahaʻa, ka ʻāʻī ʻoʻoleʻa, a me ka hiamoe nui. ʻO ka poʻe me nā ʻōnaehana pale nāwaliwali e hōʻike iki paha i kēia mau hōʻailona i ka wā mua.
- ʻAʻole laha kēia maʻi mai ke kanaka a i ke kanaka. Hiki mai ka maʻi ma ka hanu ʻana i nā spores fungal i ke kaiapuni.
- Inā ʻoe i loko o kahi hui pilikia a loaʻa iā ʻoe nā hōʻailona i luna, e ʻimi koke i ke kōkua lapaʻau . He mea nui loa ka ʻike koke ʻana a me ka mālama ʻana.
- Hiki ke hoʻolōʻihi i nā mahina i ka mālama ʻana, a he kūlana koʻikoʻi kēia e hoʻoweliweli ana i ke ola.
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