Hiki i kēia haʻiki ke hoʻopilikia i kou mau māmā pū kekahi? E aʻo kākou e pili ana i ka Histoplasmosis!

Ua lohe paha ʻoe i kahi maʻi i kapa ʻia ʻo "Histoplasmosis"? He mea ʻē paha ke kani ʻana o ka inoa. Akā, he maʻi fungal ia e hiki ke hoʻopilikia i ko kākou mau māmā a he mea ia e makaʻala ai. Noho kēia fungus i loko o ka lepo, ʻoi aku hoʻi i ka lepo i loaʻa nā ʻōpala a manu paha. Loaʻa iā kākou kēia maʻi inā hanu kākou i ka lepo i loaʻa kēia fungus.

He aha maoli ka Histoplasmosis?

I ka ʻōlelo maʻalahi, ʻo ka histoplasmosis kahi maʻi o ko kākou mau māmā i hoʻokumu ʻia e kahi ʻano fungus i kapa ʻia ʻo "Histoplasma capsulatum" (ʻo "Histoplasma capsulatum" a i ʻole "H. capsulatum"). Loaʻa kēia fungus i loko o ka lepo ma nā wahi he nui o ka honua, a he mea maʻamau ia ma nā ʻāina e like me ʻAmelika. Hiki ke loaʻa kēia fungus ma ko kākou Sri Lanka, ʻoi aku hoʻi i ka lepo a puni nā ana peʻa, nā hale kahiko, a me nā mahi manu. Komo ia i loko o ko kākou kino ke hanu kākou i ka lepo i loaʻa kēia mau spores fungal.

Aia kekahi mau ʻano like ʻole o kēia maʻi?

ʻAe, aia kekahi mau ʻano nui o ka histoplasmosis. Hoʻoholo nā kauka i kēia mau ʻano ma muli o ka lōʻihi o kou loaʻa ʻana o nā hōʻailona a inā ua laha aku i nā ʻāpana ʻē aʻe o kou kino.

1. ʻO ka histoplasmosis pulmonary koʻikoʻi

ʻO kēia ke ʻano maʻamau o ka maʻi. Ma kahi o 10% o ka poʻe i loaʻa i ka fungus e loaʻa nā hōʻailona e like me ka pneumonia. ʻO kēia ka wela, ka ʻū, a me ka paʻakikī o ka hanu ʻana. Eia nō naʻe, inā loaʻa iā ʻoe kahi maʻi haʻahaʻa, hiki ke maʻalahi nā hōʻailona a mau no kekahi mau mahina. Ua kapa ʻia kēia he kahua subacute.

2. ʻO ka histoplasmosis pulmonary cavitary mau loa

He kūlana lōʻihi kēia. ʻOi aku ka maʻamau i nā poʻe me nā maʻi māmā e like me ka emphysema a i ʻole COPD (Chronic Obstructive Pulmonary Disease). Hiki ke ʻoi aku ka mālie o nā hōʻailona ma mua o ke ʻano ʻoi, akā hiki ke loaʻa ka hou ʻana i ka pō a me ka pohō kaumaha. Hiki i nā hōʻailona ke mau no nā mahina, a hiki i nā makahiki. Hiki ke nānā aku e like me ka maʻi puʻupuʻu. Inā ʻaʻole mālama ʻia, e piʻi mālie ka pōʻino i nā māmā.

3. ʻO ka histoplasmosis hoʻolaha holomua

ʻO kēia ka manawa e laha ai ka haʻihaʻi H. capsulatum mai nā māmā a i nā ʻāpana ʻē aʻe o ke kino. Hana pinepine kēia i nā poʻe me nā ʻōnaehana pale nāwaliwali loa, e like me ka poʻe me ka maʻi HIV holomua. Hiki i kēia ke hana i nā hōʻailona e like me ka pōkole o ka hanu, ka luhi, ka pohō kaumaha, a me nā ʻeha ʻili.

Eia kekahi, aia nā ʻano histoplasmosis e hoʻopilikia i ka lolo (central nervous system histoplasmosis) a me nā mea e hoʻopilikia i nā maka (ocular histoplasmosis).

Pehea ka maʻamau o ka histoplasmosis?

ʻO kaʻoiaʻiʻo, ua manaʻo ʻia ma kahi o 75% o nā pākeke e noho ana ma nā wahi i loaʻa pinepine ai ka fungus `H. capsulatum` ua loaʻa i kēia fungus i kekahi manawa. Eia nō naʻe, ʻaʻole i loaʻa i ka hapa nui o ka poʻe kekahi mau hōʻailona.

He aha ka hana a kēia ʻano fungus i ko mākou kino?

E noʻonoʻo, hanu ʻoe i kēia haʻihaʻi 'H. capsulatum' me ka lepo. A laila hele pololei ia i kou mau māmā. Ma laila, komo kēia haʻihaʻi i loko o ko kākou mau hunaola koko keʻokeʻo a loli mai ke ʻano 'ʻōpala' i loko o ke ʻano 'hū' e hiki ke hoʻopili.

I ka hapa nui o nā kānaka, hoʻopau nā pūnaewele pale i loko o ke kino i ka haʻiki a hana paha i nā uhi kūikawā i kapa ʻia ʻo "granulomas" e hoʻopuni ana i ka haʻiki a pale iā ia mai ka hōʻeha ʻana i ke kino. ʻO ka hopena, ʻaʻole mākou e ʻike i kekahi mau hōʻailona.

Eia naʻe, i kekahi manawa hiki ke lilo kēia i maʻi:

• Inā ʻoe e hanu i ka nui o ka fungus i ka manawa hoʻokahi, hiki ke hoʻopilikia ʻia kāu ʻōnaehana pale, e hana ana i nā hōʻailona like me ka maʻi flu a me ka paʻakikī o ka hanu ʻana.
• Inā loaʻa iā ʻoe nā maʻi māmā e like me COPD, hiki i kēia haʻiki ke hoʻomau i ka hōʻino ʻana i kou mau māmā.
• Inā nāwaliwali kou ʻōnaehana pale kino (e laʻa me ka poʻe me ka maʻi HIV a i ʻole ka poʻe e lawe ana i nā lāʻau immunosuppressive), hiki i kēia fungus ke hoʻohana i kāu mau hunaola pale kino e laha i nā ʻāpana ʻē aʻe o kou kino. Hiki i kēia ke hana i nā pilikia e hoʻoweliweli ai i ke ola.

He aha nā hōʻailona o ka histoplasmosis?

ʻO nā hōʻailona o ka histoplasmosis e komo pū paha:

• kuni
• Kuke
• Ka hou ʻana
• Ka paʻakikī o ka hanu ʻana (dyspnea)
• ʻEha umauma
• ʻEha poʻo (ʻeha poʻo)
• ʻEha ʻiʻo
• ʻUlaʻula, puʻupuʻu ʻulaʻula ma nā wāwae haʻahaʻa (erythema nodosum)

Hiki i nā poʻe me ka cavitary pulmonary histoplasmosis mau loa ke ʻike i ka hou ʻana i ka pō a me ka pohō kaumaha. ʻO ka mea nui, ma kahi o 90% o ka poʻe e hanu ana i ka fungus H. capsulatum ʻaʻole lākou e loaʻa i kekahi mau hōʻailona, ​​​​a i ʻole e pau nā hōʻailona iā lākou iho.

He aha ke kumu o kēia maʻi?

ʻO ke kumu o kēia he haʻi i kapa ʻia ʻo "Histoplasma capsulatum". E like me kā mākou i ʻōlelo ai ma mua, ua hana ʻia ia ma ka hanu ʻana i nā spores mold mai ka lepo i loaʻa kēia haʻi. Ulu maikaʻi kēia haʻi i ka lepo i loaʻa nā ʻōpala a me nā ʻōpala manu. Loaʻa ia ma nā wahi he nui o ka honua:

• Ma nā awāwa o ʻAmelika Hui Pū ʻIa ma nā muliwai ʻo Ohio a me Mississippi.
• Ma ʻAmelika Waena a me ʻAmelika Hema.
• Ma ʻApelika.
• Ma ʻĀsia.
• Ma ʻAukekulelia.

ʻAʻole maʻi ka hapa nui o ka poʻe mai ka hanu ʻana i kēia fungus, akā ʻo kekahi poʻe, ʻoiai ka poʻe e hanu nui ana i ka fungus i ka manawa hoʻokahi a i ʻole ka poʻe me kekahi mau kūlana olakino, hiki ke loaʻa nā hōʻailona.

ʻO wai ka mea i ʻoi aku ka nui o ka pilikia no kēia?

ʻOi aku kou pilikia inā pili kāu hana a i ʻole nā ​​​​​​mea leʻaleʻa i ka hoʻoulu ʻana i ka lepo ma nā wahi i nui ai kēia haʻalulu. Nā Laʻana:

• Ke ʻeli ʻana i ka wai.
• Mahiʻai.
• Ka hānai ʻana i nā moa a i ʻole nā ​​​​manu ʻē aʻe.
• Ke wāwahi nei i nā hale kahiko, nā hana kūkulu hale. E noʻonoʻo, ke hoʻomaʻemaʻe nei ʻoe i kahi hale kahiko i hoʻohana ʻole ʻia no nā makahiki, inā he mau ʻōpeʻapeʻa ma luna o ka hale, a ua hui pū ʻia kēlā ʻōpala me ka lepo? Aia kahi pilikia inā ʻoe e hanu i loko.

ʻO wai ka mea i ʻoi aku ka nui o ka pilikia o ka hoʻomohala ʻana i ka histoplasmosis, ma ke ʻano koke a i ʻole ka lōʻihi?

• No ka poʻe me ka ʻōnaehana pale kino nāwaliwali. ʻO nā kumu nui o kēia, ʻo ia ka maʻi HIV a me ka lawe ʻana i nā lāʻau lapaʻau immunosuppressive.
• No nā poʻe me ka COPD a i ʻole ka emphysema.
• No nā kānaka ma luna o 55 mau makahiki a me nā pēpē ma lalo o 1 makahiki.

He aha nā pilikia e hiki ke loaʻa mai ka histoplasmosis?

Aia kekahi mau pilikia koʻikoʻi e hiki ke kū mai mai kēia:

• Ka ʻeha a i ʻole nā ​​​​hōʻeha ʻē aʻe i nā māmā.
• Fibrosing mediastinitis - He ʻeha kēia o ka ʻāpana ma waena o nā māmā.
• ʻO ka maʻi hoʻopilikia hanu koʻikoʻi (ARDS)
• ʻO ka histoplasmosis o ka ʻōnaehana nerve waena - Inā pālahalaha ka fungus i ka lolo, hiki ke loaʻa nā hōʻailona e like me ka pehu ʻana o ka lolo, ka ʻeha poʻo, ka huikau, ka paʻakikī o ka noʻonoʻo ʻana, a me ka maʻi lolo.
• ʻO ka histoplasmosis ocular - Inā pālahalaha ka haʻiki i nā maka, hiki ke pilikia a nalowale paha ka ʻike.
• Hoʻolaha i nā ʻāpana ʻē aʻe o ke kino, e like me ke akepaʻa, ka ʻōpū, ka iwi ʻiʻo, a me ka ʻili.

Pehea ʻoe e ʻike ai i kēia maʻi?

Hiki i ke kauka ke hoʻāʻo i kou koko, mimi, sputum mai kou mau māmā, iwi iwi, a i ʻole kahi hāpana o nā ʻiʻo i hoʻopilikia ʻia e ʻike ai i ka maʻi. Hiki ke hoʻohana ʻia kēia mau hāpana e:

• Ua hoʻāʻo ʻia kahi moʻomeheu o ka fungus `H. capsulatum`. ʻO kēia ke ala maikaʻi loa e ʻike ai i ka histoplasmosis. Eia nō naʻe, hiki i kēia ke lōʻihi ka manawa, a hiki i kekahi mau pule. I nā hihia koʻikoʻi, hiki i kāu kauka ke hoʻomaka i ka lāʻau me ka kali ʻole i nā hopena.
• Ke ʻimi nei mākou i ka hū mai ke ʻano ʻo `H. capsulatum`.
• Ua hoʻāʻo ʻia ʻoe no nā hōʻailona (antigens a antibodies paha) o H. capsulatum i loko o kou kino.

Eia kekahi, hana ʻia nā kiʻi X-ray umauma a i ʻole CT scans e nānā i nā loli a i ʻole nā ​​​​pōʻino i hana ʻia e H. capsulatum. ʻO nā ʻano hoʻokolohua a kāu kauka e hoʻohana ai e pili ana i ke ʻano o ka histoplasmosis āu e loaʻa ai a me ke koʻikoʻi o kāu mau hōʻailona.

He aha nā hoʻokolohua diagnostics?

Ma waho aʻe o nā X-ray a me nā CT scans, hiki i ke kauka ke lawe i nā laʻana wai a i ʻole nā ​​​​ʻiʻo e nānā i nā hōʻailona o H. capsulatum a i ʻole e hoʻoulu iā ia. Hiki ke lawe ʻia kēia mau laʻana ma nā ʻano penei:

• Nā hoʻāʻo mimi a sputum paha : Mimi ʻoe i loko o ke kīʻaha (kahi hoʻāʻo mimi) a i ʻole sputum i loko o kahi ʻōmole (kahi hoʻāʻo sputum).
• Nā hoʻāʻo kokoE lawe ke kauka i kekahi koko mai kou lima me kahi nila.
• Biopsy : Lawe ʻia kahi laʻana o ka ʻiʻo ma o kahi ʻoki liʻiliʻi a i ʻole me kahi nila. I loko o kahi biopsy iwi iwi, lawe ʻia kahi laʻana mai loko mai o ka iwi ʻūhā.
• Bronchoscopy : E nānā ke kauka i loko o kou mau māmā me ka hoʻohana ʻana i kahi ʻōmole lahilahi a hoʻomālamalama ʻia (he bronchoscope). I kēia manawa, hiki ke hana ʻia kahi kaʻina hana i kapa ʻia he bronchoalveolar lavage (BAL). Pili kēia i ka "holoi" ʻana i nā wahi liʻiliʻi o kou mau māmā me kahi wai, hōʻiliʻili i ka wai, a hoʻouna iā ia i kahi lab no ka hoʻāʻo ʻana.

Pehea e mālama ʻia ai ka histoplasmosis?

Hoʻōla ʻia ka Histoplasmosis me nā lāʻau antifungal, inā pono. Inā loaʻa iā ʻoe nā hōʻailona liʻiliʻi, ʻaʻole lākou i loaʻa no ka manawa lōʻihi, a ʻaʻole ʻoe i ka pilikia kiʻekiʻe o ka loaʻa ʻana o kahi maʻi koʻikoʻi, hiki i kāu kauka ke hoʻoholo e kali iki ma mua o ka hāʻawi koke ʻana iā ʻoe i ka lāʻau.

Aia kekahi lāʻau lapaʻau piha no kēia?

ʻAe, hiki ke ho'ōla pinepine ʻia ka histoplasmosis me nā lāʻau antifungal i nā poʻe me nā ʻōnaehana pale olakino. Hiki i kāu kauka ke kuhikuhi i nā lāʻau lapaʻau e like me:

• ʻItraconazole
• ʻAmphotericin B (AmB)
• ʻO nā Corticosteroids (Hāʻawi ʻia kēia mau mea i kekahi mau hihia kūikawā, e like me ka hōʻemi ʻana i ka pehu)

He aha ka mea e hana ʻia inā ʻaʻole mālama ʻia?

Inā hana maikaʻi kāu ʻōnaehana pale maʻi a ʻaʻohe ou maʻi ʻē aʻe, hiki i ka histoplasmosis ke nalowale iā ia iho. Eia nō naʻe, inā waiho ʻole ʻia me ka mālama ʻole, hiki iā ia ke laha i nā wahi ʻē aʻe o ke kino, ʻoiai inā ʻaʻole hana pono kāu ʻōnaehana pale maʻi. Hiki iā ia ke hōʻino i ka māmā i ka poʻe me nā maʻi māmā.

Hiki ke pale ʻia ka histoplasmosis?

Inā ʻoe e noho ana ma kahi i loaʻa pinepine ai kēia haʻiki, hiki ke paʻakikī loa ke pale aku i ka hanu ʻana i ka haʻiki `H. capsulatum`. ʻOiai ʻaʻole hiki ke pale loa iā ia, aia kekahi mau mea hiki iā ʻoe ke hana e hōʻemi i kou pilikia:

• E pale i nā wahi me ka lepo lepo a i ʻole kahi e noho ai nā manu a me nā ʻōpeʻapeʻa.
• Inā koi kāu hana a i ʻole kāu leʻaleʻa e hoʻopili iā ʻoe me ka lepo i loaʻa paha iā H. capsulatum, e ʻaʻahu i kahi pale maka N95. E kānana ia i ka ea āu e hanu ai i kekahi ʻano.

He aha kaʻu e manaʻo ai inā loaʻa iaʻu ka histoplasmosis?

ʻO ka mea e hana ʻia ke loaʻa iā ʻoe ka histoplasmosis ma muli o ke koʻikoʻi o ia mea a inā he mau maʻi ʻē aʻe kāu. No ka poʻe me kahi ʻōnaehana pale olakino a me nā hōʻailona liʻiliʻi, hiki i kāu kauka ke hoʻoholo e "nānā a kali" me ka ʻole o ka lāʻau lapaʻau. Inā nāwaliwali kou ʻōnaehana pale a maʻi nui paha ʻoe, pono paha ʻoe e lawe i ka lāʻau antifungal no ka liʻiliʻi o hoʻokahi makahiki.

ʻO ka maʻamau, he 6-12 mau pule a ʻoi aku paha ka lōʻihi o ka lāʻau no ka histoplasmosis pulmonary koʻikoʻi. I nā hihia maʻi a koʻikoʻi paha, pono paha nā lāʻau antifungal no ka liʻiliʻi o hoʻokahi makahiki.

He aha nā kūlana e ola ai i kēia maʻi?

Hoʻōla ka hapa nui o ka poʻe me nā ʻōnaehana pale olakino (ma kahi o 96%) mai ka histoplasmosis me ka lāʻau lapaʻau. Eia nō naʻe, hōʻike kekahi mau noiʻi e hiki i ka nui o ka make ma waena o ka poʻe me nā ʻōnaehana pale nāwaliwali ma waena o 25% a me 37%. No laila, pono e makaʻala loa ka poʻe me nā ʻōnaehana pale nāwaliwali.

Pehea wau e mālama ai iaʻu iho?

Inā he ʻōnaehana pale kino nāwaliwali kou, a inā he COPD a i ʻole emphysema paha kāu, pono ʻoe e hana i nā hana hou aʻe e hōʻemi i kou pilikia o ka histoplasmosis. Inā noho ʻoe ma kahi i loaʻa pinepine ai ʻo H. capsulatum, e nīnau i kāu kauka inā he mau hana palekana kūikawā hiki iā ʻoe ke hana e pale aku iā ʻoe iho.

Āhea wau e ʻike ai i ke kauka?

Inā ʻaʻole e hoʻomaikaʻi kou mau hōʻailona, ​​e like me ke kuni, ka ʻūlū, a me ka hanu pōkole, i loko o hoʻokahi pule, a inā e ʻoi aku ka ʻino o ka maʻi i ka hala ʻana o ka manawa, e ʻike i ke kauka. E haʻi i kāu kauka inā ua loaʻa iā ʻoe kēia maʻi ma o kāu hana a i ʻole nā ​​​​​​mea leʻaleʻa, a inā ua hele ʻoe i kahi i loaʻa ai kēia maʻi.

Āhea wau e hele ai i kahi Emergency Treatment Unit (ETU) ?

Inā nāwaliwali kou ʻōnaehana pale a loaʻa iā ʻoe nā hōʻailona o kahi maʻi, pono ʻoe e kamaʻilio me ke kauka a i ʻole e hele koke i ka lumi pilikia. Inā loaʻa iā ʻoe nā hōʻailona koʻikoʻi, e hele i ka lumi pilikia kokoke loa. ʻO ia mau hōʻailona:

• Kuni nui (ma luna o 103 Fahrenheit/40 Celsius).
• Ka paʻakikī nui a koke paha i ka hanu ʻana.
• ʻEha ka umauma.
• Inā ʻoe e ʻū ana i ke koko.
• Ka haunaele a i ʻole nā ​​​​loli noʻonoʻo ʻē aʻe.
• Nā ʻōʻili.
• Polū ke kala o ka ʻili, nā lehelehe, a i ʻole nā ​​​​kui lima (`cyanosis` - he hōʻailona kēia o ka haʻahaʻa o ka oxygen i loko o ke koko).

He aha nā nīnau e pono iaʻu e nīnau aku i ke kauka?

He mea kōkua paha ke nīnau i ke kauka i nā nīnau e like me kēia:

• Aia anei au i ka pilikia nui o ka loaʻa ʻana o ka histoplasmosis koʻikoʻi?
• He aha nā hana kūikawā e pono iaʻu e hana ai e hōʻemi i koʻu pilikia o ka histoplasmosis?
• He aha nā hōʻailona e pono iaʻu e makaʻala?
• Āhea wau e hele ai i ka lumi pilikia?

ʻO ka mea hope loa, nā mea e hoʻomanaʻo ai (Leka Lawe-Home)

He maʻi fungal ka Histoplasmosis e hoʻopilikia ana i kou mau māmā. Hiki ke paʻakikī ke pale aku inā ʻoe e noho ana ma kahi e ulu nui ai kēia fungus. Akā, ʻaʻole koʻikoʻi ka hapa nui o nā hihia a hoʻopau wale ʻia.

Eia nō naʻe, inā he maʻi māmā kou a i ʻole he ʻōnaehana pale nāwaliwali, ʻoi aku kou pilikia o nā pilikia koʻikoʻi mai ka histoplasmosis. No laila, he mea nui e hana pū ʻoe me kāu kauka e hoʻomohala i kahi hoʻolālā e pale ai i kou olakino a e makaʻala no nā hōʻailona. Mai hopohopo, ʻo ka ʻike ka pale maikaʻi loa!

ʻO ka Histoplasmosis, ka maʻi fungal, ka maʻi māmā, Histoplasma capsulatum, nā ʻōpala manu, nā ʻōpala peʻa, nā pilikia hanu