‘Brain fever’ emaw meningitis emaw tih hi i hre tawh ngei ang. Mahse, fungus hian he dinhmun hlauhawm tak hi a thlen thei bawk tih i hria em? Vawiin hian natna khirh tak, mahse a tam zawk hriat loh, dinhmun kan sawi dawn a ni. Cryptococcal Meningitis tih a ni. Hei hi hriat a pawimawh a, a bik takin immune system chak lo i neih chuan .
A awlsam zawngin Cryptococcal Meningitis hi eng nge ni?
Awle, a bul atang hian tan ila. Cryptococcus hi yeast chi khat a ni a, chu chu fungus chi khat a ni. He fungus hian mi hrisel leh immune system tha tak nei tan harsatna lian tham a thlen lo tlangpui. Amaherawhchu, tu emaw taksa chakna (immune system) a chak lo a nih chuan he fungus hian hun remchang ropui tak a nei a ni.
He fungus hian kan nervous system a hmangaih hle a, a bik takin thluak leh ruhro hi a hmangaih hle. Chuvangin he natna hian kan thluak vel venhimna (protective membrane) te chu direct-in a nghawng a ni. Damdawi lamah chuan heng membrane te hi ‘meninges’ kan ti thin. Chuvangin, heng membrane te hi an infect a, an lo hring a nih chuan meningitis emaw ‘brain fever’ emaw kan ti thin. Hetiang dinhmun hi Cryptococcus fungus avanga lo awm a nih chuan cryptococcal meningitis kan ti thin.
He natna hi thluak chhunga pressure sang thut avanga lo awm a ni. He pressure sang hian thluak hmun hrang hrang a tichhe thei a ni. Chu mai ni lovin, a chang chuan mit leh beng pawh a chhe thei a ni. He natna thlentu hi fungi chi hnih a awm a. Chungte chu `Cryptococcus neoformans` leh `Cryptococcus gattii` te an ni. Chung zingah chuan a chi khatna hi a tam ber a ni.
He natna hi tute nge kai theihna sang zawk?
Kan sawi tawh ang khan he fungus hi hun remchang (opportunistic) a ni. Chumi awmzia chu taksa invenna, immune system a chak loh hma chu a nghak a, chutah chuan a bei leh thin tihna a ni.
Pawimawh tak chu cryptococcal meningitis vei zinga 85% vel chu HIV kai an ni , chuvangin hei hi HIV vei te ngaihven bik tur a ni.
HIV bakah hian natna dang engemaw zat, taksa hriselna tichak lotu a awm bawk . Heng zinga pakhat i neih chuan heng symptoms te hi hriat chian a pawimawh hle.
- Thisen kaihhnawih natna (Diseases of the blood) nei te .
- Organ failure syndrome nei, liver failure ang chi te
- Kal, thin, etc.Mite chu organ transplant nei tawh leh immunosuppressive drugs ei mekte
- Immunodeficiency syndrome dang nei te
- Mite chuan immunosuppressive drugs steroid ang chi rei tak an hmang thin
Engtin nge he fungus hi kan taksaah a luh?
He Cryptococcus fungus hi boruak ah spore angin a darh zel a. A bik takin leia, sava ek (a bik takin pigeon ek) leh thing chhe laiah te an tam hle.
Chuvângin, kan thawk chhuah hian heng spore-te hi kan lungah an lut thei a ni . Mahse, lungngai suh, khawsik pangngai angin mi pakhat atanga mi dangah a darh lo.
Immune system tha tak nei mi taksaah heng spore te hi an luh chuan lung chhunga venhimna cell (alveolar macrophages) te hian an tichhia a ni. Mahse, taksa hriselna chak lo tak taksaah thil danglam tak a thleng thin.
A awlsam zawngin, hei hi a thleng thin:
1. Fungal spore te hi thawkna hmangin lung chhungah an lut thin.
2. Immuity chak loh avangin lung chhunga venhimna cell te hian hengte hi an tichhia thei lo.
3. Chuta tang chuan fungus chu lymph node-ah a kal a, chutah chuan rang takin a inthen darh a, fungal cell tam tak a siam chhuak thin.
4. Tichuan, heng fungal cell te hi thisen kal tlangin thluak leh ruhro (spinal cord) thlengin an thleng a.
5. Chutah chuan heng cell te hi thluak vel membrane ah te hian an lo thang lian tan thin. Zawi zawiin symptoms a lo lang chhuak thin.
He natna lan chhuah dan engte nge ni?
Cryptococcal meningitis symptoms hi a lo lang zauh zauh fo thin. Inthlauhna lian tak i hmu nghal lo mai thei. Chuvangin heng symptoms te hi hriat chian a pawimawh hle.
| Symptom a ni | A sawifiahna awlsam tak |
|---|---|
| Lu na | Lu na fo, na tak, natna tidamtu pangngai pawhin a chhang lo. |
| Khawsik | Khawsik tlem a awm a, chak lohna nen a inzawm bawk. |
| Mutthilh lutuk leh lungngaihna | Mutthilh reng reng, engmah tih duh loh. |
| Kawngkhar khauh tak | Kawr hmalam hawia ben harsa, a nghet lo tih hriat. |
| Nausea leh luak chhuak | Pum natna awm lovin nausea leh luak chhuak. |
| Mit lama harsatna nei | Eng en harsa (Photophobia), double hmuh harsa (Diplopia), leh mit hmuhna tlahniam. |
| Hriatna hloh | Beng chhunga hriatna hloh. |
| Seizures a awm thin | Seizures hi natna a zual chuan a awm thin. |
HIV vei ang chi, taksa hriselna chak lo tak nei mi chuan a tir lamah heng chhinchhiahnate hi a lantir lo mai thei tih hre reng ang che. Chuvang chuan natna hriatchhuah a tlai deuh thei a ni. Hetianga tihkhawtlai hian fungus hi thluak chhungah a thang tha thei a, a dinhmun a tichhe zual bawk.
Engtin nge natna hi dik taka kan hriat theih ang?
Heng symptoms pakhat emaw a aia tam emaw i neih a, a chunga kan sawi tawh risk group pakhata tel i nih chuan doctor pan nghal rawh . A pawimawh hle mai.
I doctor chuan a enfiah ang che a, meningitis a ringhlel ang. I hlauhawm a nih chuan cryptococcal meningitis vei theihna tur pawh an ngaihtuah ang.
Diagnosis finfiah nan i doctor chuan lumbar puncture a ti thei ang.Spinal tap an ti a. Lungngai suh, hei hi mi tam takin an ngaihtuah angin a hlauhawm lo. I hnungzang hnuai lam ah needle nalh tak tak dah a, i thluak leh i ruhro (Cerebrospinal Fluid - CSF) vel tui sample tlemte lak a ni. He fluid hi i central nervous system chawmtu leh tituitu a ni.
He CSF sample hi laboratory-ah Cryptococcus fungus a awm leh awm loh enfiah a ni.
Chu bakah, i doctor chuan thluak CT scan emaw MRI scan emaw pawh a rawt thei bawk.
He natna hi a hlauhawm tak tak em?
Ni e, hei hi natna khirh tak, nunna atana hlauhawm tak pawh a ni. Enkawl loh chuan thluak a tichhe nasa thei hle. A chhiatna ṭhenkhat chu tihdanglam theih loh a ni thei.
Enkawl loh chuan seizures, hriatna hloh, coma, leh thihna thlengin a awm thei.
Khawvela enkawlna tha ber berte pawh nise, he natna avanga thihna hi 15% leh 30% inkar a ni . Chu chuan he natna hi a nasat zia hriat theihna a pe tur che a ni.
Engtin nge enkawl a nih?
Hei hi antifungal damdawi hmanga enkawl a ni. Mahse, he enkawlna hi ni khat emaw ni hnih emaw chhungin a zo lo. A dam kim theih nan thla tam tak a ngai thei.
Enkawlna atana thil tum lian tak pahnih a awm a, chungte chu:
1. Damdawi lam dinhmun bulpui enkawl dan: Entirnan, HIV kai i neih chuan enkawl dan dik (antiretroviral therapy) dawng a, taksa invenna chakna siam that leh a pawimawh hle.
2. Fungal infection enkawl dan: Hemi atan hian damdawi Amphotericin B, Fluconazole, Flucytosine, leh Itraconazole te hman a ni.
Enkawlna hmasa berah damdawi inah i awm a ngai dawn a ni. Enkawlna hlawhtlinna chu natna hmuhchhuah hma leh i dinhmun hnuaia awm danah a innghat a ni.
Chuvangin, he natna hi kai theihna hlauhawm i nih chuan a lan chhuah hmasak dan hi fimkhur reng tur a ni. Ringhlelna tlemte pawh i neih chuan doctor biak pawh hreh ngai suh . Hriat hmasak leh enkawl vat hi i nunna chhanhimna tha ber a ni.
Take-Home Thuchah a ni
- Cryptococcal meningitis hi fungal infection na tak a ni a, thluak a nghawng nasa hle.
- Hei hi HIV vei, organ transplant dawngtu, leh chhan dang avanga immune system chak lote zingah a tam ber.
- A lan chhuah dan ber chu lu na fo, khawsik hniam, kawng khauh, leh mut tam lutuk te hi a ni. Immune system chak lote chuan a tir lamah heng symptoms hi an nei tlem zawk thei.
- He natna hi mi pakhat atanga mi dangah a kai lo. Infection hi boruak chhunga fungal spore awmte hip luh atanga lo awm a ni.
- Risk group-a awm i nih a, a chunga symptoms te hi i neih chuan doctor advice la nghal rawh . Diagnosis leh enkawl vat a pawimawh hle.
- Enkawlna atan thla tam tak a daih thei a, hei hi natna khirh tak a ni a, nunna atana hlauhawm tak a ni.
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