Kodi bowa uyu angakhudzenso mapapo anu? Tiyeni tiphunzire za Histoplasmosis!

Kodi mudamvapo za matenda otchedwa ``Histoplasmosis''? Dzinali lingamveke lachilendo pang'ono. Koma ndi matenda a bowa omwe angakhudze mapapo athu ndipo ndi chinthu choyenera kusamala nacho. Bowa ili limakhala m'nthaka, makamaka m'nthaka yomwe ili ndi ndowe za mbalame kapena mileme. Timadwala matendawa ngati tipuma fumbi lomwe lili ndi bowa ili.

Kodi kwenikweni Histoplasmosis ndi chiyani?

Mwachidule, histoplasmosis ndi matenda a m'mapapo mwathu omwe amayamba chifukwa cha mtundu wa bowa wotchedwa ``Histoplasma capsulatum`` (``Histoplasma capsulatum`` kapena ``H. capsulatum``). Bowa uwu umapezeka m'nthaka m'madera ambiri padziko lapansi, ndipo ndi wofala m'maiko ngati America. Bowa uwu umapezekanso ku Sri Lanka, makamaka m'nthaka yozungulira mapanga a mileme, nyumba zakale, ndi minda ya mbalame. Umalowa m'matupi mwathu tikamapuma fumbi lokhala ndi spores za bowa.

Kodi pali mitundu yosiyanasiyana ya matendawa?

Inde, pali mitundu ingapo ikuluikulu ya histoplasmosis. Madokotala amazindikira mitundu iyi kutengera nthawi yomwe mwakhala ndi zizindikiro komanso ngati zafalikira mbali zina za thupi lanu.

1. Kutupa kwa m'mapapo koopsa (acute pulmonary histoplasmosis)

Uwu ndi mtundu wofala kwambiri wa matenda. Pafupifupi 10% ya anthu omwe ali ndi bowa amakhala ndi zizindikiro zofanana ndi chibayo. Izi zikuphatikizapo malungo, chifuwa, ndi kupuma movutikira. Komabe, ngati muli ndi matenda otsika, zizindikiro zimatha kukhala zochepa ndipo zimatha kwa miyezi ingapo. Izi zimatchedwa gawo la subacute.

2. Histoplasmosis ya m'mapapo ya m'mimba yosatha

Imeneyi ndi matenda a nthawi yayitali. Amafala kwambiri kwa anthu omwe ali ndi matenda a m'mapapo monga emphysema kapena COPD (Chronic Obstructive Pulmonary Disease). Zizindikiro zimatha kukhala zochepa kuposa zomwe zimachitika mwadzidzidzi, koma kutuluka thukuta usiku ndi kuchepa thupi kumatha kuchitika. Zizindikiro zimatha kukhala miyezi ingapo, ngakhale zaka. Zingawoneke ngati chifuwa chachikulu. Ngati sichinachiritsidwe, kuwonongeka kwa mapapo kudzawonjezeka pang'onopang'ono.

3. Kufalikira kwa histoplasmosis

Apa ndi pamene bowa wa H. capsulatum umafalikira kuchokera m'mapapo kupita ku ziwalo zina za thupi. Izi nthawi zambiri zimachitika mwa anthu omwe ali ndi chitetezo chamthupi chofooka kwambiri. Mwachitsanzo, anthu omwe ali ndi kachilombo ka HIV kwambiri. Izi zingayambitse kupuma movutikira, kutopa, kuchepa thupi, komanso zilonda za pakhungu.

Kuphatikiza apo, pali mitundu ya histoplasmosis yomwe imakhudza ubongo (central nervous system histoplasmosis) ndi yomwe imakhudza maso (ocular histoplasmosis).

Kodi histoplasmosis ndi yofala bwanji?

Ndipotu, akuti pafupifupi 75% ya akuluakulu okhala m'madera omwe bowa la `H. capsulatum` limapezeka kwambiri adadwalapo bowa uwu nthawi ina. Komabe, anthu ambiri samakhala ndi zizindikiro zilizonse.

Kodi bowa uyu amachita chiyani m'thupi lathu?

Tangoganizirani, mukamapuma bowa wa 'H. capsulatum' ndi fumbi. Kenako umapita molunjika ku mapapo anu. Pamenepo, bowa uwu umalowa m'maselo athu oyera a magazi ndipo umasintha kuchoka pa mawonekedwe a 'mold' kukhala mawonekedwe a 'yisiti' omwe angapatsire matenda.

Mwa anthu ambiri, maselo oteteza thupi m'thupi amawononga bowa kapena amapanga zophimba zapadera zotchedwa ``granulomas`` zomwe zimazungulira bowa ndikuletsa kuti lisavulaze thupi. Chifukwa chake, sitimva zizindikiro zilizonse.

Komabe, nthawi zina izi zimatha kukhala matenda:

• Ngati mupuma bowa wambiri nthawi imodzi, chitetezo chanu cha mthupi chingafooke, zomwe zingakupangitseni kukhala ndi zizindikiro zofanana ndi chimfine komanso kupuma movutikira.
• Ngati muli ndi matenda a m'mapapo monga COPD, bowa uyu akhoza kupitiriza kuwononga mapapo anu.
• Ngati chitetezo chanu cha mthupi chili chofooka (monga anthu omwe ali ndi kachilombo ka HIV kapena omwe akumwa mankhwala oletsa chitetezo cha mthupi), bowa uyu angagwiritse ntchito maselo anu a chitetezo cha mthupi kufalikira ku ziwalo zina za thupi lanu. Izi zingayambitse mavuto omwe angawononge moyo.

Kodi zizindikiro za histoplasmosis ndi ziti?

Zizindikiro za histoplasmosis zingaphatikizepo:

• Malungo
• Chifuwa
• Kutuluka thukuta
• Kuvuta kupuma (kupuma movutikira)
• Kupweteka pachifuwa
• Mutu (kupweteka mutu)
• Kupweteka kwa minofu
• Matuza ofiira komanso otupa m'miyendo ya m'munsi (erythema nodosum)

Anthu omwe ali ndi vuto la chronic cavitary pulmonary histoplasmosis amathanso kutuluka thukuta usiku komanso kuchepa thupi. Chofunika kwambiri n'chakuti, pafupifupi 90% ya anthu omwe amapuma bowa wa H. capsulatum sapeza zizindikiro zilizonse, kapena zizindikirozo zimatha zokha.

N’chiyani chimayambitsa matendawa?

Choyambitsa izi ndi bowa wotchedwa ``Histoplasma capsulatum``. Monga tanenera kale, amayamba chifukwa chopuma nkhungu kuchokera m'nthaka yomwe ili ndi bowa iyi. Bowa uwu umakula bwino m'nthaka yomwe ili ndi ndowe za mileme ndi ndowe za mbalame. Umapezeka m'madera ambiri padziko lapansi:

• Mu zigwa za Ohio ndi Mississippi ku America.
• Ku Central ndi South America.
• Mu Africa.
• Ku Asia.
• Ku Australia.

Anthu ambiri sadwala chifukwa chopuma bowa uwu, koma anthu ena, makamaka omwe amapuma bowa wambiri nthawi imodzi kapena omwe ali ndi matenda enaake, amatha kukhala ndi zizindikiro.

Ndani ali pachiwopsezo chachikulu cha izi?

Muli pachiwopsezo chachikulu ngati ntchito yanu kapena zosangalatsa zanu zikuphatikizapo kusonkhezera fumbi m'malo omwe muli bowa wambiri. Zitsanzo:

• Spelunking.
• Kulima.
• Kulera nkhuku kapena mbalame zina.
• Kugwetsa nyumba zakale, ntchito yomanga. Tangoganizirani, pamene mukuyeretsa nyumba yakale yomwe sinagwiritsidwe ntchito kwa zaka zambiri, ngati pali mileme padenga, ndipo chimbudzicho chikusakanikirana ndi fumbi? Pali chiopsezo ngati mutachipuma.

Ndani ali pachiwopsezo chachikulu chotenga histoplasmosis, kaya mwadzidzidzi kapena kwa nthawi yayitali?

• Kwa iwo omwe ali ndi chitetezo chamthupi chofooka. Zifukwa zazikulu za izi ndi kutenga kachilombo ka HIV komanso kumwa mankhwala oletsa chitetezo chamthupi.
• Kwa iwo omwe ali ndi COPD kapena emphysema.
• Kwa anthu azaka zopitilira 55 ndi makanda osakwana chaka chimodzi.

Kodi mavuto omwe angabwere chifukwa cha histoplasmosis ndi ati?

Pali mavuto akuluakulu angapo omwe angabwere chifukwa cha izi:

• Zilonda kapena kuwonongeka kwina kwa mapapo.
• Fibrosing mediastinitis - Ichi ndi chilonda cha malo pakati pa mapapo.
• `Acute Respiratory Distress Syndrome (ARDS)`.
• Histoplasmosis ya mitsempha yapakati - Ngati bowa ifalikira ku ubongo, zizindikiro monga kutupa kwa ubongo, mutu, chisokonezo, kuvutika kuganiza, ndi ziwalo zimatha kuchitika.
• Histoplasmosis ya maso - Ngati bowa wafalikira m'maso, maso angawonongeke kapena kutayika.
• Kufalikira ku ziwalo zina za thupi, monga chiwindi, ndulu, mafuta a m'mafupa, ndi khungu.

Kodi mumazindikira bwanji matendawa?

Dokotala angakuyezeni magazi anu, mkodzo, makoswe ochokera m'mapapo anu, m'mafupa, kapena chitsanzo cha minofu yomwe yakhudzidwa kuti adziwe matendawo. Zitsanzo izi zingagwiritsidwe ntchito:

• Kuyesa kuchiza bowa wotchedwa `H. capsulatum`. Iyi ndiyo njira yabwino kwambiri yodziwira matenda a histoplasmosis. Komabe, izi zingatenge nthawi yayitali, mpaka milungu ingapo. Pa milandu yoopsa, dokotala wanu angayambe kulandira chithandizo popanda kuyembekezera zotsatira zake.
• Tikuyang'ana mtundu wa yisiti `H. capsulatum`.
• Mumayesedwa zizindikiro (zotsutsana ndi ma antibodies) za H. capsulatum m'thupi lanu.

Kuphatikiza apo, X-ray ya pachifuwa kapena CT scan imachitidwa kuti aone kusintha kapena kuwonongeka komwe kwachitika chifukwa cha H. capsulatum. Mitundu ya mayeso omwe dokotala wanu amagwiritsa ntchito imadalira mtundu wa histoplasmosis yomwe muli nayo komanso momwe zizindikiro zanu zilili zoopsa.

Kodi mayeso oyezetsa matenda ndi ati?

Kuwonjezera pa X-ray ndi CT scans, dokotala angatenge zitsanzo zamadzimadzi kapena minofu kuti aone zizindikiro za H. capsulatum kapena kuti azitha kuzisamalira. Zitsanzozi zitha kutengedwa m'njira zotsatirazi:

• Kuyesa mkodzo kapena mafinya : Mumakodza m'chikho (kuyesa mkodzo) kapena mafinya m'chubu (kuyesa mafinya).
• Kuyezetsa magaziDokotala adzakutengerani magazi kuchokera m'dzanja lanu pogwiritsa ntchito singano.
• Kufufuza za minofu : Chitsanzo cha minofu chimatengedwa kudzera mu kudula pang'ono kapena ndi singano. Pa kafukufuku wa mafupa, chitsanzo chimatengedwa kuchokera mkati mwa fupa la m'chiuno.
• Bronchoscopy : Dokotala adzayang'ana mkati mwa mapapo anu pogwiritsa ntchito chubu chopyapyala komanso chopepuka (bronchoscope). Panthawiyi, akhoza kuchita chinthu chotchedwa bronchoalveolar lavage (BAL). Izi zimaphatikizapo "kutsuka" madera ang'onoang'ono a mapapo anu ndi madzi, kusonkhanitsa madziwo, ndikutumiza ku labu kuti akayesedwe.

Kodi histoplasmosis imachiritsidwa bwanji?

Histoplasmosis imachiritsidwa ndi mankhwala opha mabakiteriya, ngati pakufunika kutero. Ngati muli ndi zizindikiro zochepa, sizinakhalepo kwa nthawi yayitali, ndipo simuli pachiwopsezo chachikulu chotenga matenda oopsa, dokotala wanu angaganize zodikira kwakanthawi asanakupatseni mankhwala nthawi yomweyo.

Kodi pali mankhwala athunthu a izi?

Inde, histoplasmosis nthawi zambiri imatha kuchiritsidwa ndi mankhwala opha mavairasi mwa anthu omwe ali ndi chitetezo chamthupi chathanzi. Dokotala wanu angakulembereni mankhwala monga:

• `Itraconazole`
• Amphotericin B (AmB)
• `Corticosteroids` (Izi zimaperekedwa m'mikhalidwe ina yapadera, monga kuchepetsa kutupa)

Kodi chimachitika ndi chiyani ngati sichikuchiritsidwa?

Ngati chitetezo chanu chamthupi chikugwira ntchito bwino ndipo mulibe matenda ena aliwonse omwe amayambitsa matendawa, histoplasmosis nthawi zambiri imatha yokha. Komabe, ngati sichichiritsidwa, nthawi zina imatha kufalikira ku ziwalo zina za thupi, makamaka ngati chitetezo chanu chamthupi sichikugwira ntchito bwino. Ingayambitsenso kuwonongeka kwa mapapo mwa anthu omwe ali ndi matenda ena a mapapo.

Kodi histoplasmosis ingapewedwe?

Ngati mukukhala kudera lomwe bowa uwu ndi wofala, zingakhale zovuta kwambiri kupewa kupuma bowa wa `H. capsulatum`. Ngakhale kuti n'zosatheka kuletsa kotheratu, pali zinthu zingapo zomwe mungachite kuti muchepetse chiopsezo chanu:

• Pewani malo okhala ndi fumbi kapena kumene kumakhala mbalame kapena mileme.
• Ngati ntchito yanu kapena zomwe mumakonda zimafuna kuti mukhudze dothi lomwe lingakhale ndi H. capsulatum, valani chigoba cha N95. Chidzasefa mpweya womwe mumapuma pang'ono.

Kodi ndingayembekezere chiyani ngati nditadwala histoplasmosis?

Zomwe zimachitika mukadwala histoplasmosis zimadalira momwe imakulira komanso ngati muli ndi matenda ena omwe amayambitsa matendawa. Kwa anthu omwe ali ndi chitetezo chamthupi chabwino komanso zizindikiro zochepa, dokotala wanu angasankhe "kudikira" popanda mankhwala. Ngati chitetezo chanu chamthupi chili chofooka kapena mukudwala kwambiri, mungafunike kumwa mankhwala ophera bowa kwa chaka chimodzi.

Chithandizo nthawi zambiri chimatenga milungu 6-12 kapena kuposerapo pa matenda a acute pulmonary histoplasmosis. Pa milandu yoopsa kapena yosatha, mankhwala ophera bowa angafunike kwa chaka chimodzi kapena kuposerapo.

Kodi pali mwayi wotani wopulumuka matendawa?

Anthu ambiri omwe ali ndi chitetezo chamthupi chathanzi (pafupifupi 96%) amachira ku histoplasmosis akalandira chithandizo. Komabe, kafukufuku wina akusonyeza kuti chiwerengero cha anthu omwe ali ndi chitetezo chamthupi chofooka chikhoza kukhala pakati pa 25% ndi 37%. Ichi ndichifukwa chake anthu omwe ali ndi chitetezo chamthupi chofooka ayenera kusamala kwambiri.

Kodi ndimadzisamalira bwanji?

Ngati chitetezo chanu chamthupi chili chofooka, kapena ngati muli ndi COPD kapena emphysema, muyenera kuchitapo kanthu kuti muchepetse chiopsezo chanu cha histoplasmosis. Ngati mukukhala kudera lomwe H. capsulatum ndi yofala, funsani dokotala wanu ngati pali njira zina zapadera zodzitetezera.

Kodi ndiyenera kupita kwa dokotala liti?

Ngati zizindikiro zanu, monga kutentha thupi, chifuwa, ndi kupuma movutikira, sizikuchira mkati mwa sabata imodzi, kapena ngati zikuipiraipira pakapita nthawi, pitani kwa dokotala. Uzani dokotala wanu ngati mwakumanapo ndi bowa uwu chifukwa cha ntchito yanu kapena zosangalatsa zanu, kapena ngati mwapita kudera lomwe bowa uwu ulipo.

Kodi ndiyenera kupita ku Chipinda Chothandizira Anthu Odwala Mwadzidzidzi (ETU) liti?

Ngati chitetezo chanu cha mthupi chili chofooka ndipo muli ndi zizindikiro za matenda, muyenera kulankhula ndi dokotala kapena kupita ku chipinda chodzidzimutsa nthawi yomweyo. Ngati muli ndi zizindikiro zoopsa, pitani ku chipinda chodzidzimutsa chapafupi. Zizindikirozi zikuphatikizapo:

• Malungo aakulu (oposa 103 Fahrenheit/40 Celsius).
• Kupuma movutikira kwambiri kapena mwadzidzidzi.
• Kupweteka pachifuwa.
• Ngati mutsokomola magazi.
• Kusokonezeka maganizo kapena kusintha kwina kwa maganizo.
• Kugwidwa ndi khunyu.
• Mtundu wabuluu wa khungu, milomo, kapena misomali (`cyanosis` - ichi ndi chizindikiro cha mpweya wochepa m'magazi).

Ndi mafunso ati omwe ndiyenera kufunsa dokotala?

Kufunsa dokotala mafunso ngati awa kungathandize:

• Kodi ndili pachiwopsezo chachikulu chotenga matenda oopsa a histoplasmosis?
• Ndi njira ziti zapadera zomwe ndiyenera kuchita kuti ndichepetse chiopsezo cha histoplasmosis?
• Ndi zizindikiro ziti zomwe ndiyenera kuyang'anitsitsa?
• Kodi ndiyenera kupita ku chipinda chadzidzidzi liti?

Pomaliza, zinthu zoti muzikumbukira (Uthenga Wopita Nawo Kunyumba)

Histoplasmosis ndi matenda a bowa omwe amakhudza mapapu anu. Zingakhale zovuta kupewa ngati mukukhala m'dera lomwe bowa ili likukula bwino. Koma milandu yambiri si yoopsa ndipo imatha yokha.

Komabe, ngati muli ndi vuto la m'mapapo kapena chitetezo chamthupi chofooka, muli pachiwopsezo chachikulu cha mavuto aakulu chifukwa cha histoplasmosis. Chifukwa chake, ndikofunikira kuti inu ndi dokotala wanu mugwire ntchito limodzi kuti mupange dongosolo loteteza thanzi lanu ndikukhala tcheru ndi zizindikiro zilizonse. Musachite mantha, kudziwa bwino ndiye chitetezo chabwino kwambiri!

Histoplasmosis , matenda a bowa, matenda a m'mapapo, Histoplasma capsulatum, ndowe za mbalame, ndowe za mleme, kupuma movutikira