Ngaba le fungus ingayichaphazela nemiphunga yakho? Masifunde ngeHistoplasmosis!

Ngaba wakha weva ngesifo esibizwa ngokuba yi-"Histoplasmosis"? Eli gama lisenokuvakala lingaqhelekanga. Kodwa sisifo sefungus esinokuchaphazela imiphunga yethu kwaye yinto ekufuneka siyilumkele. Esi sifo sihlala emhlabeni, ingakumbi kumhlaba onenkunkuma yeentaka okanye yeelulwane. Sifumana esi sifo ukuba siphefumla uthuli olunefungus.

Yintoni kanye kanye iHistoplasmosis?

Ngamafutshane, i-histoplasmosis lusulelo lwemiphunga yethu olubangelwa luhlobo lwefungus olubizwa ngokuba yi-``Histoplasma capsulatum`` (``Histoplasma capsulatum`` okanye ``H. capsulatum``). Le fungus ifumaneka emhlabeni kwiindawo ezininzi zehlabathi, kwaye ixhaphakile kumazwe afana neMelika. Le fungus inokufumaneka nakwiSri Lanka yethu, ingakumbi emhlabeni ojikeleze imiqolomba yamalulwane, izakhiwo ezindala, kunye neefama zeentaka. Ingena emizimbeni yethu xa siphefumla uthuli olunezi spores zefungus.

Ngaba kukho iintlobo ezahlukeneyo zesi sifo?

Ewe, kukho iintlobo ezininzi eziphambili ze-histoplasmosis. Oogqirha bamisela ezi ntlobo ngokusekwe kwixesha oye waba neempawu ngalo kunye nokuba sele zisasazeke na kwamanye amalungu omzimba wakho.

1. I-Acute pulmonary histoplasmosis

Olu lolona hlobo luqhelekileyo losulelo. Malunga ne-10% yabantu abosulelwe yifungus baba neempawu ezifana ne-pneumonia. Ezi ziquka umkhuhlane, ukukhwehlela, kunye nobunzima bokuphefumla. Nangona kunjalo, ukuba wosulelwe lusulelo olukumgangatho ophantsi, iimpawu zinokuba zincinci kwaye zihlale iinyanga ezininzi. Oku kubizwa ngokuba yi-subacute stage.

2. I-histoplasmosis yamaphaphu engapheliyo engaphakathi kwesibeleko

Le yimeko ehlala ixesha elide. Ixhaphake kakhulu kubantu abanezifo zemiphunga ezifana ne-emphysema okanye i-COPD (Chronic Obstructive Pulmonary Disease). Iimpawu zinokuba ncinci kunezo zikwimo ebukhali, kodwa ukubila ebusuku kunye nokwehla kobunzima kunokwenzeka. Iimpawu zinokuhlala iinyanga, kwaneminyaka. Zingabonakala ngathi sisifo sephepha. Ukuba azinyangwa, umonakalo emiphungeni uya kwanda kancinci kancinci.

3. I-histoplasmosis esasazekileyo eqhubekayo

Kulapho i-H. capsulatum fungus isasazeka ukusuka emiphungeni iye kwezinye iindawo zomzimba. Oku kudla ngokukwenzeka kubantu abaneenkqubo zomzimba ezibuthathaka kakhulu. Umzekelo, abantu abane-HIV eqhubele phambili. Oku kunokubangela ukuba ukuphefumla kube nzima, ukudinwa, ukwehla kobunzima kunye nezilonda zesikhumba zibe mandundu.

Ukongeza, kukho iintlobo ze-histoplasmosis ezichaphazela ingqondo (i-central nervous system histoplasmosis) kunye nezo zichaphazela amehlo (i-ocular histoplasmosis).

Ixhaphake kangakanani i-histoplasmosis?

Enyanisweni, kuqikelelwa ukuba malunga nama-75% abantu abadala abahlala kwiindawo apho i-'H. capsulatum' ixhaphake khona baye bosulelwa yile fungus ngaxa lithile. Nangona kunjalo, uninzi lwabantu alubonakalisi zimpawu.

Yintoni eyenziwa yile fungus emizimbeni yethu?

Khawuthelekelele, uphefumla le fungus ethi 'H. capsulatum' ngothuli. Emva koko iya ngqo emiphungeni yakho. Apho, le fungus ingena ngaphakathi kwiiseli zethu ezimhlophe zegazi kwaye itshintshe ukusuka kwimo 'yokubumba' ukuya kwimo 'yeast' enokosulela.

Kubantu abaninzi, iiseli zomzimba ezikhusela umzimba ziyayitshabalalisa ifungus okanye zenze imigqumo ekhethekileyo ebizwa ngokuba yi-"granulomas" ejikeleze ifungus kwaye iyithintele ukuba ingalimazi umzimba. Ngenxa yoko, asibi nazimpawu.

Nangona kunjalo, ngamanye amaxesha oku kungaba sisifo:

• Ukuba uphefumla inani elikhulu lefungus ngaxeshanye, amasosha omzimba wakho asenokuphelelwa ngamandla, nto leyo ebangela iimpawu ezifana nomkhuhlane kunye nobunzima bokuphefumla.
• Ukuba unezifo zemiphunga ezifana ne-COPD, le fungus ingaqhubeka nokonakalisa imiphunga yakho.
• Ukuba inkqubo yakho yomzimba yokuzikhusela ibuthathaka (umz., abo bane-HIV okanye abo basebenzisa amayeza okunciphisa umzimba), le fungus ingasebenzisa iiseli zakho zomzimba ukuba zisasazeke kwezinye iindawo zomzimba wakho. Oku kunokubangela iingxaki ezisongela ubomi.

Zithini iimpawu ze-histoplasmosis?

Iimpawu ze-histoplasmosis zingabandakanya:

• Ifiva
• Ukukhwehlela
• Ukubila
• Ubunzima bokuphefumla (ukuphelelwa ngamandla)
• Iintlungu zesifuba
• Intloko ebuhlungu (intloko ebuhlungu)
• Intlungu yemisipha
• Ubomvu, amaqhuqhuva aqhumayo kwimilenze engezantsi (i-erythema nodosum)

Abantu abane-cavitary pulmonary histoplasmosis engapheliyo banokufumana ukubila ebusuku kunye nokwehla kobunzima. Okubalulekileyo kukuba, malunga ne-90% yabantu abaphefumla i-fungus H. capsulatum ababonakalisi zimpawu, okanye iimpawu ziyaphela ngokwazo.

Yintoni ebangela esi sifo?

Unobangela woku yi-fungus ebizwa ngokuba yi-``Histoplasma capsulatum``. Njengoko besitshilo ngaphambili, ibangelwa kukuphefumla ii-spores ze-mold ezivela kumhlaba oqulethe le fungus. Le fungus ikhula kakuhle kumhlaba oqulethe i-bat droppings kunye ne-bird droppings. Ifumaneka kwiindawo ezininzi zehlabathi:

• Kwiindawo eziphantsi koMlambo iOhio neMississippi eMelika.
• KuMbindi nakuMzantsi Merika.
• EAfrika.
• EAsia.
• E-Australia.

Uninzi lwabantu aluguliswa kukuphefumla le fungus, kodwa abanye abantu, ingakumbi abo baphefumla isixa esikhulu sefungus ngaxeshanye okanye abo baneengxaki ezithile zempilo, banokuba neempawu.

Ngubani osengozini enkulu yoku?

Usemngciphekweni omkhulu ukuba umsebenzi wakho okanye izinto ozithandayo ziquka ukuxovula uthuli kwiindawo apho kukho olu hlobo lwefungus luninzi khona. Imizekelo:

• I-Spelunking.
• Ukulima.
• Ukukhulisa iinkukhu okanye ezinye iintaka.
• Ukudiliza izakhiwo ezindala, umsebenzi wokwakha. Khawucinge nje, xa ucoca indlu endala engasetyenziswanga iminyaka, ukuba kukho amalulwane eluphahleni, kwaye loo ndle ixutywe nothuli? Kukho umngcipheko ukuba uyayiphefumla.

Ngubani osengozini enkulu yokufumana i-histoplasmosis, nokuba ngokukhawuleza okanye ngokungapheliyo?

• Kwabo banenkqubo yomzimba yokuzikhusela ebuthathaka. Ezona zizathu ziphambili zoku kusulelwa yi-HIV kunye nokuthatha amayeza okunciphisa amajoni omzimba.
• Kwabo baneCOPD okanye i-emphysema.
• Kubantu abaneminyaka engaphezu kwama-55 ubudala kunye neentsana ezingaphantsi konyaka omnye ubudala.

Ziziphi iingxaki ezinokubakho ze-histoplasmosis?

Kukho iingxaki ezininzi ezinzulu ezinokuvela koku:

• Amanxeba okanye umonakalo ongomnye emiphungeni.
• I-Fibrosing mediastinitis - Oku kukuvaleka kwendawo ephakathi kwemiphunga.
• `Isifo Sokuxhalaba Okungapheliyo Kweengqondo (ARDS)`.
• I-histoplasmosis yenkqubo yemithambo-luvo ephakathi - Ukuba i-fungus isasazeka iye engqondweni, iimpawu ezinje ngokudumba kobuchopho, intloko ebuhlungu, ukudideka, ubunzima bokucinga, kunye nokukhubazeka komzimba zinokubakho.
• I-histoplasmosis yeliso - Ukuba i-fungus isasazeka emehlweni, umbono unokuba buthathaka okanye ulahleke.
• Isasazeka kwezinye iindawo zomzimba, ezifana nesibindi, i-spleen, umongo wethambo kunye nolusu.

Uyixilonga njani le sifo?

Ugqirha angavavanya igazi lakho, umchamo, i-sputum evela kwimiphunga yakho, umongo wethambo, okanye isampuli yezicubu ezichaphazelekileyo ukuze kufunyaniswe isifo. Ezi sampuli zingasetyenziselwa:

• Kuzanywa ukukhuliswa kwesikhunta i-'H. capsulatum'. Le yeyona ndlela ilungileyo yokufumanisa i-histoplasmosis. Nangona kunjalo, oku kungathatha ixesha elide, ukuya kuthi ga kwiiveki ezimbalwa. Kwiimeko ezinzima, ugqirha wakho unokuqalisa unyango ngaphandle kokulinda iziphumo.
• Sikhangela uhlobo lwemvubelo oluthi `H. capsulatum`.
• Uvavanywa iimpawu (ii-antigens okanye ii-antibodies) ze-H. capsulatum emzimbeni wakho.

Ukongeza, ii-X-ray zesifuba okanye ii-CT scans zenziwa ukujonga utshintsho okanye umonakalo obangelwe yi-H. capsulatum. Iintlobo zovavanyo olusetyenziswa ngugqirha wakho zixhomekeke kuhlobo lwe-histoplasmosis onayo kunye nokuba iimpawu zakho zinzima kangakanani.

Zithini iimvavanyo zokuxilonga?

Ukongeza kwi-X-reyi kunye ne-CT scans, ugqirha unokuthatha iisampulu zolwelo okanye zezicubu ukujonga iimpawu ze-H. capsulatum okanye ukuyicoca. Ezi sampuli zingathathwa ngeendlela ezilandelayo:

• Uvavanyo lomchamo okanye lwesikhohlela : Uchamela kwikomityi (uvavanyo lomchamo) okanye isikhohlela kwityhubhu (uvavanyo lwesikhohlela).
• Uvavanyo lwegaziUgqirha uza kuthatha igazi elingalweni yakho ngenaliti.
• I-Biopsy : Isampuli yezicubu ithathwa ngenxeba elincinci okanye ngenaliti. Kwi-bone marrow biopsy, isampuli ithathwa ngaphakathi kwithambo lesinqe.
• I-Bronchoscopy : Ugqirha uza kujonga ngaphakathi kwemiphunga yakho esebenzisa ityhubhu ebhityileyo nekhanyisiweyo (i-bronchoscope). Ngeli xesha, inkqubo ebizwa ngokuba yi-bronchoalveolar lavage (BAL) inokwenziwa. Oku kubandakanya "ukuhlamba" iindawo ezincinci zemiphunga yakho ngolwelo, ukuqokelela ulwelo, kunye nokuluthumela kwilebhu ukuze luvavanywe.

Iphathwa njani i-histoplasmosis?

I-Histoplasmosis inyangwa ngamayeza okubola, ukuba kuyimfuneko. Ukuba uneempawu ezingephi, azikho ixesha elide, kwaye awukho semngciphekweni omkhulu wokufumana usulelo olukhulu, ugqirha wakho unokugqiba ekubeni alinde ixesha elithile ngaphambi kokuba akunike amayeza ngoko nangoko.

Ngaba ikho indlela epheleleyo yokunyanga oku?

Ewe, i-histoplasmosis inokunyangwa ngamayeza okulwa nentsholongwane kubantu abaneenkqubo zomzimba ezisempilweni. Ugqirha wakho angakunika amayeza anjengala:

• `Itraconazole`
• I-Amphotericin B (AmB)
• `Ii-Corticosteroids` (Ezi zinikwa kwiimeko ezithile ezikhethekileyo, njengokunciphisa ukudumba)

Kuza kwenzeka ntoni ukuba ayinyangwa?

Ukuba inkqubo yakho yokuzikhusela komzimba isebenza kakuhle kwaye awunazo ezinye iimeko ezifihlakeleyo, i-histoplasmosis idla ngokuziphelela. Nangona kunjalo, ukuba ayinyangwa, ngamanye amaxesha inokusasazeka kwezinye iindawo zomzimba, ingakumbi ukuba inkqubo yakho yokuzikhusela yomzimba ayisebenzi kakuhle. Inokubangela umonakalo emiphungeni kubantu abaneengxaki zemiphunga ezingaphantsi.

Ngaba i-histoplasmosis ingathintelwa?

Ukuba uhlala kwindawo apho le fungus ixhaphake khona, kunokuba nzima kakhulu ukuphepha ukuphefumla i-fungus ethi 'H. capsulatum'. Nangona kungenakwenzeka ukuyithintela ngokupheleleyo, kukho izinto ezimbalwa onokuzenza ukunciphisa umngcipheko wakho:

• Ziphephe iindawo ezinomhlaba onothuli okanye apho kuhlala khona iintaka okanye amalulwane.
• Ukuba umsebenzi wakho okanye into oyenzayo ifuna ukuba unxibelelene nomhlaba onokuba ne-H. capsulatum, nxiba imaski ye-N95. Iya kucoca umoya owuphefumlayo ukuya kuthi ga kwinqanaba elithile.

Ndingalindela ntoni ukuba ndifumana i-histoplasmosis?

Okwenzekayo xa ufumana i-histoplasmosis kuxhomekeke ekubeni imbi kangakanani na kwaye nokuba unezinye iimeko ezifihlakeleyo. Kubantu abanenkqubo yomzimba yokuzikhusela esempilweni kunye neempawu ezincinci, ugqirha wakho unokugqiba ekubeni "ulinde kwaye ulinde" ngaphandle kwamayeza. Ukuba inkqubo yakho yomzimba yokuzikhusela ibuthathaka okanye ugula kakhulu, kunokufuneka uthathe amayeza okulwa ne-fungus ubuncinane unyaka.

Unyango luhlala iiveki ezi-6 ukuya kwezili-12 okanye ngaphezulu kwi-acute pulmonary histoplasmosis. Kwiimeko ezingapheliyo okanye ezinzima, amayeza okulwa ne-fungus anokufuneka ubuncinane unyaka.

Zithini amathuba okusinda kwesi sifo?

Uninzi lwabantu abaneenkqubo zokuzikhusela zomzimba ezisempilweni (malunga nama-96%) bayasinda kwi-histoplasmosis ngonyango. Nangona kunjalo, ezinye izifundo zibonisa ukuba izinga lokufa phakathi kwabantu abaneenkqubo zokuzikhusela zomzimba ezibuthathaka linokuba phakathi kwama-25% nama-37%. Yiyo loo nto abantu abaneenkqubo zokuzikhusela zomzimba ezibuthathaka kufuneka balumke kakhulu.

Ndingazinyamekela njani?

Ukuba unenkqubo yomzimba yokuzikhusela ebuthathaka, okanye ukuba une-COPD okanye i-emphysema, kufuneka uthathe amanyathelo ongezelelweyo ukunciphisa umngcipheko wakho we-histoplasmosis. Ukuba uhlala kwindawo apho i-H. capsulatum ixhaphake khona, buza ugqirha wakho ukuba kukho naziphi na izilumkiso ezikhethekileyo onokuzithatha ukuze uzikhusele.

Ndifanele ndimbone nini ugqirha?

Ukuba iimpawu zakho, ezinje ngomkhuhlane, ukukhohlela, kunye nokuphefumla kancinci, aziphucukanga kwiveki, okanye ukuba ziya zisiba mandundu ngokuhamba kwexesha, bona ugqirha. Xelela ugqirha wakho ukuba ukhe wachaphazeleka yile fungus ngenxa yomsebenzi wakho okanye izinto ozithandayo, okanye ukuba uye waya kwindawo apho le fungus ikhona khona.

Ndingaya nini kwiYunithi yoNyango oluNgxamisekileyo (i-ETU) ?

Ukuba inkqubo yakho yomzimba yokuzikhusela ibuthathaka kwaye uneempawu zosulelo, kufuneka uthethe nogqirha okanye uye kwigumbi likaxakeka ngoko nangoko. Ukuba uneempawu eziqatha, yiya kwigumbi likaxakeka elikufutshane. Ezi mpawu ziquka:

• Umkhuhlane ophezulu (ngaphezulu kwe-103 Fahrenheit/40 Celsius).
• Ubunzima obukhulu okanye obukhawulezileyo bokuphefumla.
• Iintlungu zesifuba.
• Ukuba ukhwehlela igazi.
• Ukuphazamiseka kwengqondo okanye olunye utshintsho engqondweni.
• Ukuxhuzula.
• Umbala oluhlaza okwesibhakabhaka wolusu, imilebe, okanye iinzipho (`i-cyanosis` - olu luphawu lokuba ioksijini iphantsi egazini).

Ndingayibuza yiphi imibuzo ugqirha?

Kunganceda ukubuza ugqirha imibuzo efana nale:

• Ngaba ndisengozini enkulu yokufumana i-histoplasmosis enzima?
• Ngawaphi amanyathelo akhethekileyo endifanele ndiwathathe ukunciphisa umngcipheko wam we-histoplasmosis?
• Zeziphi iimpawu ekufuneka ndizijonge?
• Ndingaya nini kwigumbi likaxakeka?

Okokugqibela, izinto ekufuneka uzikhumbule (Umyalezo Wokuya Ekhaya)

I-Histoplasmosis sisifo sefungus esichaphazela imiphunga yakho. Kunokuba nzima ukusiphepha ukuba uhlala kwindawo apho esi sifo sikhula khona. Kodwa uninzi lweemeko azibi zinzulu kwaye ziyaphela ngokwazo.

Nangona kunjalo, ukuba unesifo semiphunga okanye inkqubo yomzimba yokuzikhusela ebuthathaka, usengozini enkulu yokufumana iingxaki ezinkulu ezivela kwi-histoplasmosis. Ke ngoko, kubalulekile ukuba wena nogqirha wakho nisebenzisane ukuze niphuhlise isicwangciso sokukhusela impilo yakho kwaye niqaphele naziphi na iimpawu. Musa ukoyika, ukuqonda yeyona ndlela ilungileyo yokuzikhusela!

I- Histoplasmosis, usulelo lwefungus, isifo semiphunga, i-Histoplasma capsulatum, indle yeentaka, indle yelulwane, ubunzima bokuphefumla