Ingabe le fungus ingathinta namaphaphu akho? Ake sifunde nge-Histoplasmosis!

Wake wezwa ngesifo esibizwa ngokuthi "i-Histoplasmosis"? Igama lingase lizwakale lingavamile. Kodwa yisifo se-fungus esingathinta amaphaphu ethu futhi kuyinto okufanele siyiqaphele. Lesi sikhunta sihlala enhlabathini, ikakhulukazi enhlabathini equkethe indle yezinyoni noma yamalulwane. Sithola lesi sifo uma siphefumula uthuli oluqukethe lesi sikhunta.

Iyini ngempela i-Histoplasmosis?

Kalula nje, i-histoplasmosis ukutheleleka kwamaphaphu ethu okubangelwa uhlobo lwesikhunta olubizwa ngokuthi ``Histoplasma capsulatum`` (``Histoplasma capsulatum`` noma ``H. capsulatum``). Le khunta itholakala enhlabathini ezindaweni eziningi zomhlaba, futhi ivame emazweni afana neMelika. Le khunta ingatholakala naseSri Lanka yethu, ikakhulukazi enhlabathini ezungeze imihume yamalulwane, izakhiwo ezindala, kanye namapulazi ezinyoni. Ingena emizimbeni yethu uma siphefumula uthuli oluqukethe lezi zinhlamvu zesikhunta.

Ingabe kunezinhlobo ezahlukene zalesi sifo?

Yebo, kunezinhlobo eziningana eziyinhloko ze-histoplasmosis. Odokotela banquma lezi zinhlobo ngokusekelwe ekutheni usunesikhathi esingakanani unezimpawu nokuthi ngabe sezisakazekele kwezinye izingxenye zomzimba wakho.

1. I-acute pulmonary histoplasmosis

Lolu uhlobo lokutheleleka oluvame kakhulu. Cishe abantu abayi-10% abangenwe yi-fungus baba nezimpawu ezifana ne-pneumonia. Lokhu kufaka phakathi umkhuhlane, ukukhwehlela, kanye nobunzima bokuphefumula. Kodwa-ke, uma ungenwe yigciwane eliphansi, izimpawu zingase zibe zincane futhi zihlale izinyanga eziningana. Lokhu kubizwa ngokuthi isigaba se-subacute.

2. I-histoplasmosis yamaphaphu e-cavitary pulmonary engapheli

Lesi yisimo sesikhathi eside. Sivame kakhulu kubantu abanezifo zamaphaphu ezifana ne-emphysema noma i-COPD (Isifo Sokuvimbela Amaphaphu Esingapheli). Izimpawu zingase zibe zincane kunesimo esiphuthumayo, kodwa ukujuluka ebusuku nokwehla kwesisindo kungase kwenzeke. Izimpawu zingase zihlale izinyanga, ngisho neminyaka. Kungabukeka njengesifo sofuba. Uma kungelashwa, umonakalo emaphashini uzokhula kancane kancane.

3. I-histoplasmosis esakazeke ngokuqhubekayo

Yilapho isikhunta se-H. capsulatum sisakazeka sisuka emaphashini siye kwezinye izingxenye zomzimba. Lokhu kuvame ukwenzeka kubantu abanamasosha omzimba abuthakathaka kakhulu. Isibonelo, abantu abanesifo se-HIV esithuthukile. Lokhu kungabangela ukuphefumula okunzima, ukukhathala, ukwehla kwesisindo, kanye nezilonda zesikhumba eziqhubeka ziba zimbi.

Ngaphezu kwalokho, kunezinhlobo ze-histoplasmosis ezithinta ubuchopho (i-central nervous system histoplasmosis) kanye nalezo ezithinta amehlo (i-ocular histoplasmosis).

Ivame kangakanani i-histoplasmosis?

Eqinisweni, kulinganiselwa ukuthi cishe abantu abadala abangu-75% abahlala ezindaweni lapho i-fungus ethi 'H. capsulatum' ivame khona bake batheleleka ngale fungus ngesikhathi esithile. Kodwa-ke, abantu abaningi ababi nazo izimpawu.

Le fungus yenzani emizimbeni yethu?

Cabanga nje, uphefumula le fungus ethi 'H. capsulatum' ngothuli. Bese iya ngqo emaphashini akho. Lapho, le fungus ingena ngaphakathi kwamaseli ethu amhlophe egazi bese ishintsha kusuka efomini 'lesikhunta' iye efomini 'lemvubelo' engangena.

Kwabaningi abantu, amangqamuzana omzimba abhubhisa isikhunta noma akhe izembozo ezikhethekile ezibizwa ngokuthi "ama-granuloma" azungeze isikhunta futhi asivimbeli ukuba singalimazi umzimba. Ngenxa yalokho, asibi nazo izimpawu.

Nokho, ngezinye izikhathi lokhu kungaba yisifo:

• Uma uphefumula inani elikhulu lesikhunta ngesikhathi esisodwa, amasosha omzimba wakho angase anqotshwe, okubangela izimpawu ezifana nomkhuhlane kanye nobunzima bokuphefumula.
• Uma unezifo zamaphaphu ezifana ne-COPD, le fungus ingaqhubeka nokulimaza amaphaphu akho.
• Uma amasosha omzimba wakho ebuthakathaka (isib. labo abane-HIV noma labo abasebenzisa imithi yokucindezela amasosha omzimba), le fungus ingasebenzisa amangqamuzana akho omzimba ukuze isakazekele kwezinye izingxenye zomzimba wakho. Lokhu kungabangela izinkinga ezisongela ukuphila.

Ziyini izimpawu ze-histoplasmosis?

Izimpawu ze-histoplasmosis zingafaka:

• Imfiva
• Ukukhwehlela
• Ukujuluka
• Ubunzima bokuphefumula (ukuphelelwa umoya)
• Ubuhlungu besifuba
• Ikhanda elibuhlungu (ikhanda elibuhlungu)
• Ubuhlungu bemisipha
• Ubomvu, ubomvu obunamaqhubu emilenzeni engezansi (i-erythema nodosum)

Abantu abane-cavitary pulmonary histoplasmosis engapheli bangase babe nokujuluka ebusuku kanye nokwehla kwesisindo. Okubalulekile, cishe abantu abangu-90% abaphefumula i-fungus H. capsulatum ababi nazo izimpawu, noma izimpawu ziyaphela zodwa.

Yini ebangela lesi sifo?

Imbangela yalokhu isikhunta esibizwa ngokuthi ``Histoplasma capsulatum``. Njengoba sishilo ngaphambili, sibangelwa ukuhogela izinhlamvu zesikhunta ezivela enhlabathini equkethe le khunta. Le khunta ikhula kahle enhlabathini equkethe amaconsi elulwane kanye namaconsi ezinyoni. Itholakala ezingxenyeni eziningi zomhlaba:

• Ezigodini zoMfula i-Ohio ne-Mississippi zaseMelika.
• EMelika Ephakathi naseNingizimu.
• E-Afrika.
• E-Asia.
• E-Australia.

Iningi labantu aliguli ngenxa yokuphefumula le fungus, kodwa abanye abantu, ikakhulukazi labo abaphefumula inani elikhulu le fungus ngesikhathi esisodwa noma labo abanezinkinga ezithile zempilo, bangase babe nezimpawu.

Ubani osengozini enkulu yalokhu?

Usengozini enkulu uma umsebenzi wakho noma izinto ozithandayo zihilela ukuxova uthuli ezindaweni lapho kugcwele khona leli fungus. Izibonelo:

• I-Spelunking.
• Ukulima.
• Ukufuya izinkukhu noma ezinye izinyoni.
• Ukubhidliza izakhiwo ezindala, umsebenzi wokwakha. Cabanga nje, uma uhlanza indlu endala engasetshenziswa iminyaka eminingi, uma kukhona amalulwane ophahleni, futhi leyo ndle ixubene nothuli? Kukhona ingozi uma uyiphefumula.

Ubani osengozini enkulu yokuthola i-histoplasmosis, kungaba ngokushesha noma ngokungapheli?

• Kulabo abanesimiso somzimba esibuthakathaka. Izizathu eziyinhloko zalokhu ukutheleleka nge-HIV kanye nokuphuza imithi yokucindezela amasosha omzimba.
• Kulabo abane-COPD noma i-emphysema.
• Kubantu abaneminyaka engaphezu kwengu-55 ubudala kanye nezinsana ezingaphansi konyaka owodwa ubudala.

Yiziphi izinkinga ezingaba khona ze-histoplasmosis?

Kunezinkinga eziningana ezinkulu ezingavela kulokhu:

• Izibazi noma okunye ukulimala emaphashini.
• I-Fibrosing mediastinitis - Lokhu kuyisibazi sendawo ephakathi kwamaphaphu.
• `Isifo Sokucindezeleka Kokuphefumula Okukhulu (i-ARDS)`.
• I-histoplasmosis yesistimu yezinzwa ephakathi - Uma isikhunta sisakazekela ebuchosheni, izimpawu ezifana nokuvuvukala kobuchopho, ikhanda elibuhlungu, ukudideka, ubunzima bokucabanga, kanye nokukhubazeka komzimba zingase zibe khona.
• I-histoplasmosis yeso - Uma isikhunta sisakazekela emehlweni, umbono ungase uphazamiseke noma ulahleke.
• Kusakazeka kwezinye izingxenye zomzimba, njengesibindi, ubende, umongo wethambo kanye nesikhumba.

Uthola kanjani lesi sifo?

Udokotela angase ahlole igazi lakho, umchamo, isikhwehlela esivela emaphashini akho, umnkantsha, noma isampula yezicubu ezithintekile ukuze ahlole lesi sifo. Lawa masampula angasetshenziswa:

• Kuzanywa ukukhuliswa kwesikhunta i-'H. capsulatum'. Lena yindlela engcono kakhulu yokuthola i-histoplasmosis. Kodwa-ke, lokhu kungathatha isikhathi eside, kuze kube amasonto amaningana. Ezimweni ezimbi kakhulu, udokotela wakho angase aqale ukwelashwa ngaphandle kokulinda imiphumela.
• Sifuna uhlobo lwemvubelo oluthi `H. capsulatum`.
• Uhlolwa izimpawu (ama-antigen noma ama-antibodies) ze-H. capsulatum emzimbeni wakho.

Ngaphezu kwalokho, kwenziwa i-X-ray yesifuba noma i-CT scans ukuze kubhekwe izinguquko noma umonakalo obangelwe yi-H. capsulatum. Izinhlobo zokuhlolwa udokotela wakho azisebenzisayo zincike kuhlobo lwe-histoplasmosis onalo nokuthi izimpawu zakho zimbi kangakanani.

Yiziphi izivivinyo zokuxilonga?

Ngaphezu kwe-X-ray kanye ne-CT scan, udokotela angathatha amasampula oketshezi noma ezicubu ukuze abheke izimpawu ze-H. capsulatum noma ukuze ayihlakulele. Lawa masampula angathathwa ngezindlela ezilandelayo:

• Ukuhlolwa komchamo noma kwesikhohlela : Uchamela enkomishini (ukuhlolwa komchamo) noma isikhohlela ungene epayipini (ukuhlolwa kwesikhohlela).
• Ukuhlolwa kwegaziUdokotela uzothatha igazi engalweni yakho ngenaliti.
• I-Biopsy : Isampula yezicubu ithathwa ngokusikwa okuncane noma ngenaliti. Ku-biopsy yomnkantsha wethambo, isampula ithathwa ngaphakathi kwethambo lesinqe.
• I-Bronchoscopy : Udokotela uzobheka ngaphakathi kwamaphaphu akho esebenzisa ipayipi elincane, elikhanyayo (i-bronchoscope). Ngalesi sikhathi, inqubo ebizwa ngokuthi i-bronchoalveolar lavage (BAL) ingenziwa. Lokhu kuhilela "ukugeza" izindawo ezincane zamaphaphu akho ngoketshezi, ukuqoqa uketshezi, bese uluthumela elabhorethri ukuze luhlolwe.

Iphathwa kanjani i-histoplasmosis?

I-Histoplasmosis yelashwa ngemithi yokukhunta, uma kudingeka. Uma unezimpawu ezincane, azikaze zibe khona isikhathi eside, futhi ungekho engozini enkulu yokuthola ukutheleleka okukhulu, udokotela wakho angase anqume ukulinda isikhashana ngaphambi kokukunikeza imithi ngokushesha.

Ingabe ikhona ikhambi eliphelele lalokhu?

Yebo, i-histoplasmosis ivame ukwelapheka ngemithi yokulwa namagciwane kubantu abanezivikeli mzimba eziphilile. Udokotela wakho angase akunike imithi efana nalokhu:

• `Itraconazole`
• I-Amphotericin B (AmB)
• `Ama-Corticosteroids` (Lawa anikezwa kwezinye izimo ezikhethekile, njengokunciphisa ukuvuvukala)

Kwenzekani uma ingelashwa?

Uma amasosha omzimba wakho esebenza kahle futhi ungenazo ezinye izimo eziyisisekelo, i-histoplasmosis ivame ukuziphelela yodwa. Kodwa-ke, uma ingelashwa, ngezinye izikhathi ingasakazekela kwezinye izingxenye zomzimba, ikakhulukazi uma amasosha omzimba wakho engasebenzi kahle. Ingabangela nomonakalo emaphashini kubantu abanezinkinga zamaphaphu eziyisisekelo.

Ingabe i-histoplasmosis ingavinjelwa?

Uma uhlala endaweni lapho le fungus ivame khona, kungaba nzima kakhulu ukugwema ukuphefumula i-fungus ethi 'H. capsulatum'. Nakuba kungenakwenzeka ukuyivimbela ngokuphelele, kunezinto ezimbalwa ongazenza ukuze unciphise ingozi yakho:

• Gwema izindawo ezinenhlabathi enothuli noma lapho kuhlala khona izinyoni noma amalulwane.
• Uma umsebenzi wakho noma into oyithandayo idinga ukuthi uthinte inhlabathi engase ibe ne-H. capsulatum, gqoka imaski ye-N95. Izohlunga umoya owuphefumulayo ngezinga elithile.

Yini engingayilindela uma ngithola i-histoplasmosis?

Okwenzekayo uma uthola i-histoplasmosis kuncike ekutheni imbi kangakanani nokuthi unezinye izimo eziyisisekelo. Kubantu abanesimiso sokuzivikela somzimba esinempilo kanye nezimpawu ezincane, udokotela wakho angase anqume "ukubuka nokulinda" ngaphandle kwemithi. Uma isimiso sakho sokuzivikela somzimba sibuthakathaka noma ugula kakhulu, kungadingeka ukuthi uthathe imithi yokulwa nezifo okungenani unyaka.

Ukwelashwa kuvame ukuthatha amasonto ayi-6-12 noma ngaphezulu kwe-acute pulmonary histoplasmosis. Ezimweni ezingamahlalakhona noma ezinzima, imithi yokukhunta ingadingeka okungenani unyaka.

Angakanani amathuba okusinda kulesi sifo?

Iningi labantu abanezinhlelo zomzimba eziphilile (cishe ama-96%) bayalulama kwi-histoplasmosis ngokwelashwa. Kodwa-ke, ezinye izifundo ziphakamisa ukuthi izinga lokufa phakathi kwabantu abanezinhlelo zomzimba ezibuthakathaka lingaba phakathi kwama-25% nama-37%. Yingakho abantu abanezinhlelo zomzimba ezibuthakathaka kudingeka baqaphele kakhulu.

Ngizinakekela kanjani?

Uma unesimiso somzimba esibuthakathaka, noma uma une-COPD noma i-emphysema, kufanele uthathe izinyathelo ezengeziwe zokunciphisa ingozi yakho ye-histoplasmosis. Uma uhlala endaweni lapho i-H. capsulatum ivame khona, buza udokotela wakho ukuthi kukhona yini izinyathelo zokuphepha ezikhethekile ongazithatha ukuze uzivikele.

Kufanele ngimbone nini udokotela?

Uma izimpawu zakho, njengomkhuhlane, ukukhwehlela, kanye nokuphelelwa umoya, zingathuthuki phakathi nesonto, noma uma ziba zimbi kakhulu ngokuhamba kwesikhathi, bona udokotela. Tshela udokotela wakho uma uke wachayeka kulesi sikhunta ngenxa yomsebenzi wakho noma izinto ozithandayo, noma uma uke waya endaweni lapho lesi sikhunta sikhona khona.

Kufanele ngiye nini e-Emergency Treatment Unit (ETU) ?

Uma amasosha omzimba wakho ebuthakathaka futhi unezimpawu zokutheleleka, kufanele ukhulume nodokotela noma uye egumbini lezimo eziphuthumayo ngokushesha. Uma unezimpawu ezimbi kakhulu, iya egumbini lezimo eziphuthumayo eliseduze. Izimpawu ezinjalo zifaka:

• Umkhuhlane ophezulu (ngaphezu kuka-103 Fahrenheit/40 Celsius).
• Ukuphefumula okunzima noma okungazelelwe.
• Ubuhlungu besifuba.
• Uma ukhwehlela igazi.
• Ukudideka noma ezinye izinguquko zengqondo.
• Ukuquleka.
• Umbala oluhlaza okwesibhakabhaka wesikhumba, izindebe, noma izinzipho (`i-cyanosis` - lokhu kuyisibonakaliso somoya-mpilo ophansi egazini).

Yimiphi imibuzo okufanele ngiyibuze udokotela?

Kungaba usizo ukubuza udokotela imibuzo efana nale:

• Ingabe ngisengozini enkulu yokuthola i-histoplasmosis enzima?
• Yiziphi izinyathelo ezikhethekile okufanele ngizithathe ukuze nginciphise ingozi yami ye-histoplasmosis?
• Yiziphi izimpawu okufanele ngiziqaphele?
• Kufanele ngiye nini egumbini lezimo eziphuthumayo?

Okokugcina, izinto okufanele uzikhumbule (Umyalezo Wokuya Ekhaya)

I-Histoplasmosis iwukutheleleka kwesikhunta okuthinta amaphaphu akho. Kungaba nzima ukukugwema uma uhlala endaweni lapho le fungus ikhula khona. Kodwa izimo eziningi azizimbi kakhulu futhi ziyaxazululeka zodwa.

Kodwa-ke, uma unesifo samaphaphu noma isimiso somzimba sokuzivikela esibuthakathaka, usengozini enkulu yezinkinga ezinkulu ezivela ku-histoplasmosis. Ngakho-ke, kubalulekile ukuthi wena nodokotela wakho nisebenzisane ukwakha uhlelo lokuvikela impilo yakho futhi niqaphele noma yiziphi izimpawu. Ungesabi, ukuqaphela kuyindlela engcono kakhulu yokuzivikela!

I- Histoplasmosis, ukutheleleka ngefungus, isifo samaphaphu, i-Histoplasma capsulatum, indle yezinyoni, indle yamalulwane, ubunzima bokuphefumula