Ƙunƙashin Ƙarƙashin Ƙasa zai iya ci gaba da cutar rashin lafiya ta AIDS
Cryptococcosis wani cututtuka ne mai cututtuka wanda ya shafi mutane fiye da 16,000 a kowace rana ko kusan mutane miliyan daya kowace shekara.
Karin ƙwayoyin cryptococcosis (wanda ya haɗa da meningitis cryptococcal) ne Cibiyar Kula da Cututtuka na Rarraba da Cututtuka ta Amurka ta tsara ta matsayin yanayin AIDS . Bisa ga al'amuran, cizon ƙwaƙwalwar ƙwaƙwalwar ƙwayar cuta shine ƙwayar cuta ta musamman na tsarin kulawa na tsakiya da na uku mafi yawan rikici ga mutanen da ke fama da cutar AIDS .
Da zuwan haɗuwa da maganin rigakafi (ART) , ƙwayoyin cryptococcosis sun ki yarda a cikin kasashe masu tasowa tun daga tsakiyar shekarun 1990.
Duk da haka, daga hangen zaman gaba na duniya, yawan shekarun mutuwar da ake danganta ga cizon cizon ƙwaƙwalwar ƙwayar cuta a halin yanzu ya wuce 625,000-tare da mafi girma a cikin yankunan Saharar Afirka, inda aka kiyasta mutuwa tsakanin 50% da 70%.
Ya bambanta, mace-mace ta hanyar cryptococcosis a Amurka da wasu ƙasashe masu tasowa yana kusa da 12%.
Causal Agents
Cryptococcosis ne lalacewa ta hanyar naman gwari Cryptococcus neoformans da Cryptococcus gattii . A baya, cryptococcosis an danganta shi ne kawai zuwa ga C. neoformans , amma binciken ya rigaya ya ware kuma ya gano duka biyan kuɗi.
Daga cikin mutanen da ke dauke da kwayar cutar HIV, fiye da kashi uku cikin dari na lokuta na cryptococcosis an ruwaito a cikin mutane da CD4 masu ƙididdiga a ƙasa da sel 50 / ml. Cryptococcosis zai iya faruwa a cikin mutane tare da tsarin rigakafin m.
Hanyoyin Transmission
Ana tsarawa cewa ana samo cryptococcosis ta hanyar inhaling da spores reprores (basidiospores) na C. neoformans ko C. gattii .
Yayinda C. neoformans ke samuwa a cikin ƙasa wanda ke dauke da tsuntsaye, musamman tattabara, inhalation har yanzu ana daukar su a matsayin hanya mafi mahimmanci na kamuwa da cuta (kamar yadda ya dace da rashin haɗari da haɗari ko tuntuɓar fata).
A bambanta, ba a samo C. gattii ba a cikin furotin avian, amma a cikin bishiyoyi (mafi yawan eucalyptus). An san naman gwari don yadawa a cikin rassan a kusa da tushen bishiyoyi.
Duk da yake cryptococcosis yakan faru akai-akai a cikin dabbobi, da dabbobi masu shayarwa da kuma dabba, ƙwayoyin dabba-dabba-dan Adam suna da wuya. Hakanan ana daukar nauyin watsa labaran dan adam a matsayin abin ban mamaki.
Bayyanar cututtuka na Cryptococcosis
Bayanin asibiti na kamuwa da Crytococcal yakan fara ko'ina daga watanni biyu zuwa 11 bayan shawagi.
Rashin kamuwa da ƙwayoyin cryptococcal na yau da kullum zai iya zama mai matukar damuwa a marasa lafiya, ko ba tare da marasa lafiya ba, wadanda ba a kwakwalwa ba. Magunguna da ciwon ƙwayar cuta na cryptococcal sukan fuskanci tari, ƙwaƙwalwar kirji, ƙananan zazzabi, malaise, da rashin ƙarfi na numfashi. A wasu lokuta, asarar hasara zai kasance, ƙwayar lymph mai ƙumi ( lymphadenopathy ), hanzari mai ƙarfi ( tachypnea ), da kuma ƙwaƙwalwa a cikin ƙwayar (rales).
Idan kamuwa da kamuwa da cuta fiye da huhu (extrapulmonary), mafi yawancin lokuta yakan gabatar da shi a cikin tsarin kulawa ta tsakiya kamar yadda ake kira cryptococcal meningitis. A cikin waɗannan lokuta, marasa lafiya na iya gabatarwa tare da bayyanar cututtuka irin su ciwon kai, zazzabi, ko canje-canje a yanayin tunanin mutum (misali, asarar faɗakarwa, rashawa, ƙetare).
Kwayoyin cututtuka suna sau da yawa sau da yawa a farkon, suna ci gaba da tsananta a cikin hanyoyi da dama.
Abubuwan halayen muni da kuma ciwon daji na cututtuka na cryptococcal meningitis sun hada da:
- Nuna da zubar
- Binciken tsoro
- Sensitivity zuwa haske
- Raunin kunne ko asara
- Ƙara yawan matsa lamba
- Mai tsananin ciwon kai
- Sweff wuyansa
- Canje-canje na mutum
- Difficulty magana, karatu ko rubutu
- Riƙewa ko asarar haɗin muscular
- Majalisa
- Coma
Tun da wasu daga cikin bayyanar cututtukan da ke haɗuwa da tsinkaye na jiki (irin su tauraron dangi da farfadowa zuwa hasken) ba a faruwa a cikin marasa lafiya da yawa tare da meningitis cryptococcal, sanarwa game da yanayin a wani lokaci ana rasa, jinkirta likita don 'yan makonni har ma watanni har sai bayyanuwar m bayyanar cututtuka.
Bayan ƙwaƙwalwar huhu da tsarin kulawa na tsakiya, ƙwaƙwalwar ƙwayar cututtuka na iya bayyana a kan fata kamar launi, ulcers, plaques, abscesses, da kuma duk wasu yanayin cutanous (ko subcutaneous). Hakanan zai iya rinjayar gland, da prostate, da sauran sassan kwayoyin.
Sanin asali na Cryptococcosis
An gano asali na cryptococcosis ta hanyar gabatar da siffofin asibiti da kuma alamun bayyanar, kuma an tabbatar ta hanyar nazarin jini, nama, ruwan sanyi, ko sauran ruwan jiki. Hanyar ganewar asali na iya haɗawa da:
- Kwayoyin cryptococcal antigen gwajin jini ko ruwan sanyi
- Nazarin kwayoyin halitta da / ko al'ada na nama, jini ko ruwan sanyi
- Al'adu na wanke wanke-wanke na bronchoalveolar
Duk da yake hasken rukuni na kirji zai iya bayyanawa a fili ko yadawa ya shiga cikin huhu a lokuta na kamuwa da cutar huhu, suna taimakawa wajen tabbatar da ganewar asali.
Jiyya na Cryptococcosis
Don marasa lafiya marasa rigakafi da cututtuka masu tsauri ko ƙwayar cuta mai tsaka-tsaka, za a iya tsara wata hanya ta maganin farfadowa (fluconazole, itraconazole) har sai an magance cutar ta fungal.
A yayin cutar mai tsanani, magani yakan fara da amphotericin B, sau da yawa a hade da flucytosine. Ana bin wannan ta gaba ta hanyar ci gaba da kulawa ta hanyar yin amfani da nauyin yau da kullum na maganin antifungal (kazalika da farawar ART idan mai haƙuri ba tukuna ba).
Dole ne a ci gaba da farfadowa na aikin gyare-gyare har zuwa lokacin da CD4 ya fi sama da 100 kwayoyin / mL kuma ana ɗaukar nauyin hoto mai tsai da hankali ga matakan da ba a gane ba. Idan CD4 ya fāɗi a kasa 100, ya kamata a sake farfadowa don hana yaduwar cutar.
A Amurka da kuma mafi yawan ƙasashe masu tasowa, ba a ba da shawara ga ƙwararruwar maganin rigakafi na farko (preventative) ba, kodayake ana gwada gwaje-gwaje na antigen ga marasa lafiya a kara yawan haɗari ko kuma a cikin yankuna masu tsanani.
نطق:
- krip-to-kaw-KO-sus
- krip-to-KOK-ul da-nin-JYE-tus
Har ila yau Known As:
- Crypto (launi)
- Cutar crypotococcal
Sources:
Cibiyoyin Kula da Cututtuka da Cututtuka na Amurka (CDC). "Shafi A - Dandalin Ƙididdigar Yanayi." Atlanta, Jojiya; nazarin karshe na Nuwamba 20, 2008.
Cogliati, M. "Tsarin Lafiya na Duniya na Cryptococcus neoformans da Cryptococcus gattii: Wani Atlas na Nau'in Halittu." Kimiyya. Disamba 11, 2012. Mataki na ID 675213, shafuka 23.
Del Valle, L. da Piña-Oviedo, S. "Rashin cutar HIV daga kwakwalwa, cututtuka da cututtuka." Faransanci a Bioscience. Janairu 2006; 11 (1): 718-732.
Holmes, C. Losina, E. Walensky, R .; et al. "Bincike kan cutar rashin lafiyar ɗan adam irin wannan cututtukan da ke da alaka da 1 cikin Saharar Afirka." Cututtuka na cututtuka na asibiti. 2003; 36 (5): 652-662.
Cibiyoyin Kula da Cututtuka da Cututtuka na Amurka (CDC). "Cutar da ake kira Cryptococcal: cuta mai tsanani a tsakanin mutanen dake zaune tare da HIV / AIDS." Atlanta, Jojiya; takardar shaidar CS21371B; nazarin karshe na Oktoba 2, 2012.
Pinner, R .; Hajjeh, R; da kuma Powderly, W. "Hanyoyin da za su hana cryptococcosis a cikin mutanen da ke fama da cutar rashin lafiyar mutum." Cututtuka na cututtuka na asibiti. Agusta 1995; 21 (S1): 103-107.
Rhein, J. da Boulware, D. "Fassarar da kuma gudanar da maganin cututtuka na cryptococcal a cikin marasa lafiya da kamuwa da cututtukan kwayoyin halitta." Neurobehavioral HIV Medicine. Yuni 12, 2012; 2012 (4): 45-61.
Kanji, S .; Kakai, R .; da kuma Onyango, R. "Cikakken cryptococcal tsakanin marasa lafiyar mutum marasa lafiya marasa lafiya da ke halartar babban asibitin Kisumu, yammacin Kenya." Cibiyar Nazarin Kwayoyin Kimiyya ta Clinical. 2011; 2 (12); Doi: 10: 3823/220.
Daidai, J. Dismukes, W .; Dromer, F .; et al. "Ayyuka na Kasuwanci na Gudanarwa don Gudanar da Cutar Cryptococcal: 2010 Sabuntawa ta Cibiyar Cututtuka na cututtukan cututtuka na Amurka." Cututtuka na cututtuka na asibiti. . 2010: 50 (3): 291-322.