I-Coccidioimycosis yintlupheko ebangelwa yiCoccidioides immitis okanye uCoccidioides posadaii , eyaziwa ngokuba yi "Valley Fever." Kuyinto enzima kumalungu eMzantsi-ntshona wase-US, ukusuka eTexas ukuya kusezantsi kweCalifornia, kunye nomntla waseMexico, iPentral America, kunye neMzantsi Melika.
Ngoxa i-coccidioimycosis ibonisa ngaphakathi kwimiphunga (pulmonary), xa isasazeka ngaphaya kweemiphunga (i-extrapulmonary) ibonwa ngokuba yi- AIDS-defining condition yi-US Centers for Control and Prevention (CDC) ye-US.
Inani leNkcazo yeCoccidioimycosis
Ngokutsho kwe-CDC, izinga le- incidence kwi-US ngabantu abangama-44 ngabantu abayi-100,000. Nangona kunjalo, uninzi lwale matyala luvela kwiindawo ezimbini (iArizona, eCalifornia), apho izinga lezeziganeko likwazi ukuqhuba eliphezulu njengama-248 kuma-100,000.
Ngo-2011, ii-22 000 ezintsha ze-coccidioimycosis zabikwa yi-CDC, ukunyuka kweshumi ukusuka ngo-1998. E-California kuphela, inani landa ukusuka ngo-719 ngo-1998 ukuya kuma-5,697 aphezulu ngo-2011.
Oko kwathiwa, phakathi kwabantu abane-HIV, iziganeko ze-coccidioidomycosis ziye zahla kakhulu ngenxa yokufika kwe- antiretroviral therapy (ikarita) , ngelixa ukubonakaliswa kliniki kwesi sifo kubonakala kunzima kakhulu.
Iimodeli zoTshintshelo
I-Coccidioides ikhona emhlabathini apho ingavelisa khona iindawo ezinobuncwane ngexesha lonyaka. Ukukhulelwa kubangelwa ukunyusa iifolo zefungal, ngokuqhelekileyo ngaphandle komntu, nokuba wazi.
Xa sele ungaphakathi kumaphaphu, i-spores inokuvelisa ezinye i-spores, ezenza izigulane ezinokukhupha kwaye zidale ukuvuvukala ngaphakathi kwe-bronchi. Amajoni omzimba-okhuselweyo-ngokukodwa abantu abanesifo se-HIV abaneengxelo ze- CD4 ngaphantsi kweeseli ezingama-250 / μL-oku kunokubangela ukusuleleka kwintsholongwane. I-fungus isenokusasazeka kwimiphunga ibe ngegazi, apho inokuchaphazela ezinye iinxalenye zomzimba.
I-Coccidioides ayidluliselwa kumntu kumntu.
Iimpawu zeCoccidioimycosis
Uninzi lwabantu abanesifo abasenayo nayiphi na impawu okanye iziphumo zentsholongwane. Kwizinto ezenzayo, iimpawu zivame ukuzikhawulela kwaye zikhoyo ngeempawu ezifana ne:
- Fever
- Intloko
- Isiqhamo
- Iintlungu zesifuba
- Ukuqhawukelwa ngumphefumlo
- IChills
- I-Myalgia (intlungu yesisu) kunye ne- arthralgia (intlungu edibeneyo)
- Ukukhathala
Ukukhawuleza kungahlakulela kwi-25% yamatyala. Ukugqithisa ngokuqhelekileyo kunqamle kwiimida eziphantsi, ezifakwe ngamagundane obomvu okanye izibonda zesimo esingavumelekanga. Kwezinye iimeko (malunga no-5-8%), ukusuleleka kunokunyuka kwi-pneumonia (CAP), esoloko ixazulula ngokukhawuleza ngaphandle kwonyango oluthe ngqo olukhuselweyo.
Nangona kunjalo, kwiimeko ezinqabileyo, i-coccidioimycosis ingaba nzima kakhulu, kubangele ukutshabalalisa kunye nemivumba emiphakeni. Xa usasazwa (okt wasasa ngaphaya kwemiphunga), inokutshatyalaliswa komzimba, oku kubangela ukuba:
- Izilonda zesikhumba kunye nama-abscesses
- Ukuxhamla kunye neentlungu ezibuhlungu
- Izilonda zesifo
- Ukuvutha kwentliziyo
- Iingxaki zee-Urinary
- Meningitis
I-Meningitis yinkxalabo ebomngcipheko yobomi be-coccidioimycosis. Nangona izinga lokufa kwabantu bonke e-US libhekwa liphantsi (0.07%), kulabo abane- HIV ephambili (i-CD4 ngaphantsi kweeseli / i-μL), ukufa kufana nokufikelela kuma-70% nangona unyango olufanelekileyo.
Ukuxilongwa kweCoccidioimycosis
I-Coccidioimycosis inokufunyanwa ngokuhlolwa kwezinto ezincinci zomzimba, i-sputum, i-exudates (umz. Pus), okanye i-biopsies yamathambo. Ukuxilongwa kungenziwa kunye ne-PCR (i-polymerase chain reaction reaction), eyenza i-DNA ivela kwiisampuli ze-serological ukuqinisekisa ukusuleleka kweCoccidioides .
Unyango lweCoccidioimycosis
Abantu abane-HIV abane-HIV (i-CD4 ngaphezu kwama-cell cell / μL), i-coccidioimycosis ngokuqhelekileyo iyancipha kwaye ayifuni unyango oluthile ngaphandle kokunyamekela.
Kwalabo abafuna unyango-nokuba ngenxa yeempawu eziqhubekayo okanye izifo eziqhubekayo-izalathisi zomlomo zibhekwa njengeyokuqala yokukhetha.
Kule, i ketoconazole yiyona kuphela ikhetho elivunywe yi-FDA ekwenzeni unyango lwe-coccidioimycosis, nangona ezininzi iingcali namhlanje ziba yi-fluconazole okanye i-itraconazole. (Nceda uqaphele ukuba i ketoconazole, i-fluconazole, kunye ne-itraconazole zichasene ngexesha lokukhulelwa nokuncelisa.)
Xa ugula kakhulu, i-antifungal amphotericin B ibonwa njengeziyobisi ezikhethiweyo. Ilawulwa nge-intravenously de i-infection isilawulwa, emva koko i-prophylaxis yomlomo omdala we-ketoconazole, i-fluconazole okanye i-itraconazole imiselwe.
Kwizigulane ezine-coccidioidal meningitis, i-amphotericin B inokulawulwa nge-intrathecally (oko kukuthi kwindawo ejikeleze ingqondo okanye umthambo womthambo).
Ukuthintela iCoccidioimycosis
Kunzima ukukhusela i-coccidioimycosis kwimimandla ekhoyo. Ngenxa yokukhuseliswa ngamandla kwe-immune, unyango lweprophylactic lunokunceda ukunqanda usulelo. Akukho zitofu ezikhoyo. Ukuba uhlala kwindawo eyimimandla kwaye ukholelwa ukuba usemngciphekweni, kukho izicwangciso ezimbalwa ongayithatha:
- Gqoka i-mask uthuli xa usebenza nomhlaba, okanye unge amanzi phantsi komhlaba ukuze unciphise iifungus.
- Gwema ukuphuma ngaphandle ngexesha lesiphango sothuli okanye umoya ophezulu.
- Sebenzisa amanyathelo omgangatho womoya, njengesihlungi se- HEPA , kwaye ufake ifowuni engabizi kunye nezicwangciso zomnyango.
- Ukuba usebenza kwisiza sokwakha, gqoka i-mask ye-N95 ifayile yokucoca.
Imithombo:
Amaziko e-US for Control and Prevention (CDC) yeZifo. "Ukwandiswa kweNgxelo yeCoccidioidomycosis - eMelika, ngo-1998-2011." Ukufa kunye nokuLawulwa kweeNgxelo zeveki nganye (MMWR). NgoMatshi 29, 2013: 62 (12): 217-221.
Galgiani, J. "Coccidioimycosis." Umbhalo weRoyal Society of Medicine and Hygiene. 2005; 41 (9): 1217-1223.
Pickering, L .; Baker, C .; Kimberlin, D; okqhubekayo. "Coccidioimycosis." I-American Academy ye-Pediatrics, iBhuku eliBomvu: Ingxelo ka-2009 kwiKomidi yezifo ezithathelwanayo. Elk Grove Village, e-Illinois; Uhlobo lwe-28: 266-268.
IMasannat, F. kunye ne-Ampel, M. "Coccidioidomycosis kwizigulane ezine-HIV-1 Infection kwi-Era ye-Antiretroviral Treatment." Izifo ezithathelwanayo zonyango. Ja nuwari 2010; 50: 1-7.
Amaziko e-US for Control and Prevention (CDC) yeZifo. "Ukwandiswa kweCoccidioidomycosis - United States, 2009." Ukufa kunye nokuLawulwa kweeNgxelo zeveki nganye (MMWR). NgoFebruwari 13, 2009: 58 (5): 105-109.
Ukubizwa: kok-si-dee-oh-my-KOH-sis
Kwaziwa njenge:
- Coccidioidal Granuloma
- Cocci
- "I-California Fever"
- "Intlango yaseRheumatism"
- Izifo zePasadas Wernicke
- "I-San Joaquin Valley Fever"
Iimpazamo eziqhelekileyo: i- coccidiomycosis