Yintoni eyenzekayo xa i-Fungus ichaphazela ubuchopho
Kukho into ephazamisayo malunga nefungus. Mhlawumbi kungenxa yokuba iifungi zifani nakwezinye iindlela eziqhelekileyo zobomi, ezifana nezityalo okanye izilwanyana. Okanye mhlawumbi ngumbutho phakathi kwefungus nezinto ezifile okanye ezifa. Ngoxa kungekho sisifo esamkelekileyo, into ethile malunga nokusuleleka kwe-fungal ibonakala iyinto engathandekiyo. Oku kubaluleke kakhulu xa i-fungus ihlasela into ethile njengexabiso kwaye liyimfihlo njengengqondo yethu.
Izifo zentsholongwane yenkqubo ye-nervous central ayiqhelekanga, kodwa xa izifo ezinjalo zenzeka, iziphumo zingonakalisa. Oku kulandelwayo igalari yezigulane zezifo eziqhelekileyo ezifayilini kwi-neurology, kodwa ngelanga, uluhlu olupheleleyo lwabahlaseli banokuthi lube lude kangakanani.
Aspergillus
Iintlobo ze-Aspergillus ziqhelekileyo ngokwemvelo. Naphezu kokungcola rhoqo, ukusuleleka kwe-Aspergillus kunokungaqhelekanga, ngaphandle kokuba i-immune system ikhutshwe. Imiba yengozi ye-immune system ixhomekeke kwisifo sikashukela, ukwelashwa kwe-steroid , ukuguqulwa kwamalungu , i-cancer, i-trauma, ukungondleki, kunye ne- AIDS , phakathi kwabanye.
Umzimba ungena emzimbeni emva kokuphefumla kwimiphunga, apho ungena kwigazi. Ngenye egazini, i-Aspergillus inokuchaphazela ezininzi izitho ezahlukeneyo, kuquka ubuchopho. I-Aspergillus ehlaselwa ingqondo ingabangela ukuxhamla okanye ukusilela, njengobunzima okanye ubuthathaka.
Inokubangela ukuba i- meningitis . Iimpawu ze-meningitis ziquka intloko, umkhuhlane kunye nentamo eqinile.
Kwi-MRI, intsholongwane ka-Aspergillus ibangela i-abscess ebonakala ngathi i-cannonball engqondweni. Utyando lunommeli we-antitifungal njenge-voriconazole okanye i-amphotericin. Ngaphandle kwonyango, ukufa kwale ntsholongwane kuphezulu.
Candida Albicans
Phantse wonke umntu sele sele ehlala e- candida emzimbeni; inxalenye yeeflethi eziqhelekileyo zamaphepheni kunye namagqabantshintshi. Ngamanye amaxesha kwenzeka isiganeko esenza ukuba i-candida ikhuphe imida yayo eqhelekileyo, edla ngokubangela ukuba izifo zesinkwa kubafazi. Candida nayo iyaziwa ngokubangela i- thrush , ingubo ebomvu emlonyeni nasemqaleni.
Kwizigulane ezixhatshazileyo, izilwanyana ze-Candida zingangena kwigazi kwaye zisasaze kwiindawo ezahlukahlukeneyo emzimbeni. I-Candida ingabangela i-meningitis, ngokuqhelekileyo i-neonates engaphambi kwexesha, okanye ingxaki yokuhlinzwa. Ukuxilongwa kwenziwa ngokuqokelela inani elikhulu le- cerebrospinal fluid (CSF) ukukhula kwimiba yebhu.
Coccidioides Immitis
I-Coccidioides ifumaneka kwiindawo ezinxweme ezisemzantsi-ntshona eMelika kunye naseMbindi naseMzantsi Melika. Usulelo lwe-coccidiosis lunokubangela iingxaki ezininzi, ezivela kwintlambo yesifo senqwelomoya esibulalayo.
Ukuba ayengaphathwa, malunga neepesenti ezingama-95 zezigulane ezine-cervical meningitis ziya kufa zingakapheli iminyaka emibili, ngokweZiko leZiko lezeMpilo, kodwa ngoxa ama-150,000 angama-infections kunye noCoccidioides zenzeka minyaka yonke, ngaphantsi kwe-100 kwezi zinto zibandakanya i-meningitis. Kungathabatha inyanga ukusuka kwintsholongwane yokuqala yo-meningitis ukuba ibonakale.
Iimpawu ziquka intloko enzima, kunye nezinye iimpawu ezingenakho ukuba zifike emva kwesi sifo.
Ukuxilongwa kwe-coccidia meningitis yinto efanelekileyo yenziwe ngokuhlolwa kwe-CSF, efunyenwe ngophawu oluthile. Ama-antibodies malunga nomzimba angahlolwa kwi-CSF. Kwizihlandlo ezingaqhelekanga, i-biopsy yeengxube ezungeze ingqondo (i-meninges) ingafuneka ukuba ichongiwe ngokuchanekileyo.
Unyango olukhethiweyo lwe-coccidiosis infections ngumlomo we-fluconazole. Abanye oogqirha baya kwongeza i-amphotericin B. Ukuba i-hydrocephalus ikhoyo, i- shunt ingafuneka kwakhona. Kungathatha iiveki ngaphambi kokuba kukho uphuculo olucacileyo.
Cryptococcus Neoformans
I-Cryptoccus ingena emzimbeni ngemiphunga emva kokuba umntu ephefumula nge-spore foreal. Ukusuka apho, i-fungus ingena kwigazi kwaye isasazeka emzimbeni, ingakumbi kwingqondo. Oku kubaluleke kakhulu kubantu abaxhatshazwa ngamagciwane omzimba, nangona ngamanye amaxesha abantu abanempilo banesifo sikaCleptococcus.
I-Cryptococcus ibangela ukuba i-aseptic meningoencephalitis (ukuvuvukala kwengqondo kunye nezicubu ezijikelezayo), eneentloko, umkhuhlane, kwaye kaninzi intamo eqinile nokuhlanza. Icandelo le-encephalitis lubangela ukuguquka kwememori ehambisana kunye nezinye iingxaki ezingenangqondo.
I-cryptococcal meningitis ingafunyanwa ngokuqhuba iimvavanyo ezifanelekileyo kwi- cerebrospinal fluid eqokelelwe ngophawu olugqithisiweyo . Ukuba uxinzelelo lwe-CSF lulinganiswa, lunokuphakanyiswa kakhulu kwezi zifo. I-MRI ayisoloko ibonisa utshintsho, nangona ngamanye amaxesha ubunzima bungaba khona. Uvavanyo lwegazi luyakwenziwa nakwizigulane kwi-antigen cryptococcal ezingasiluncedo ekwenzeni ukuxilongwa .
Histoplasmosis
I-Histoplasmosis yi-fungus enokufumaneka kwiindawo eziqhelekileyo, abantu abanempilweni-kodwa nakwezinye izihlandlo kubangela ukugula okukhulu. EUnited States, ngokuqhelekileyo kufumaneka kwii-Ohio ne-Mississippi River izilambo kwi-Midwestern States.
Ininzi yexesha, i-fungus ibangela kuphela iingxaki kubantu abaxhomekeke kwiimpawu zokuzikhusela ezikhuselweyo ngeemeko ezifana noGawulayo okanye imithi ethile. I-Histoplasma ingabangela umkhuhlane, ukulahleka kwesisindo kunye nokukhathala.
Nangona i-hertoplasmosis ingabangela iingxaki kulo lonke umzimba-ingakumbi imiphunga-xa ihlasela inkqubo yentsholongwane, ingafunyanwa ngokufuna ama-antigen kwi- cerebrospinal fluid . Umzimba awubonakali ukukhula lula kwibhubhoratri. Ingxenye yexesha, iinkcubeko ze-CSF azikhulanga umzimba, nangona kukho isifo. Ngamanye amaxesha, ubuchopho okanye i-biotical biopsy yindlela kuphela yokwenza ufumane ukuxilongwa.
I-Histoplasmosis engena kwinkqubo yesantya ephakathi kunokuba nzima kakhulu ukuyiphatha. Ama-60 ukuya kuma-80 ekhulwini kwizigulane ziphendula unyango ekuqaleni, ngokubhekiselele kwiZiko lezeMpilo zeSizwe, kodwa malunga nesiqingatha sazo zingaphinda zibuyele kwiminyaka kamva. Kwimeko yokuphindaphinda, ezinye izigulane zingadinga ixesha elide-okanye nokuba yinkqubo yokuphilisa i-long-fungal.
I-Amphotericin B yonyango olucetyiswayo kwezi gulane ezigulayo ngokwaneleyo zokubhedlelelwa esibhedlele. Abo bangagula kakhulu bangaphathwa kangcono nge-itraconazole.
Mucormycosis
I-Mucormycosis yenye yezona ntsholongwane ezivayo. Xa le fungus ihlasela ingqondo okanye imithwalo yegazi ebalulekileyo ejikeleze ingqondo, izinga lokufa liphezulu kakhulu. Izigulana ezimbalwa ziye zaphiliswa phantsi kwezi meko.
I-fungi ebangela ukuba izifo zifuthi zifumaneke kwiimeko kwaye bonke abantu bahlala bebonakala. Njengezifo ezininzi ezifayo, cishe zonke iziganeko zabantu zokuhlasela ziya kwenzeka xa isigulane singakhuselekanga.
Intsholongwane ye-mucormycosis ngokuqhelekileyo iqala kwisono se- nasal , apho isifo sifana nokulinganisa i- sinusitis eneentloko , ukuxinana kunye nomkhuhlane. I-fungus ibulala ihlasela izicubu ngokukhawuleza kwaye iyakwazi ukusasazeka kwizono ngokuthe ngqo kwamehlo nangengqondo. Ngokuqhelekileyo, i-fungus inokufikelela kwiingqondo ngezinye iindlela, njengokuba sele ijojowe kwigazi kunye nezidakamizwa ezinobungozi.
Ngokukhawuleza ukuba ukuxilongwa kwe-mucormycosis kwenziwa, ugqirha kufuneka ugqirha zonke izicubu ezifileyo. Olu hlobo lonyango luyakwazi ukutshatyalaliswa, njengoko i-cartilage yamanzi, i-orbit of eye, kunye nesalathiso, kufuneka ukuba isuswe. Ukuqaliswa kokuqala kwe-agent anti-fungal efana ne-amphotericin nayo ibaluleke kakhulu. Nangona unyango olunzima, ukusinda kwale ndlela engabonakaliyo ye-cerebral mucormycosis ayinqabile.
Njengoko uye waphawula, ezininzi iinkalo zezifo zentsholongwane ze-fungal zenzeka kubantu abaxhomekeke kwiimpawu zokuzivikela . Ngoxa i-fungus ihlasela abantu abanobuchopho, izifo ezinjalo azinqabile. Oko kwathiwa, ezi zifo ziyakwazi kakhulu, okanye zibulale, kwaye zifuna ukuba zibonwe kwaye ziphathwe ngokukhawuleza.
Imithombo:
- UHerbrecht R, uDenning DW, uPatterson TF, et al. I-Voriconazole ngokumalunga ne-amphotericin B yonyango oluphambili lwe-aspergillosis. N Engl J Med 2002; 347: 408.
- UBrahim AS, uSpellberg B, uWalsh TJ, uKontoyiannis DP. I-Pathogenesis ye-mucormycosis. Iiklinikhi ezingenayo i-Disfect Dis 2012; 54 I-Suppl 1: ulawulo16.
- Igel HJ, uBolande RP. Izindlela zokuzikhusela ezidalwa kwi-cryptococcosis: izinto kwi-serum yomntu ngokuqhelekileyo, umsila kunye ne-cerebrospinal fluid echaphazela ukukhula kwe-Cryptococcus neoformans. I-Disfect Dis Dis 1966; 116: 75.
- Johnson RH, uEinstein HE. Coccidioidal meningitis. Iiklinikhi ezingenayo i-Disf Dis 2006; 42: 103
- Segal BH. Aspergillosis. N Engl J Med 2009; 360: 1870.
- Ngqolowa i-LJ, i-Batteiger BE, i-Sathapatayavongs B. I-Histoplasma capsulatum isifo sesistim se-central nervous system. Uhlolo lwekliniki. Amachiza (iBaltimore) ngo-1990; 69: 244.
- Ngqolowa LJ, uMusical CE, uJenny-Avital E. Diagn Ukulawulwa kwenkqubo ye-nervous histoplasmosis. Iiklinikhi ezingagqibekanga Dis 2005; 40: 844.