I-Coccidioimycosis isifo esibangelwa i- Coccidioides immitis noma i- Coccidioides posadaii , eyaziwa ngokuthi "i-Valley Fever." Kungokwemvelo izingxenye zeNingizimu-ntshonalanga ye-US, ezivela eTexas kuya eningizimu yeCalifornia, kanye nasenyakatho yeMexico, eNyakatho Melika naseNingizimu Melika.
Ngenkathi i-coccidioimycosis iveza ngaphakathi kwamaphaphu (amapulmonary), lapho isakazeka ngaphezu kwamapayipi (okungekho emthethweni) kuthathwa njengesimo esichazayo se- AIDS yi-US Centers for Disease Control and Prevention (CDC).
Izinga lomthelela weCoccidioimycosis
Ngokusho kwe-CDC, isilinganiso senani labantu abahlala e-US ngabantu abangu-44 ku-100,000. Kodwa-ke, iningi lalezi zimo zenzeka emazweni amabili (i-Arizona, eCalifornia), lapho izinga lokungena khona likwazi ukugijima eliphakeme njengama-248 ku-100,000.
Ngo-2011, kubikwa amacala amasha angaphezu kwezingu-22 000 ze-coccidioimycosis, i-CDC, ukukhula okuphindwe kabili kusukela ngo-1998. E-California kuphela, inani landa kusuka ku-719 ngo-1998 lalinganiselwa ku-5,697 ngo-2011.
Lokho kusho ukuthi phakathi kwabantu abanesandulela ngculaza, inani le-coccidioidomycosis ephawulekayo liye lahleka kakhulu kusukela ekufikeni kwe- antiretroviral therapy (i-MAP) , kanti ukubonakaliswa kwemitholampilo yesifo kubonakala kunzima kakhulu.
Amamodeli wokuThunyelwa
I-Coccidioides ikhona enhlabathini lapho ingahlakulela khona izinhlamvu ezindizayo ngesikhathi semvula. Ukwelashwa kubangelwa ukuvuselela lezi zinhlamvu ze-fungal, ngokuvamile ngaphandle komuntu ngisho nokuzi.
Uma usengaphakathi emaphashini, izinhlamvu zingakhipha amanye ama-spores, enza ama-nodules angase aqhume futhi abangele ukuvuvukala ngaphakathi kwe-bronchi. Ezimpilweni ezingenakuzivikela-ikakhulukazi abantu abanegciwane lesandulela ngculaza abanezibalo ze- CD4 ngaphansi kwama-250 amaseli / μL-lokhu kungabangela ukutheleleka okuvame ukwanda kwamapulmoni. I-fungus ingabe isakazeka emaphashini angene egazini, lapho ingathinta ezinye izingxenye zomzimba.
I-Coccidioides ayidluliselwa kusuka kumuntu kuya komuntu.
Izimpawu zeCoccidioimycosis
Abantu abaningi abanesifo abasenayo izimpawu noma imiphumela yokutheleleka. Kulabo abakwenzayo, izimpawu zivame ukuzithiba futhi zikhona ngezibonakaliso ezifana nezifo:
- Fever
- Izinwele
- Isikhukhula
- Ubuhlungu besifuba
- Ukuphelelwa umoya
- Ama-Chills
- I-Myalgia (ubuhlungu be-muscle) ne- arthralgia (ubuhlungu obuhlangene)
- Ukukhathala
Ukuhlaselwa kungahle futhi kuthuthuke emaveni angama-25%. Ukuqhuma ngokuvamile kuvame ukuphela kwamaphethelo aphansi, okufanekiselwa ama-nodules abomvu amancane noma izibambo zesimo esingavamile. Kwezinye izimo (cishe u-5-8%), ukutheleleka kungadlulela emzimbeni ongenazinkinga womphakathi (CAP), ovame ukuxazulula ngokuzenzekelayo ngaphandle kokwelapha okuphikisayo.
Kodwa-ke, ezimweni ezingavamile, i-coccidioimycosis ingaba nzima nakakhulu, okwenza kube khona ukulahleka okuphawulekayo namapayipi emaphashini. Uma usakaze usakaze (okungukuthi usakaze ngaphesheya kwamaphaphu), ungadla umzimba, okuholela eku:
- Izilonda zesilonda nama-abscesses
- Amajoyina avuvukile futhi abuhlungu
- I-Bone lesions
- Ukuvutha kwenhliziyo
- Izinkinga ze-Urinary tract
- I-Meningitis
I-Meningitis iyinkimbinkimbi yokusongela impilo ye-coccidioimycosis. Nakuba inani lokufa kwabantu e-US libhekwa njengelincane (0.07%), kulabo abanesandulela ngculazi (i-CD4 ngaphansi kwamangqamuzana angu-100 / μL), ukufa kungaba ngaphezu kuka-70% ngisho nangokwelashwa okufanele.
Ukuxilongwa kweCoccidioimycosis
I-Coccidioimycosis ingatholwa ukuhlolwa okuncane kakhulu kwamanzi omzimba, i-sputum, i-exudates (isib. Pus), noma i-biopsies yezicubu. Ukuxilonga kungenziwa futhi nge-PCR (polymerase chain reaction reaction), okukhulisa i-DNA kuma-sampuli we-serological ukuqinisekisa ukutheleleka kwe- Coccidioides .
Ukwelashwa kweCoccidioimycosis
Kubantu abanekhono lokuzivikela abane-HIV (i-CD4 engaphezu kwama-250 cells / μL), i-coccidioimycosis ngokuvamile iyanqanda futhi ayidingi ukwelashwa okuqondile ngaphandle kokunakekelwa okusekelayo.
Kulabo abadinga ukwelashwa-noma ngenxa yezibonakaliso eziphikisanayo noma izifo eziqhubekayo zesifo-izitho zomlomo zibhekwa njengendlela yokuqala yokukhetha.
Kulezi, ketoconazole yiyona ndlela kuphela evunyelwe i-FDA yokwelashwa kwe-coccidioimycosis, nakuba ochwepheshe abaningi namuhla beba fluconazole noma i-itraconazole. (Sicela uqaphele ukuthi i-ketoconazole, i-fluconazole, ne-itraconazole bayaphikisana ngesikhathi sokukhulelwa nokuncelisa.)
Kulabo abagula kakhulu, i-antifungal amphotericin B ibhekwa njengesidakamizwa esizikhethelayo. Ihlinzekwa nge-intravenously kuze kube yilapho ukutheleleka kulawulwa, emva kwalokho okuqhubekayo komlomo prophylaxis ye-ketoconazole, i-fluconazole noma i-itraconazole inqunywe.
Kulezi ziguli ezine-coccidioidal meningitis, i-amphotericin B ingalawulwa nge-intrathecally (okungukuthi endaweni esungeze ubuchopho noma intambo yomgogodla).
Ukuvimbela i-Coccidioimycosis
Kunzima ukuvimbela i-coccidioimycosis ezindaweni ezimbi. Ukuze i-immune compromised, i-prophylactic therapy ingasiza ekuvimbeleni ukutheleleka. Ayikho imithi okwamanje etholakalayo. Uma uhlala endaweni engaphelele futhi ukholelwa ukuthi usengozini, kunezinyathelo ezimbalwa ongaziqapha ongazithatha:
- Gqoka imaski enothuli lapho usebenza nomhlabathi, noma unge amanzi phansi enhlabathini ukuze unciphise amafungus aphezulu.
- Gwema ukuphuma ngaphandle ngesikhathi sevunguvungu noma imimoya ephakeme.
- Sebenzisa izinyathelo zekhwalithi yomoya, njengesihlungi se- HEPA , bese ufaka amafasitela angabizi namasango omnyango.
- Uma usebenza endaweni yesakhiwo, gqoka imaski yokuhlunga i-N95.
Imithombo:
Amasevisi aseMelika okuLawula nokuvimbela izifo (CDC). "Ukwandisa ku-Coccidioidomycosis ebikiwe - i-United States, ngo-1998-2011." Ukufa kanye nokubika kweMasonto onke (MMWR). NgoMashi 29, 2013: 62 (12): 217-221.
Galgiani, J. "Coccidioimycosis." Journal of the Royal Society of Tropical Medicine and Hygiene. 2005; 41 (9): 1217-1223.
Pickering, L .; Baker, C .; Kimberlin, D; et al. "Coccidioimycosis." I-American Academy of Pediatrics, Incwadi Ebomvu: 2009 Umbiko weKomidi Yezifo Ezifozisayo. I-Elk Grove Village, e-Illinois; Ukukhishwa kwe-28: 266-268.
I-Masannat, i-F. ne-Ampel, M. "I-Coccidioidomycosis ku-Iziguli ezine-HIV-1 Infection esikhathini esibizwa ngokuthi i-Anti-Retroviral Therapy." Izifo Ezithathelwanayo Emitholampilo. Januwari 2010; 50: 1-7.
Amasevisi aseMelika okuLawula nokuvimbela izifo (CDC). "Ukwandisa eCoccidioidomycosis - United States, 2009." Ukufa kanye nokubika kweMasonto onke (MMWR). Ngo-February 13, 2009: 58 (5): 105-109.
Igama lokubiza: kok-si-dee-oh-my-KOH-sis
Obeye aziwe njengo:
- I-Granuloma yeCoccidioidal
- I-Cocci
- "I-California Fever"
- "I-Desert Rheumatism"
- Izifo ze-Posadas Wernicke
- "I-San Joaquin Valley Fever"
Ama-misspellings ajwayelekile: i- coccidiomycosis