Caabuq faafa ayaa horey u sii wadi kara AIDS-ka Qeexaya Xanuunka
Cryptococcosis waa cudur halis ah oo fungal ah oo saameeya in ka badan 16,000 oo qof oo dunida ah maalin kasta ama qiyaastii hal milyan oo qof sanad walba.
Cryptococcosis-ka 'extrapulmonary cryptococcosis (oo ay ku jiraan meningitis-ka' Cryptococcal meningitis ') waxaa lagu qeexay xarumaha Maraykanka ee Xakamaynta iyo Kahortagga Cudurrada sida xaaladda AIDS-ka . Guud ahaan, cudurka meningitis-ka ee "cryptococcal" waa cudurka ugu caansan ee nidaamka dhexe ee dareenka iyo dhibaatada saddexaad ee ugu badan ee dadka qaba AIDS .
Iyadoo ay soo ifbaxday daaweynta antiretroviral ee isku-dhafan (ART) , dhacdooyinka Cryptococcosis ayaa hoos u dhigtay aduunka oo dhan ilaa 1990-kii.
Si kastaba ha ahaatee, marka laga eego aragtida adduunka, tirada sanadka ee dhimashada ee loo yaqaan 'Cryptococcal meningitis' ayaa hadda ka badan 625,000 - oo ah heerka ugu sarreeya ee ka dhacda Afrika subagta hoose, oo dhimashada lagu qiyaasay inuu u dhexeeyo 50% iyo 70%.
Taas bedelkeeda, dhimashada sababtoo ah cryptococcosis ee Maraykanka iyo wadamada kale ee horumaray waa qiyaastii 12%.
Wakiilada Cozal
Cryptococcosis waxaa sababa Cryptococcus neoformans iyo Cryptococcus gattii fungus . Markii hore, cryptococcosis waxaa loo gooyey oo kaliya caanaha C. neoforman , laakiin cilmi baaris ayaa tan iyo markii la go'doomiyey laguna aqoonsaday subaxii subaxnimo.
Dadka qaba HIV, in ka badan saddexda rubuc ee kiisaska cryptococcosis ayaa lagu soo waramey shakhsiyaadka qaba CD4 ka hooseeya 50 unug / mL. Cryptococcosis marar dhif ah ayay ku dhacdaa dadka shakhsiyaadka leh difaaca difaaca oo si joogto ah u socda.
Noocyada Gudbinta
Waxaa la soo dhajiyay in cryptococcosis ay heshay ayadoo la neefsanayo taranka taranka (basidiospores) ee C. neoformans ama C. gattii .
Inkastoo C. neoformansku badiyaa laga helaa ciidda oo ay ku jiraan shimbir shimbireed, gaar ahaan qoryaha, neefsashada ayaa weli loo tixgeliyaa habka ugu badan ee infekshanka (marka laga reebo si aan sax ahayn ama u taabto maqaarka).
Marka la barbardhigo, C. gattii guud ahaan laguma helin maqaarka avian, laakiin halkii geedo ah (badanaaba cunuggga). Fungus waxaa loo yaqaanaa in uu ku faafo qashinka hareeraha hareeraha geedaha.
Inkastoo cryptococcosis dhacaan inta badan xayawaanka, labadaba naas iyo avian, xaaladaha xayawaan-ilaa-bini-aadan ayaa aad u yar. Kala-bixinta bini-aadannimada ayaa sidoo kale loo arkaa mid dhif ah.
Astaamaha Cryptococcosis
Calaamadaha kiliiniga ee infekshanka Cryptococcal guud ahaan wuxuu ka bilaabmaa meel kasta oo ka bilaabma laba illaa 11 bilood kadib soo-gaadhista.
Infakshanka 'cryptococcal' ayaa badanaa noqon kara asymptomatic ee bukaanka, ama ay la socdaan calaamadaha neefsashada ee aan hooseeyn, oo aan gaar aheyn. Bukaan-socodka qaba oof-wareenka "cryptococcal pneumonia" ayaa badanaa la kulma qufac, xanuunka laabta, qandhada hoose-hoose, xajmiga, iyo neefta gaaban. Xaaladaha qaarkood, waxaa sidoo kale jiri kara miisaan lumis ah, qanjidhada qanjirada ( lymphadenopathy ), neefsashada degdegga ah ( tachypnea ), iyo jajab maqal oo sambabada ah.
Haddii caabuqa lagu faafiyo meel ka baxsan sanbabada (extrapulmonary), wuxuu badanaa keenaa habka dhexe ee neerfaha isagoo ah 'Cryptococcal meningitis'. Xaaladahaan, bukaanku wuxuu markii ugu horreyn la imaan karaa astaamaha xanuunka daran sida madax-xanuun, qandho, ama isbeddel dhinaca maskaxda ah (tusaale ahaan, luminta feejignaanta, ciladda, lakariga).
Calaamaduhu badanaa waa kuwo aad u culus oo bilawga ah, oo ka sii daraya durbadiiba dhowr toddobaad.
Astaamaha calaamadaha daran ee ba'an ee 'meningitis' (Cryptococcal meningitis) waxaa ka mid ah:
- Lalabbo iyo matag
- Aragga cakiran
- Dareenka iftiinka
- Maqalka maqalka ama khasaaraha
- Cadaadiska siyaadada ah
- Madax xanuun daran
- Qoorta qoorta
- Isbedelka shakhsiga
- Dhibaato hadalka, akhrinta ama qorista
- Suuxdin ama luminta isku-duwidda murqaha
- Maqalka
- Coma
Maaddaama qaar ka mid ah calaamadaha la xidhiidha meningitis-ka caadiga ah (sida qoortu adkaato iyo dareemidda iftiinka) ma ku dhacaan bukaanno badan oo qaba qoorgooyaha 'cryptococcal meningitis', wacyigelinta xaaladdan mararka qaar seegto, dib u dhigista daaweynta caafimaad toddobaadyo iyo xitaa bilooyin illaa laga gaarayo calaamadaha.
Marka laga reebo sanbabada iyo nidaamka dhexe ee dareenka, infekshanka Cryptococcal ayaa sidoo kale laga yaabaa inuu maqaarku u muuqdo sida xanuun, boogo, dabar, maqnaasho, iyo tiro kasta oo shuban (ama subag) oo kale. Waxay sidoo kale saameyn kartaa qanjirrada adrenal, prostate, iyo nidaamyada kale ee jirka.
Baaritaanka Cryptococcosis
Baaritaanka cryptococcosis waxaa lagu taageeraa soo bandhigidda astaamaha kiliinikada iyo calaamadaha muuqda, waxaana lagu xaqiijiyey falanqaynta dhiiga, unugyada, dheecaanka xiniinyaha, ama dheecaannada jirka kale. Hababka baadhitaanka waxaa ka mid noqon kara:
- Baaritaanka "Cryptococcal antigen" ee dhiigga ama dheecaanka cerebrospinal
- Baadhitaanka dhirta iyo / ama dhaqanka unugyada, dhiigga ama dheecaanka cerebrospinal
- Dhaqanka lagu maydho dhaqdhaqaaqa muusikada
Inkastoo raajada feedhaha laga yaabo inay muujiso infiltrated gudaha ama sambabada ee sambabada xaaladaha caabuqa sambabada, waxay ugu dambeyntii taageeraan halkii ay xaqiijin lahaayeen ogaanshaha.
Daaweynta Cryptococcosis
Dadka bukaanka ah ee difaaca jirka qaba cudurka asymptomatic ama qallal-celin-qafiifka ah, waxaa laga yaabaa in daaweynta antifungal (fluconazole, itraconazole) laga dhigo ilaa infekshanka fungal la xalliyo.
Haddii ay dhacdo cudur daran, daaweyntu badanaaba waxay ku bilaabataa amphotericin B, badanaa waxaa lagu daraa flucytosin. Tani waxaa badanaa la socotaa daaweynta joogtada ah ee socota iyada oo la isticmaalayo qiyaasta maalin kasta ee dawada antifungal (iyo sidoo kale bilaabista ART haddii bukaanku aanu weli ku jirin daweyn).
Daaweynta dayactirka waa in la sii wataan illaa waqtigaas sida tirada CD4 ay ka sarreyso 100 unug / mL iyo bukaanshaha fayraska bukaanku si joogto ah ayaa loo xakameynayaa heerarka aan la ogaan karin. Haddii CD4 hoos u dhaco 100, daaweynta waa in dib loo bilaabo si looga hortago soo noqoshada cudurka.
Wadamada Maraykanka iyo kuwa ugu horumaray, daaweynta asaasiga ah ee ka hortagga ah (antifungal prophylaxis) laguma talin, in kasta oo baaritaanka antigen-ka ee laga yaabo in loo tixgeliyo bukaanka halis dheeraad ah ama goobaha cudur culus.
Qaamuuska:
- Krip-to-kaw-KO-sus
- krip-to-KOK-ul aniga-nin-JYE-tus
Sidoo kale waa la yaqaan:
- Crypto (slang)
- Cudurka 'Crypotococcal'
Ilaha:
Xarumaha Xakamaynta iyo Kahortagga Cudurrada Maraykanka (CDC). "Lifaaqa A - Xaaladaha Qeexaya Xaaladaha." Atlanta, Georgia; dib u eegistii ugu dambaysay November 20, 2008.
Cogliati, M. "Epidemiology Global Cryptococcus Cryptococcus and Cryptococcus gattii: Atlas of Noocyada Molecular." Saynis. December 11, 2012. Aqoonsiga Aqoonsiga 675213, 23 bog.
Del Valle, L. iyo Piña-Oviedo, S. "Cudurada HIV-ga ee maskaxda, cudur-sidaha iyo pathogenesis." Xuduudaha Biyuhu. Janaayo 2006; 11 (1): 718-732.
Holmes, C .; Losina, E .; Walensky, R .; et al. "Dib u eegista fayraska insulinta difaaca jirka ee nooca 1-la xiriirta cudurrada fursadaha ee ku yaala saxaraha hoose ee Afrika." Cudurada Cudurrada Cudurrada ah. 2003; 36 (5): 652-662.
Xarumaha Xakamaynta iyo Kahortagga Cudurrada Maraykanka (CDC). "Cryptococcal meningitis: cudur halis ah oo ka dhex jira dadka qaba HIV / AIDS." Atlanta, Georgia; dukumeenti CS21371B; dib u eegistii ugu dambaysay October 2, 2012.
Kufsi, R .; Hajjeh, R; iyo Powderly, W. "Rajada laga qabo ka hortagga cryptococcosis ee dadka qaba cudurka fayruska aadanaha." Cudurada Cudurrada Cudurrada ah. Agoosto 1995; 21 (S1): 103-107.
Rhein, J. iyo Boulware, D. "Saadaalinta iyo maareynta qoorgooyaha Cryptococcal ee bukaanka qaba caabuqa fayruska aadanaha." Daaweynta Naasnuujiyadda Naasnuujinta. Juun 12, 2012; 2012 (4): 45-61.
Kanji, S .; Kakai, R .; iyo Onyango, R. "Qoorgooyaha Cryptococcal ee bukaanka fayruska difaaca jirka ee ku jira isbitaalka weyn ee Kisumu, Western Kenya." Archives of Microbiology Clinical. 2011; 2 (12); doi: 10: 3823/220.
Dhamaan, J.; Dismukes, W .; Dromer, F .; et al. "Tilmaamaha Tababarrada Caafimaadka ee Maareynta Cudurka Cudurka Cryptococcal: 2010 Soo cusbooneysiinta Cudurada Cudurrada Cudurrada Mareykanka." Cudurada Cudurrada Cudurrada ah. . 2010: 50 (3): 291-322.