Matenda a Lyme

Matenda a Lyme ndi matenda omwe amabwera chifukwa cha kuluma kwa mitundu ingapo ya nkhupakupa.

Matenda a Lyme amayamba chifukwa cha mabakiteriya otchedwa Borrelia burgdorferi (B burgdorferi). Nkhupakupa zakuda (zomwe zimatchedwanso kuti nkhupakupa) zimatha kunyamula mabakiteriyawa. Si mitundu yonse ya nkhupakupa yomwe imatha kunyamula mabakiteriyawa. Nkhupakupa zosakhwima zimatchedwa nymphs, ndipo zimakhala ngati kukula kwa mutu wa pinini. Nymphs amatenga mabakiteriya akamadyetsa makoswe ang'onoang'ono, monga mbewa, zomwe zimadwala B burgdorferi. Mutha kutenga matendawa ngati mwalumidwa ndi nkhupakupa.

Matenda a Lyme adanenedwa koyamba ku United States mu 1977 m'tawuni ya Old Lyme, Connecticut. Matenda omwewo amapezeka m'malo ambiri ku Europe ndi Asia. Ku United States, matenda ambiri amtundu wa Lyme amapezeka m'malo otsatirawa:

• Kumpoto chakum'mawa, kuchokera ku Virginia kupita ku Maine
• Madera akumpoto, makamaka ku Wisconsin ndi Minnesota
• West Coast, makamaka kumpoto chakumadzulo

Pali magawo atatu a matenda a Lyme.

• Gawo 1 limatchedwa matenda a Lyme oyambilira. Mabakiteriya sanafalikire m'thupi lonse.
• Gawo 2 limatchedwa matenda ofala a Lyme. Mabakiteriya ayamba kufalikira m'thupi lonse.
• Gawo lachitatu limatchedwa matenda ofalitsa a Lyme mochedwa. Mabakiteriya afalikira mthupi lonse.

Zowopsa za matenda a Lyme ndi awa:

• Kuchita zinthu zakunja zomwe zimawonjezera kupezeka kwa nkhupakupa (mwachitsanzo, kulima dimba, kusaka, kapena kukwera mapiri) kudera lomwe matenda a Lyme amapezeka
• Kukhala ndi chiweto chomwe chimanyamula nkhupakupa kunyumba
• Kuyenda muudzu waukulu m'malo omwe matenda a Lyme amapezeka

Zofunikira pakuluma kwa nkhupakupa ndi matenda a Lyme:

• Chizindikiro chiyenera kulumikizidwa mthupi lanu kwa maola 24 mpaka 36 kuti mufalitse mabakiteriyawo m'magazi anu.
• Nkhupakupa zakuda zitha kukhala zazing'ono kwambiri mwakuti zimakhala zosatheka kuziwona. Anthu ambiri omwe ali ndi matenda a Lyme sawona kapena kumva nkhuku pathupi lawo.
• Anthu ambiri amene alumidwa ndi nkhupakupa samadwala matenda a Lyme.

Zizindikiro zamatenda oyambilira a ku Lyme (gawo 1) amayamba masiku kapena milungu ingapo matenda. Amakhala ofanana ndi chimfine ndipo amatha kuphatikiza:

• Malungo ndi kuzizira
• Kumva kudandaula
• Mutu
• Ululu wophatikizana
• Kupweteka kwa minofu
• Khosi lolimba

Pakhoza kukhala kuphulika kwa "diso la ng'ombe", malo ofiira kapena owoneka pang'ono ofiyira pamalo olumalirana ndi nkhupakupa. Nthawi zambiri pamakhala malo omveka bwino pakatikati. Itha kukhala yayikulu ndikukula kukula. Izi zidzidzi zimatchedwa erythema migrans. Popanda chithandizo, amatha masabata anayi kapena kupitilira apo.

Zizindikiro zimatha kubwera ndikupita. Popanda kuchiritsidwa, mabakiteriya amatha kufalikira kuubongo, mtima, komanso malo olumikizana.

Zizindikiro za matenda ofala a Lyme (gawo lachiwiri) zitha kuchitika patatha milungu ingapo miyezi ingapo nkhuku italuma, ndipo itha kuphatikizaponso:

• Dzanzi kapena kupweteka m'dera lamitsempha
• Kufa ziwalo kapena kufooka mu minofu ya nkhope
• Mavuto amtima, monga kugunda kwamtima (kugundagunda), kupweteka pachifuwa, kapena kupuma movutikira

Zizindikiro zakumapeto kwa matenda a Lyme (gawo lachitatu) zimatha kuchitika patatha miyezi kapena zaka atadwala. Zizindikiro zofala kwambiri ndi kupweteka kwa minofu ndi kulumikizana. Zizindikiro zina zitha kuphatikiza:

• Kusuntha kwaminyewa yachilendo
• Kutupa pamodzi
• Minofu kufooka
• Dzanzi ndi kumva kulasalasa
• Mavuto olankhula
• Mavuto olingalira (kuzindikira)

Kuyeza magazi kumatha kuchitika kuti muwone ngati ma antibacterial omwe amayambitsa matenda a Lyme. Omwe amagwiritsidwa ntchito kwambiri ndi ELISA poyesa matenda a Lyme. Kuyesedwa kwa immunoblot kumachitika kuti zitsimikizire zotsatira za ELISA. Dziwani kuti, kumayambiriro kwa matenda, kuyesa magazi kumatha kukhala kwachilendo. Komanso, ngati mutapatsidwa mankhwala opha tizilombo koyambirira, thupi lanu silitha kupanga ma antibodies okwanira kuti athe kupezeka poyesa magazi.

M'madera omwe matenda a Lyme amapezeka kwambiri, wothandizira zaumoyo wanu amatha kuzindikira kuti matenda a Lyme omwe amafalitsidwa msanga popanda kuyesa mayeso a labu.

Mayesero ena omwe angachitike pamene matenda afalikira ndi awa:

• Electrocardiogram
• Echocardiogram kuyang'ana pamtima
• MRI yaubongo
• Mphepete wam'mimba (kubowola lumbar kuti muwone zamadzimadzi)

Anthu olumidwa ndi nkhupakupa ayenera kuyang'anitsitsa kwa masiku osachepera 30 kuti awone ngati pali zotupa kapena zizindikilo.

Mlingo umodzi wa maantibayotiki wa doxycycline ukhoza kupatsidwa kwa wina atangolumidwa ndi nkhupakupa, pamene zonsezi zili zowona:

• Munthuyo ali ndi nkhupakupa yomwe imatha kunyamula matenda a Lyme ophatikizidwa ndi thupi lake. Izi nthawi zambiri zimatanthauza kuti namwino kapena adotolo adayang'ana ndikuzindikira nkhupakupa.
• Mafunso akuganiza kuti amamangiriridwa kwa munthuyo kwa maola osachepera 36.
• Munthuyo amatha kuyamba kumwa maantibayotiki pasanathe maola 72 atachotsa nkhupakupa.
• Munthuyu ali ndi zaka 8 kapena kupitirira ndipo alibe pakati kapena kuyamwitsa.
• Mlingo wa nkhupakupa wanyumba B burgdorferi ndi 20% kapena kupitilira apo.

Mankhwala a masiku 10 mpaka masabata anayi amagwiritsidwa ntchito pochiza anthu omwe amapezeka ndi matenda a Lyme, kutengera kusankha kwa mankhwala:

• Kusankha kwa maantibayotiki kumatengera gawo la matendawa komanso zizindikilo zake.
• Zosankha zambiri zimaphatikizapo doxycycline, amoxicillin, azithromycin, cefuroxime, ndi ceftriaxone.

Mankhwala opweteka, monga ibuprofen, nthawi zina amalembedwa kuti awonongeke palimodzi.

Ngati atapezeka koyambirira, matenda a Lyme amatha kuchiritsidwa ndi maantibayotiki. Popanda chithandizo, zovuta zokhudzana ndi mafupa, mtima, ndi mantha zimatha kuchitika. Koma zizindikirozi zimachiritsidwabe komanso ndizotheka kuchira.

Nthawi zambiri, munthu amakhala ndi zizindikilo zosokoneza moyo watsiku ndi tsiku atalandira mankhwala. Izi zimatchedwanso matenda a post-Lyme. Zomwe zimayambitsa matendawa sizidziwika.

Zizindikiro zomwe zimachitika pambuyo poti maantibayotiki ayimitsidwa sizingakhale zizindikiro za matenda opatsirana ndipo sizingayankhe mankhwala a maantibayotiki.

Gawo lachitatu, kapena kufalikira mochedwa, matenda a Lyme amatha kuyambitsa kutupa kwa nthawi yayitali (nyamakazi ya Lyme) komanso mavuto amtima. Mavuto amtundu wa ubongo ndi manjenje ndiwotheka, ndipo atha kuphatikizira:

• Kuchepetsa chidwi
• Matenda okumbukira
• Kuwonongeka kwa mitsempha
• Kunjenjemera
• Ululu
• Kufa kwa minofu ya nkhope
• Matenda ogona
• Mavuto masomphenya

Itanani omwe akukuthandizani ngati muli ndi:

• Kutupa kwakukulu, kofiira, kofutukuka komwe kumatha kuwoneka ngati diso la ng'ombe.
• Anali ndi nkhupakupa ndikukula, kufooka, kumva kulira, kapena mavuto amtima.
• Zizindikiro za matenda a Lyme, makamaka ngati mwina mudakumana ndi nkhupakupa.

Samalani kuti musadwale nkhupakupa. Samalani kwambiri m'miyezi yotentha. Ngati zingatheke, pewani kuyenda kapena kukwera mitengo m'nkhalango ndi malo omwe muli udzu wapamwamba.

Ngati mukuyenda kapena kukwera maderawa, chitanipo kanthu kuti muchepetse kulumidwa ndi nkhupakupa:

• Valani zovala zonyezimira kuti ngati nkhupakupa zitafika kumtunda, ziwonekere ndikuchotsani.
• Valani manja atali ndi mathalauza ataliatali okhala ndi miyendo yamphongo yolowetsedwa m'masokosi anu.
• Dulani khungu lowonekera komanso zovala zanu ndi mankhwala othamangitsa tizilombo, monga DEET kapena permethrin. Tsatirani malangizo pachidebecho.
• Mukabwerera kunyumba, chotsani zovala zanu ndikuyang'anitsitsa khungu lonse, kuphatikizapo khungu lanu. Sambani posachedwa kuti musambe nkhupakupa zomwe sizimawoneka.

Ngati nkhupakupa ili ndi inu, tsatirani izi kuti muchotse:

• Gwirani nkhupakupa pafupi ndi mutu kapena pakamwa pake ndi zopalira. Musagwiritse ntchito zala zanu. Ngati kuli kotheka, gwiritsani ntchito thaulo kapena pepala.
• Tambasulani molunjika pang'onopang'ono. Pewani kufinya kapena kuphwanya nkhupakupa. Samalani kuti musasiye mutu wophatikizidwa pakhungu.
• Sambani malowo bwinobwino ndi sopo. Komanso sambani manja anu bwinobwino.
• Sungani nkhupakupa mumtsuko.
• Onetsetsani mosamala sabata yamawa kapena awiri azizindikiro za matenda a Lyme.
• Ngati magawo onse a nkhupakupa sangathe kuchotsedwa, pitani kuchipatala. Bweretsani nkhupakupa mumtsuko kwa dokotala wanu.

Matenda; Matenda a Bannwarth

• Matenda a Lyme - zomwe mungafunse dokotala wanu

• Matenda a Lyme - Borrelia burgdorferi
• Chongani - nswala adalowa pakhungu
• Matenda a Lyme - Borrelia burgdorferi chamoyo
• Tick, nswala - wamkulu wamkazi
• Matenda a Lyme
• Matenda a Lyme - erythema osamuka
• Matenda apamwamba a lyme

Malo Othandizira Kuteteza Matenda. Matenda a Lyme. www.cdc.gov/lyme. Idasinthidwa pa Disembala 16, 2019. Idapezeka pa Epulo 7, 2020.

Kutentha AC. Matenda a Lyme (Lyme borreliosis) chifukwa cha Borrelia burgdorferi. Mu: Bennett JE, Dolin R, Blaser MJ, olemba., Eds. Mandell, Douglas, ndi Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020: chap 241.

Wormser GP. Matenda a Lyme. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. 26 wa. Philadelphia, PA: Elsevier; 2020: chap 305.