Mimba

Ehrlichiosis ndi matenda a bakiteriya opatsirana ndikuluma kwa nkhupakupa.

Ehrlichiosis imayambitsidwa ndi mabakiteriya omwe ali am'banja lotchedwa rickettsiae. Mabakiteriya a Rickettsial amayambitsa matenda angapo padziko lonse lapansi, kuphatikiza malungo a Rocky Mountain omwe amapezeka ndi malungo ndi typhus. Matenda onsewa amafalikira kwa anthu chifukwa cha nkhupakupa, utitiri, kapena kuluma nthata.

Asayansi adayamba kufotokoza za ehrlichiosis mu 1990. Pali mitundu iwiri ya matenda ku United States:

• Human monocytic ehrlichiosis (HME) imayambitsidwa ndi bakiteriya wa rickettsial Ehrlichia chaffeensis.
• Human granulocytic ehrlichiosis (HGE) amatchedwanso kuti granulocytic anaplasmosis (HGA). Zimayambitsidwa ndi bakiteriya wa rickettsial wotchedwa Anaplasma phagocytophilum.

Mabakiteriya a Ehrlichia atha kunyamulidwa ndi:

• American galu nkhupakupa
• Chizindikiro cha nswala (Ixodes scapularis), zomwe zingayambitsenso matenda a Lyme
• Lone Star nkhupakupa

Ku United States, HME imapezeka makamaka kum'mwera chapakati ndi Kumwera chakum'mawa. HGE imapezeka makamaka kumpoto chakum'mawa ndi kumtunda kwa Midwest.

Zowopsa za ehrlichiosis ndizo:

• Kukhala pafupi ndi dera lomwe lili ndi nkhupakupa zambiri
• Kukhala ndi chiweto chomwe chingabweretse nkhuku kunyumba
• Kuyenda kapena kusewera muudzu

Nthawi yosakaniza pakati pa kuluma kwa nkhupakupa komanso pamene zizindikiro zimachitika ndi masiku 7 mpaka 14.

Zizindikiro zitha kuwoneka ngati chimfine, ndipo zingaphatikizepo:

• Malungo ndi kuzizira
• Mutu
• Kupweteka kwa minofu
• Nseru

Zizindikiro zina zotheka:

• Kutsekula m'mimba
• Madera abwino azipilala zakumaso akuthira magazi pakhungu (petechial rash)
• Ziphuphu zofiira zofiira (maculopapular rash), zomwe sizachilendo
• Kumva kudwala (malaise)

Kuthamanga kumawoneka ochepera gawo limodzi mwamagawo atatu. Nthawi zina, matendawa amatha kukhala olakwika chifukwa cha malungo a Rocky Mountain, ngati zidzolo zilipo. Zizindikiro nthawi zambiri zimakhala zochepa, koma anthu nthawi zina amadwala mokwanira kuti athe kuwona wothandizira zaumoyo.

Woperekayo ayesa thupi ndikuwunika zizindikilo zanu zofunika, kuphatikiza:

• Kuthamanga kwa magazi
• Kugunda kwa mtima
• Kutentha

Mayesero ena ndi awa:

• Kuwerengera kwathunthu kwa magazi (CBC)
• Banga la Granulocyte
• Mayeso olimbana ndi ma virus a fluorescent
• Polymerase chain reaction (PCR) kuyesa magazi

Maantibayotiki (tetracycline kapena doxycycline) amagwiritsidwa ntchito kuchiza matendawa. Ana sayenera kumwa tetracycline pakamwa mpaka mano awo atakula kale, chifukwa amatha kusintha mtundu wamano akukula. Doxycycline yomwe imagwiritsidwa ntchito kwa milungu iwiri kapena yocheperako nthawi zambiri siyimitsa mano okhazikika a mwana. Rifampin yakhala ikugwiritsidwanso ntchito mwa anthu omwe sangalole doxycycline.

Ehrlichiosis nthawi zambiri imapha. Ndi maantibayotiki, anthu nthawi zambiri amasintha mkati mwa maola 24 mpaka 48. Kuchira kumatha kutenga milungu itatu.

Osalandira chithandizo, matendawa atha kubweretsa ku:

• Coma
• Imfa (yosowa)
• Kuwonongeka kwa impso
• Kuwonongeka kwa mapapo
• Zowonongeka zina
• Kulanda

Nthawi zambiri, kuluma kwa nkhupakupa kumatha kubweretsa matenda opitilira amodzi (co-infection). Izi ndichifukwa choti nkhupakupa zimatha kunyamula mitundu yambiri yazamoyo. Matenda awiriwa ndi awa:

• Matenda a Lyme
• Babesiosis, matenda opatsirana ofanana ndi malungo

Itanani omwe akukuthandizani mukadwala mukangoluma kumene kapena ngati mwakhalapo m'malo omwe nkhupakupa ndizofala. Onetsetsani kuti muuze wothandizira wanu za kukhudzana ndi nkhupakupa.

Ehrlichiosis imafalikira ndi kulumidwa ndi nkhupakupa. Njira zoyenera kuthana ndi kulumidwa ndi nkhupakupa, kuphatikizapo:

• Valani mathalauza ataliatali ndi mikono yayitali mukamayenda pakati pa burashi lolemera, udzu wamtali, komanso malo okhala ndi mitengo yambiri.
• Kokani masokosi anu kunja kwa mathalauza kuti nkhupakupa zisakwere mwendo wanu.
• Sungani malaya anu atalowa mu thalauza lanu.
• Valani zovala zoyera kuti nkhupakupa ziwonekere mosavuta.
• Phulani zovala zanu ndi mankhwala othamangitsa tizilombo.
• Yang'anani zovala zanu ndi khungu lanu nthawi zambiri mukakhala kuthengo.

Nditabwerera kunyumba:

• Chotsani zovala zanu. Yang'anani mosamala paliponse pakhungu, kuphatikiza pamutu. Nkhupakupa zimatha kukwera msanga kutalika kwa thupi.
• Nkhupakupa zina ndi zazikulu komanso zosavuta kupeza. Nkhupakupa zina zimatha kukhala zazing'ono, choncho yang'anani mosamala mawanga onse akuda kapena abula pakhungu.
• Ngati ndi kotheka, pemphani wina kuti akuthandizeni kuyesa thupi lanu ngati ali ndi nkhupakupa.
• Munthu wamkulu ayenera kufufuza ana mosamala.

Kafukufuku akuwonetsa kuti nkhupakupa iyenera kulumikizidwa mthupi lanu kwa maola osachepera 24 kuyambitsa matenda. Kuchotsa msanga kumatha kuteteza matenda.

Ngati mwalumidwa ndi nkhupakupa, lembani tsiku ndi nthawi yomwe kulumako kunachitika. Bweretsani izi, pamodzi ndi nkhupakupa (ngati zingatheke), kwa omwe akukuthandizani mukadwala.

Anthu monocytic ehrlichiosis; HME; Ma granulocytic ehrlichiosis; HGE; Granulocytic anaplasmosis; HGA

• Mimba
• Ma antibodies

Dumler JS, Walker DH. Ehrlichia chaffeensis (anthu monocytotropic ehrlichiosis), Anaplasma phagocytophilum (granulocytotropic anaplasmosis), ndi maaplasmataceae ena. 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 192.

Fournier PE, Raoult D. Rickettsial matenda. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. 26 wa. Philadelphia, PA: Elsevier; 2020: chap 311.