Leishmaniasis kwemhuka: Zviratidzo, kuongorora chirwere neMarapirwo

Leishmaniasis chinhu zvirwere zvemhuka kunokonzerwa nevanhu intracellular chisvetasimba. chisvetasimba ichi pamusoro genus Leishmania iri noutunga. Kupararira chirwere zvinoita kuti zvipfuwo nemhuka dzomusango mhuka. Leishmaniasis kungava visceral kana cutaneous.

etiology

The kutenderera chisvetasimba upenyu kunoitika ne kuchinja vanatenzi: vertebrates, kusanganisira vanhu, uye mutakuri - umhutu. Leishmania marudzi kunoitika 2 - flagellated parasitizing miviri muropa-yakayamwa tumbuyu uye bezzhgutikovaya - macrophages mune hondo mumasero.

Vakagovera leishmaniasis kwemhuka nevanhu kunyanya endemic. Muchiitiko chino, vakawanda vanenge vakanyorwa iri kusimukira. Munyika 32, chirwere pasi fanira kunyoresa.

Kokutanga mune leishmaniasis mhuka muRussia zvakanzi yakawanikwa 1909. Iyi kunetseka imbwa yacho eCaucasus. Kubva 2008 kusvika 2010, 52 zviitiko chirwere ichi mu imbwa zvave vakanyorwa muUkraine.

epizootology

The chirwere rinotanga kubva nemhuka utachiona kana vanhu. Zvine bloodsucking kuwana amastigote, izvo kutanga vachishingaira ruminant mu dumbu rake. Mazuva 8-10 amastigote yachinjwa kuva invasive muchimiro, kusimbiswa umhutu proboscis uye zvikamu pamberi ura. Pauchazotaura kuruma keriya chisvetasimba anopinda muropa uye musana vanotanga bereka. Just zuva muchitokisi kungava zvidimbu anopfuura 200 amostigot. Masero ungana chisvetasimba yaparadzwa zvachose, amastigote vari akabatwa masero pedyo umo muitiro inodzokororwa. Saka, leishmania vari paganda, mumwongo chiropa, node nodes kana nedzimwe nhengo.

The incubation nguva

Zvichienderana Maumbirwe kiriniki zvakasiyana chirwere. The incubation Nguva visceral leishmaniasis hunogara kusvika 10 mwedzi, kukura zvishoma nezvishoma.

Skin Leishmaniasis iri kukura nokukurumidza, ayo incubation nguva ipfupi chaizvo.

umboo

Chirwere asingatani mhuka ipi zera uye munhui. In mhuka wechiduku tanga kashoma kuratidza zviratidzo, zvinoita kuti mukupera nechirwere, uye vakawanda chikamu kufa. Vamwe ongororo dzinoratidza kuti vakawanda kubatwa leishmaniasis mhuka makore makore 3-5.

Leishmaniasis kwemhuka, mapikicha izvo zvinogona kuonekwa pano, ndakaiswa ne dzekare zano, bata nhengo dzose uye masero hwemhuka.

Cutaneous leishmaniasis rinotanga chimiro nodules pa nzvimbo mutakuri ikaruma. Nokufamba kwenguva, nodules izvi dzinoyerera kupinda nemaronda. Most kubatwa nezvirwere chepuraimari nzvimbo yakapoteredza meso, zambuko mhino uye nenzeve mhuka.

In chimiro ichi chirwere chaidzo usimbe kwegore kana akatowanda. Pokufa mhuka Panguva iyi apo neapo. Visceral leishmaniasis kunoitika rakaoma zvikuru; zvingava chakasimba kana chirwere. Kana paine chimiro fivha, pane vakawanda mwoyo wemhuka, yakanyanya uremu.

Panguva imwe chete nevamwe zviratidzo murwere mhuka yakatanga conjunctivitis, kupererwa neropa, fufune inowanzoshandiswa kuchengetwa. Pangava nourema kana paresis, yekudyidzana vasingadzoreki hemodynamics. Sezvo pasi pokudzora parasitic muviri akaparadza zvishoma nezvishoma, sema kana chepfu siyana.

Panguva chokuwanziridza pamusoro Leishmania yakawedzera chiropa, node nodes uye chirwatata. The chenjera chimiro chirwere zvikuru kwese mhuka duku. Kazhinji, rufu kunoitika mumwedzi mishomanana pashure nezviratidzo chirwere wokutanga. Rare zviitiko zviitiko kupora.

In visceral leishmaniasis chimiro zvishoma nezvishoma nokusimbaradza pemhuka muviri simba, zvakawedzera kuneta. Skin blanch, kudya ipfupi. In danho iri, unogona kuonekwa palpation awanda chirwatata. A zvishomanana kuwedzera tembiricha kunoitika. Kana tembiricha rwuchiwanzwa zvinokosha, inoratidza pakakwirira chirwere. Kwakadaro mararamiro chirwere hunogara kusvika 3 months.

kupererwa, cachexia angatanga panguva kukura chirwere. Musiwa mucous nzvimbo kukanganiswa necrosis. Unogona kuona mwoyo chirwere.

Leishmaniasis kwemhuka muchimiro ganda kunoitika mukati memazuva 10-20. Pakutanga kwakanga papule dhayamita vanenge 3 cm. Pashure vanenge 2 weeks atova zvinogoneka kuchengeta necrotic centre vakakomba chinotenderera infiltrated ganda chete hune secretions. Kwete kure chikuru leyshmanomy vakaumba yechipiri anorovera kuti kugume nemaronda itsva. Nokufamba kwenguva, vose matambudziko batanidza chimwe muzinda guru. Zvakakodzera uye nenguva kurapwa nemaronda izvi kuporesa mumwedzi mishomanana, panzvimbo yavo, mugaremo zvinokosha mavanga kuti kashoma ane mvere zvakare. The anorovera uye maronda dzinenge nyarara idzodzo.

yematambudziko

At kosi zvakakwana refu-refu kwechirwere chacho kumusoro pangozi yokuita nephritis, diathesis, mabayo, agranulocytosis. High ndingangokuvara suppurative necrotizing kuzvimba. With chinokosha lesion muviri inobvira kusingarapiki nhengo kukuvara zvaakaratidzwa.

Diagnostics

Kana leishmaniasis aiitisa zvidzidzo siyana kuziva causative pomutumwa. Saka, munhu wakakwana ropa kuongorora anogona kuratidza rakawedzera ESR, hypochromic kupererwa neropa, pasi Kuwanda maplatelet. Nemakemikari omuviri anoratidza hypergammaglobulinemia. Cutaneous leishmaniasis kwemhuka chirwere pashure voga pakati nayo utachiona kubva nemaronda uye tubercles. Visceral Leishmania dzakaonekwa mune tsika ropa. Mune zvimwe zviitiko, rimwe biopsy chakagadzirwa siyana nhengo.

In epidemiological ongororo zvinosvibisa ganda bvunzo pamwe leyshmaninom (Montenegro kuita).

Pari kukura nzira itsva nechirwere pamusoro leishmaniasis, sezvo vari pari iripo, zvinoda zvinokosha zvinhu yokufambisa uye tora nguva yakawanda.

Nemaronda vane leishmaniasis kufanana foci panguva nechigwadara nekabhunakeri, saka kuti kuongororwa zvakarurama Zvinosarudzwa kudzivisa kuvapo kuti mumiririri wenyika nechigwadara.

mataridzikiro

Leishmaniasis mune imwe mhuka kupfuura runyoro, dzimwe nguva rinopera yakazvimirira kupora. With nenguva chirwere uye zvakakodzera zvokurapa kupindira zvakanaka kugumiswa chirwere mukuru. Panguva chakakomba, kana chirwere vanhu simba kutapata, pasina pharmacological kubatsira kunge rufu. Leishmaniasis ganda nguva dzose kunosiya mavanga kana mavanga.

mabatiro

Leishmaniasis mhuka kubatwa pentavalent namavara akanaka zvinodhaka. Izvi mhando mishonga "Glyukantima", "Solyusurmina" kana "Neostibozana". Kana visceral chimiro chirwere, mishonga aya akapiwa nomutsinga pamusoro mazuva 7-10 ane nezvishoma kuwedzera inokurudzirwa dose. Kana kukwana kubudirira kurapwa batanidza "Amphotericin B", riri jekiseni zvishoma nezvishoma nomutsinga akabatana ane 5% shuga mhinduro.

Cutaneous leishmaniasis kwemhuka vachiri Danho inogona kurapika ne Kubayiwawo jekiseni hillocks "monomitsin" "Urotopinom". Uyezve majekiseni dzinoitwa ne chete mafuta kugadzirira. Kana urikanwi yakatotanga kuumbwa, shandisa intramuscular rinoreva "Miramistin". Kuti mhanyisa muitiro tightening maronda, izvozvo ashandise Laser mishonga.

Negadziriro yeparutivi nzira iri chirwere vari "Pentamidine" uye "Amphotericin B", riri basa muzviitiko chisvetasimba kuramba tsika Formulations kana panguva kuitazve kuti utachiona.

Kuti anyatsobudirira kurapwa Wakawedzerwa recombinant interferon wegamma akagadzirirwa kurapwa kwevanhu.

Mune zvisingawanzoitiki kacho zvakakodzera kurapa kubviswa chirwatata surgically.

Pasinei ose matanho akatorwa kubvisa chirwere, kunyange pashure kuzoita mhuka utachiona hwakakura zvakakwana kubva pamuviri leishmaniasis haagoni zvachose kunyangarika.

dziviriro

Panguva iyoyo, hapana nzira baya mhuka uye vanhu. Nokuti kudzivirirwa ikaruma pamusoro Phlebotomus izvozvo ashandise dzinokosha zvipembenene, rakagadzirirwa wemhuka kushandiswa.

Sezvo kudzivirira leishmaniasis ari munzvimbo pangozi, liquidated kugarwa site umhutu akaita disinfestation zvivako.

Kuona chirwere mudzimba mhuka, unahwo vakabvuma chemoprophylaxis "pyrimethamine."

Pamusoro kuonekwa chirwere iri nemhuka kuitira kudzivirira kuparadza mhuka idzi inokurudzirwa kupedza liquidation avo mapfupa.

Maonerwo kuvanhu

vanhu vanopfuura mamiriyoni 350 vari Parizvino pane mukana wokutapukirwa. Foci kuti leishmaniasis vari ndokuwarira pamusoro zvakawanda nzvimbo Asia uye Europe. Muzvinhu siyana vectors ose leishmaniasis - mupenyu ropa-yakayamwa ipapo nezvipembenene. Zviitiko visceral leishmaniasis vakanyorwa muUkraine, North Ossetia, muna Crimean steppes, pamakomo Caucasus nedzimwe nzvimbo.

The chirwere haisi inoparadzirwa zvakananga kubva mhuka kumunhu, asi kana wokutanga chirwere prophylaxis pachii vanhu, nokuti chokwadi pamusoro chirwere kunoratidza kuvapo vatakuri ayo.

migumisiro

Leishmaniasis - ndidzo zvirwere, izvo regai kubereka antibodies. Saizvozvowo, mhuka vanorwara kana munhu zvinogona uye kechipiri uye wechitatu. Zvisinei, zviitiko zvakadaro apo neapo, saka hazvingaiti kuti mhuka inogona kurarama akadzokorora zvirwere anopfuura maviri.

Kudzivirira dzokororo chirwere mishonga rakarumbidza kunorapwa, shandisa mwedzi mitanhatu ose. Zvisinei, kushandiswa kakawanda zvakadaro kungatowedzera kukura kurwisa zviri Muviri chepfu nemigumisiro.

Mushure chirwere mhuka anoda refu vapore, sezvo zvakaita kukwana kana zvakakwana kubviswa mitumbi anofanira surgically kudhayeta.

Leishmaniasis kwemhuka - hazvina ngozi chaizvo uye achinyengera chirwere, saka kugara vanotambudzika munzvimbo inofanira nokungwarira kuongororwa kuti mhuka kusvikira pakuonekwa wokutanga zviratidzo (kana kunyange nokufungirana zvirwere) kuva nguva kupa rubatsiro zvakakodzera.