Monocytic ehrlichiosis umuntu: ukuxilongwa kanye nokwelashwa

Monocytic ehrlichiosis umuntu - lesi sifo ezingavamile ezithathelwanayo ezibangelwa amagciwane omkhaya Ehrlich. Pathology engaveza waba ukwanda okukhulu kwezincwadi lokushisa komzimba, ikhanda elibuhlungu, imisipha ubuhlungu (myalgia), Ukugodola, ukukhathala simbe, ubuthakathaka. Symptomatology siyenzeka emasontweni ambalwa ngemva ukutheleleka kokuqala. Ngaphezu kwalokho, ezikhathini eziningi, ngenxa ukuhlolwa laboratory wembula nokuncipha inani zegazi afundwa igazi (thrombocytopenia) kanye ukwehla ezimhlophe cell segazi (leucopenia), kanye Ukwanda okungavamile amazinga enzyme ethile isibindi (transaminase hepatic). Kwezinye izimo, izimpawu bathuthuke futhi obonakaliswe isicanucanu, ukuhlanza, uhudo, ukuncipha emzibeni, ukulahlekelwa orientation emkhathini. Uma isiguli kutholwa abantu ehrlichiosis monocytic, ukwelashwa kufanele ulandele ngokushesha ngemva uphethwe, ngoba ukungabi khona i eyanele yokwelapha isifo kuholela yezinkinga eziyingozi ezifana ukwehluleka kwezinso noma zokuphefumula. Abathwali izifo ezithathelwanayo izibungu.

Izimpawu nezinkomba

Monocytic ehrlichiosis umuntu, izimpawu zazo kulula kudidaniswe izimpawu nezinye izifo ezithathelwanayo, futhi kwatholakala elithe muva uphenyo. Ngokuvamile, zokugula wabonakaliswa cishe amasonto amathathu ngemva kokulunywa umkhaza - Ehrlich amagciwane yenethiwekhi umndeni. Ekuqaleni, iziguli izimpawu ejwayelekile ukutheleleka, kuhlanganise waba ukwanda okukhulu kwezincwadi izinga lokushisa komzimba nokugeleza ubuthakathaka jikelele. Kwezinye izimo, ukuqubuka kwesikhumba sengezwe izimpawu ezinjalo. Ngo ngamagciwane okunzima isiguli ilahlekelwa esesuthi, ulahlekelwe isisindo fast futhi isengozini we-anorexia isifo. Ngezinye izikhathi, kukhona izimpawu ehrlichiosis lingandile - ezifana ukukhwehlela, uhudo, umphimbo obuhlungu (pharyngitis), futhi ubuhlungu besisu.

Ezimweni eziningi, lapho abantu ehrlichiosis monocytic okusolwa, uphethwe kuhilela ukuhlolwa igazi. Imiphumela yalezi ukuhlolwa (inhlanganisela leuko- futhi thrombocytopenia kanyekanye nge ephakeme okungavamile enzyme isibindi) ukuvumela nesineke ukubeka uphethwe yini. Kwezinye izimo, isiguli nayo inenkinga isibindi ukuvuvukala (i-hepatitis).

In the ukungabikho ukwelashwa okufanele ukuthuthukisa ezinzima monocytic ehrlichiosis umuntu. Izimpawu zesifo kulesigaba kuhluke ekubonakalisweni ejwayelekile ukutheleleka futhi kungase kubonise ku izenzakalo ezilandelayo futhi uthi:

• iphika (dyspnea, dyspnea);
• izinkinga nge igazi ekunqandeni (coagulopathy) engaholela ukopha pheshana emathunjini;
• iziyaluyalu zezinzwa ngenxa ukutheleleka cerebral spinal (isimiso sezinzwa).

Uma ukutheleleka wahlasela isimiso sezinzwa esiyinhloko, isiguli ukuxilongwa "ehrlichiosis womuntu monocytic" Kutholwe izicubu normal (isimila) ebuchosheni. Ngaphezu kwalokho, kwezinye izimo athuthukile meningitis - ukuvuvukala zokuzivikela ulwelwesi ulwelwesi zobuchopho nomgogodla. cerebrospinal fluid ingaphinda ehlaselwe ukutheleleka.

ukubonakaliswa zezinzwa

izimpawu zokungasebenzi kahle kwemizwa lesi sifo zihlanganisa:

• disorientation;
• ukuzwela normal nokukhanya (photophobia);
• ukuqina entanyeni;
• iziqephu engalawuliwe umsebenzi kagesi ebuchosheni (nokuquleka);
• ikhoma.
• Ezimweni ezingavamile, kukhona:
• ukusabela reflex okukhulu ngokweqile (hyperreflexia);
• incoordination ukunyakaza yokuzithandela (ataxia);
• ukulahlekelwa esinqunyiwe motor amakhono unyakazise imisipha yobuso ngenxa umonakalo elilodwa (noma ngaphezulu) ngababili eziyishumi nambili zakwa-izinzwa elihlobene ne-ubuchopho (cranial emsipheni palsies).

ehrlichiosis Monocytic futhi abantu granulocytic anaplasmosis ngokungabi bikho belashwe odokotela izifo esongela ukuphila.

izizathu

Zonke izinhlobo ze-pathology ihlaziye ezibangelwa amagciwane omndeni ka Ehrlich. Lwegciwane ehrlichiosis monocytic umuntu ubhekwa Gram-HIV.

Kukholakala ukuthi imbangela enkulu yokutheleleka - kokulunywa umkhaza. Ezinye zalezi izinambuzane kukhona abathwali kwamagciwane.

Uma emzimbeni ngegazi, Ehrlichia asakaze ngokusebenzisa igazi lymph. Lymph - uketshezi komzimba ethwele amaseli ezakhelwe ukulwa nezifo ezithathelwanayo. I-bacterium bahlale kwamanye amaseli (monocytes futhi macrophage), okuyinto zidlala indima eliyigugu ekugcineni ukusebenza esitebeleni kwesimiso somzimba sokuzivikela ezifweni. La mangqamuzana ukuzikisa bacterium kusetshenzwe (inqubo ebizwa ngokuthi i phagocytosis), kuhlanganise amagciwane nezinye izakhi angaphandle. Nokho, Ehrlichia engena ijule ukuzivikela masosha omzimba uqala zikhule kule vacuoles - izimbobo emazinyweni, lizungezwe ulwelwesi. Lesi sifo hhayi kuphela monocytes futhi macrophage egazini, kodwa futhi ezithile kwezicubu komzimba (kuhlanganise umnkantsha, izindlala zamanzi, isibindi, ubende, nezinso, amaphaphu uketshezi lomgogodla).

Differentsiatsialnaya uphethwe: anaplasmosis granulocytic

Izimpawu zalesi ukutheleleka kungenziwa udidekile kalula izimpawu nezinye pathologies. I njalo kunazo umehluko ukuxilongwa ukuba ehrlichiosis monocytic futhi abantu anaplasmosis granulocytic.

Ngokungafani Mach, anaplasmosis granulocytic ezibangelwa amagciwane enegama ezifanele Anaplasma. Silwanyana eyalo imikhaza, kuthinta luyimbudumbudu amhlophe egazi amaseli ezithile - granulocytes neutrophilic. Lezi amaseli ahileleke inqubo phagocytosis futhi ngokuvamile obhekene ukubhujiswa amagciwane ayingozi. Lapho itheleleke nge Anaplasma izimpawu Ngokuvamile ubonakaliswa isimo sengqondo isonto emva kokulunywa umkhaza - Transporter amagciwane. Cishe njalo, isiguli uhlushwa imfiva, Ukugodola, imisipha ubuhlungu (myalgia), ubuthakathaka jikelele, ukukhathala, ukuphathwa ikhanda. Ngezinye izikhathi kukhona ukukhwehlela, ukuhlanza, kanye / noma disorientation. Ngaphezu kwalokho, granulocytic anaplasmosis efana ukutheleleka ezifana ehrlichiosis womuntu monocytic, iqiniso lokuthi imiphumela ukuhlolwa kwegazi kwembula ukuthi leli ukwanda efanayo enzyme ethile isibindi (transaminase hepatic). Ngokuvamile asixilongwa futhi anaemia kubangelwa Ukwehla okungavamile ezingeni kwamangqamuzana egazi abomvu egazini circulating. In the ukungabikho ukwelashwa okufanelekile kwenzeka ingozi yokuba ukwehluleka kwezinso. E-US, amacala anaplasmosis womuntu granulocytic evamise ezilotshwe uthi enyakatho-mpumalanga futhi entshonalanga.

imfiva sennetsu

Monocytic ehrlichiosis umuntu (Mach) okufanele ahlukaniswe futhi imfiva eyingozi sennetsu - kakhulu kabi eyaziwa futhi ezingavamile kakhulu izifo ezithathelwanayo okuqondene subtype ka ehrlichiosis womuntu ezibangelwa amagciwane kanye ngokufanele ngokuthi - Ehrlichia sennetsu. Ngemva kwamasonto ambalwa ukutheleleka kokuqala ukuthuthukisa nezimpawu ezifanayo kuya izimpawu ezivamile Mach: waba ukwanda okukhulu kwezincwadi lokushisa komzimba, ikhanda elibuhlungu, imisipha ubuhlungu (myalgia). Ezinye iziguli isicanucanu, ukuhlanza noma ukungakuthandi ukudla kuze nokuzincisha ukudla. Ngaphezu kwalokho, imiphumela ukuhlolwa kwegazi kungabonwa ukunciphisa izinga white cell segazi (leucopenia) kanye nokwanda sokugembula emqulwini we enzyme isibindi. Inkampani yenethiwekhi (noma inkampani yenethiwekhi) sennetsu imfiva Namanje hhayi ngokunembile ezimisiweyo; abanye ososayensi babonisa ukuthi kungase imikhaza, kuyilapho abanye abacwaningi bathi lesi sifo bangaba elinegciwane ngemva edla inhlanzi eluhlaza. Okwamanje, izifo babonakala kuphela empumalanga Japan neMalaysia.

saseLyme borreliosis

SaseLyme borreliosis - isifo esithathelanayo ezibangelwa amagciwane, spirochetes omkhaya Borrelia. amagciwane zenethiwekhi vredosnosnyh kukhona Ixodes scapularis. Ezimweni eziningi, lesi sifo singumbulali ukubukeka ngokuyinhloko lapho kubonakala a ukuvuvukala abomvu esikhumbeni, ngaleso ukubukeka lokuqala sengathi ephakanyiswe indawo isiyingi yobukhulu ezincane (papules). Papule uqala zikhule ngokushesha futhi ekugcineni sifinyelela amasentimitha okungenani ezinhlanu ububanzi. Ngemva kwalokho kukhona symptomatology, esibonisa futhi monocytic ehrlichiosis umuntu. Amathuba isifo saseLyme borreliosis kuyinto ephansi kakhulu kunalokho ingozi ekubambeni Mach, kodwa umehluko ukuxilongwa uhlala isinyathelo kudingekile ekunqumeni ukutheleleka. Iziguli saseLyme borreliosis futhi ngokuvamile esekhala imfiva (hhayi njengoba abukhali futhi iyingozi, njengasezulwini Mach), Ukugodola, myalgia, ikhanda elibuhlungu, ukukhathala, futhi ubuhlungu noma ukuqina emalungeni ezinkulu (isifo sokuqaqamba kwamalunga esithathelanayo), ngokuvamile ngamadolo. I symptomatology kungathatha ngesimo imijikelezo yansukuzonke. Ezimweni ezimbi kakhulu, uma iyekwa ingelashwa waphawula iziyaluyalu nezifo imisipha yenhliziyo zezinzwa. Ngokwezibalo, iningi saseLyme borreliosis kutholakala esenyakatho-mpumalanga ye-United States. Nokho, zikhona izimo ukutheleleka futhi kwamanye amazwe, kuhlanganise iChina, i-Japan, Australia futhi kwamanye amazwe aseYurophu.

piroplasmosis umuntu

Monocytic ehrlichiosis umuntu, amathuba okutheleleka lapho kungenazo ephakeme kunaleyo ingozi yokutheleleka namanye amagciwane, akuyona kuphela yingozi le izifo ezithathelwanayo ezithwalwa imikhaza. Piroplasmosis umuntu (e neminye imibandela - babesiosis) - ngegciwane kubangelwa owumphumela amagciwane emndenini Babesia. Ngokuvamile lesi sifo sithinta izilwane, kodwa ngezinye izikhathi kunezindlela amacala abantu abangenwe ke. Ikakhulukazi, kodwa kukholakala ukuthi imikhaza kukhona abathwali Babesia ezingaba parasitize umzimba womuntu. Piroplasmosis njengomuntu ehrlichiosis umuntu izimpawu monocytic lokuqala: iziguli esekhala imfiva, Ukugodola, ikhanda kanye ubuhlungu bemisipha, isicanucanu, ukuhlanza. Ngaphezu kwalokho, kukhona enjalo imihlola normal lapho sekusondele ukubhujiswa kwanoma amangqamuzana abomvu e-kwegazi (hemolytic anaemia), Ukwehla okungavamile izinombolo zabo (thrombocytopenia), wehlise isiyonke egazi amhlophe ukubala (leucopenia), kanye kweNdikimba ubende (splenomegaly). Abantu nge izimpawu ezivamile wezempilo egculisayo kungahluka umsungulo noma ngingekho ngokuphelele. Ukugula okukhulu of piroplasmosis umuntu waphawula ezigulini ngaphambilini ngahlinzwa ukuze kususwe ubende (splenectomy) noma uhlelo ababuthakathaka mzimba. Ngokuvamile kutholakala ukuthi uphethwe yini babesiosis womuntu enyakatho e-United States, kodwa kukhona amacala ukuthola yayo emazweni ase-European.

American umkhaza typhus

Monocytic ehrlichiosis umuntu kumele ahlukaniswe kusukela American umkhaza ricketsiosis - isifo ezingavamile ezithathelwanayo ezibangelwa amagciwane omkhaya Rickettsia. isilawuli Vector iyona izinambuzane efanayo kungathelela obuntu ehrlichiosis monocytic. Lapho-typhus waphawula zekhanda ezinamandla lapho ukhwehlela nobuhlungu bomzimba, imfiva, Ukugodola, ukulahlekelwa orientation emkhathini. Ezimweni eziningi, ngemva ezimbili - izinsuku eziyisithupha ngemva kokulunywa umkhaza kukhona ukuqubuka kwesikhumba, ngokuyinhloko esehlanganise izintende, izihlakala amathe ezinyawo, nokwephuka ngemilenze. Kamuva, ukuqubuka isakazekela ebusweni, esifubeni kanye nomlenze aphansi. Ngezinye izikhathi kukhona isicanucanu, ukuhlanza kanye ubuhlungu besisu. Kwezinye izimo, lapho lesi sifo hhayi sitholakale isikhathi, noma ngokungabi bikho ukwelashwa okufanele, izimpawu uphawu yizinambuzane US ricketsiosis kungenzeka ukuphila kusengozini. Nokuqubuka kwalesi sifo alotshwe ezifundeni ezahlukene US.

ukuhlola

Xilonga ehrlichiosis womuntu monocytic, ukutheleleka okuyinto wakwazi ukubangela izimpawu yingozi, udinga ukusebenzisa ukuxilongwa okujuli- yezokwelapha, ukuhlaziya ukuhlolwa izifo khulula futhi laboratory ezikhethekile. Ukuhlolwa kwegazi ngokuvamile abonisa ukubonakaliswa ejwayelekile ka ehrlichiosis womuntu monocytic: ukwehla abomvu egazi ukubala (thrombocytopenia), ukuncishiswa ezithile amangqamuzana amhlophe ukubala (leucopenia), kanye nokukhula kanyekanye ezingeni isibindi enzyme ethize (isib, serum aspartate aminotransferase futhi aminotransferase alanine). Kwezinye izimo, ngenxa ukuhlolwa laboratory wathola sokugembula cerebrospinal fluid. Ngaphezu kwalokho, esifubeni X-ray kungase ukubona ushintsho olwenzeka normal emaphashini (isb lingene yamaphaphu noma ngokweqile uketshezi ekuqongeleleni).

Ucwaningo igazi smear ngaphansi electron-ugongolo isibonakhulu kungathola ekuqongeleleni kwegciwane vacuoles lamaseli ezithile (ikakhulukazi monocytes), kodwa kuzo lapho kusaqalwa ukutheleleka amaqoqo enjalo awabonakali njalo. Kwezinye izimo, ezengeziwe ukuhlolwa laboratory ezikhethekile ukucacisa uhlobo oluthile ukutheleleka futhi uqinisekise uphethwe.

Okunjalo ukuhlolwa ezikhethekile zihlanganisa, isibonelo, engaqondile immunofluorescence indlela pathologies uzingela, okubandakanya ekutadisheni serum ekhiqizwa ngesisekelo umthamo wegazi lesiguli. Amasosha Omzimba - amaprotheni ezivezwa amaseli ezithile igazi emhlophe - ukusiza ubuthi umzimba ekulweni nezinto ezincane eziphilayo eziyingozi. Lapho usebenzisa i-engaqondile immunofluorescence staining omzimba womuntu othize anelebuli udayi Fluorescent, serum yafakwa ngaphansi emisebeni ultraviolet futhi ukuyihlola ngesibonakhulu ukuhlonza okuhambisanayo omzimba asabela ngayo nezilwanyana ezincane ezithile.

ukwelashwa

Uma ukuqinisekisile ukuxilongwa "ehrlichiosis womuntu monocytic," ukwedlula ukwelapha lesi sifo? Ngokuvamile, odokotela libeke Isikali esezingeni tetracycline antibiotic. Njengoba yokwelapha ehlukile ngezinye izikhathi lisetshenziselwa ngesisekelo doxycycline. Ezimweni ezimbi kakhulu, isiguli kungase kudingeke kokuqondisa professional in esibhedlela. Ngaphezu imithi elwa namagciwane, kungenzeka ukuthatha imvume noma yimuphi udokotela imithi ukuze lula izimpawu ejwayelekile ukutheleleka.

zokuvimbela

Uma uhlala endaweni ngokwebalazwe, okuyinto owakhiwe imikhaza ezinobungozi, kuhlanganise abathwali Ehrlich amagciwane umndeni, kuyinto efiselekayo ukuthatha izinyathelo ezifanele. Uma izwe lakubo, khumbula ukuthi wena kanjalo ukukhulisa ingozi kokuthola isifo esibi ezifana monocytic ehrlichiosis umuntu. Photo izibungu kuthiwa abathwali amagciwane kuqinisekisiwe, Nokho ngeke bahlale beqaphile, ukwazi isitha okunamandla ebusweni akwanele. Gqoka eside ibhulukwe shirts and izikibha nge ezinemikhono emide. Kubalulekile ukugqoka izigqoko, okungcono - izigqoko zelanga eziwumhelane, njengoba izibungu eziningi bahlala izihlahla. Khetha izingubo okhanyayo, njengoba kuyintando elula ukubona isinambuzane. Sebenzisa ekhethekile amathuluzi-oxosha futhi qiniseka kokubili isikhumba futhi izingubo bangasiduduza nokuhlola. Iningi umkhaza ukulunywa zenzeka ekhanda nasentanyeni.