Monocytic ehrlichiosis munhu: kuongorora chirwere uye kurapwa

Monocytic ehrlichiosis munhu - ichi haiwanzowaniki zvirwere zvinokonzerwa nemabhakitiriya dzemhuri Ehrlich. Zvokurwara anogona kuratidza munhu unopinza kuwedzera muviri tembiricha, nomusoro, tsandanyama marwadzo (myalgia), chills, hazvitaurwi kuneta, utera. Symptomatology ari kuchengetwa vhiki shomanana pashure pokuiswa utachiona. Uyezve, kazhinji kacho, somugumisiro sokuongorora kwomurabhoritari yakaratidza zvinoderedza uwandu maplatelet mu achiparadzira ropa (thrombocytopenia) pamwe vasanyanye chena eropa count (leucopenia), uye vanokara kuwedzera kwevari zvimwe chiropa makemikari (hepatic transaminase). Mune zvimwe zviitiko, zviratidzo mberi uye runoratidzwa kuda kurutsa, kurutsa, manyoka, uremu, kurasikirwa zvevhiki muchadenga. Kana murwere dzakaonekwa dzevanhu monocytic ehrlichiosis, kurapwa vanofanira kutevera pakarepo mushure nechirwere, nekuti kusavapo mukana wakakwana kurapa chirwere kunotungamirira yematambudziko ngozi zvakadai renal kana kufema kukundikana. Vatakuri zvirwere zviri mites.

Zviratidzo uye zviratidzo

Monocytic ehrlichiosis munhu, zviratidzo izvo zviri nyore kuvhiringidzwa zviratidzo nezvimwe zvirwere, uye vakawana vanganzi achangobva kuongororwa. Kazhinji, asi zvokurwara richiratidzwa vanenge nhatu pashure gupa nokuruma - Ehrlich bacteria keriya mhuri. Pakutanga, varwere vanenge mifananidzo zviratidzo chirwere, kusanganisira rakapinza kuwedzera muviri tembiricha uye zvayo neutera. Mune zvimwe zviitiko, ganda mapundu inowedzerwa zviratidzo zvakadaro. In zvirwere zvakakomba murwere anorasikirwa havi, uremu kutsanya uye riri pangozi chirwere neanorexia. Dzimwe nguva, munewo zviratidzo ehrlichiosis vashoma - zvakadai chikosoro, manyoka, kwazvo huro (pharyngitis), uye abdominal kurwadziwa.

Kazhinji, kana monocytic vanhu ehrlichiosis iri vanofungidzirwa, chirwere kunosanganisira kuongorora ropa. Zvakabuda bvunzo idzi (mubatanidzwa leuko- uye thrombocytopenia Panguva aine zvemamiriro pakukwirira chiropa makemikari) kubvumira murwere kuisa zvakarurama zvawanikwa. Mune zvimwe zviitiko, murwere kutamburawo kubva chiropa kuzvimba (chiropa).

Pasina zvakakwana kurapwa kuva zvikuru monocytic ehrlichiosis munhu. Zviratidzo zviri chirwere Panguva iyi vakasiyana mureza kuratidzirwa neutachiona uye ringaratidzwa inotevera mananara uye rinoti:

• kupfupika mweya (dyspnea, dyspnea);
• nezvinetso pakugwamba ropa (coagulopathy) kuti kungaita kuti ropa iri nemudumbu;
• chetsinga zvinetso nokuda chepfungwa uye musana chirwere (nechepakati tsinga).

Kana chirwere hwapararira nechepakati tsinga, murwere ane chirwere che "munhu monocytic ehrlichiosis" padzakacherechedza zvemamiriro zvinyama (bundu) muuropi. Uyezve, dzimwe nguva yakatanga yomumuzongoza - kuzvimba runodzivirira Kamudzira membranes uropi uye musana. Cerebrospinal Urume rinogonawo kukanganiswa utachiona.

chetsinga kuratidzwa

Chetsinga zviratidzo chirwere zvinosanganisira:

• nekuvhiri- ngika;
• zvemamiriro aikanganiswa nechiedza (photophobia);
• kuomarara muna pamutsipa;
• Zvikamu wehasha dzisingadzorwi zvemagetsi muuropi (pfari);
• pakoma.
• Mune zvisingawanzoitiki Muzviitiko, pane:
• zvakanyanyisa zvikuru dzepanguva siyana (hyperreflexia);
• incoordination yokuzvidira kufamba (ataxia);
• Mienzaniso arasikirwa injini nemano tsandanyama dzechiso nokuda kuzotadzira mumwe (kana kupfuura) gumi yegwara tsinga chokuita uropi (cranial tsinga vakaoma mitezo).

Monocytic ehrlichiosis evanhu granulocytic anaplasmosis pasina nyanzvi dzezvokurapa zvirwere upenyu pangozi.

zvikonzero

Ose ari vakaongorora zvokurwara kunokonzerwa bacteria vechigaro mhuri Ehrlich. Utachiona hwakakura monocytic ehrlichiosis munhu anonzi giremu negative.

Zvinofungidzirwa kuti huru kukonzera chirwere - munhu chishambwe nokuruma. Vamwe Zvipembenene izvi vatakuri utachiona.

Kamwe mumuviri kubudikidza neropa, Ehrlichia kuparadzira kuburikidza neropa uye nhengo dzinobudisa nemidziyo. Node - a pamuviri mvura akatakura masero dzakagadzirirwa kurwa zvirwere zvinotapuriranwa. Utachiona tora kugara mune dzimwe masero (monocytes uye macrophages), izvo kutamba inokosha basa kuramba irambe kushanda zvirwere. Masero aya richawira utachiona uye kupatsanurwa (muinonzi phagocytosis), kusanganisira utachiona uye dzimwe dzimwe zvinhu. Zvisinei, Ehrlichia pinda zvakadzika wepo masoja kudzivirira anotanga kukura vacuoles - in, takapoteredzwa membrane. The chirwere chinobata kwete chete monocytes uye macrophages muropa, asi mamwe muviri munyama (kusanganisira mumwongo node nodes, chiropa, chirwatata, itsvo, mapapu uye musana mvura).

Differentsiatsialnaya chirwere: granulocytic anaplasmosis

Zviratidzo chirwere ichi chinogona nyore kuvhiringidzwa zviratidzo zvimwe pathologies. Zvikuru kakawanda differential chirwere kuva monocytic ehrlichiosis uye munhu granulocytic anaplasmosis.

Kusiyana Mach, granulocytic anaplasmosis kunokonzerwa utachiona pamwe yakakodzera zita Anaplasma. Microorganism kutakurwa Zvikwekwe, chinobata zvimwe granular chena ropa masero - neutrophilic granulocytes. masero Ava kubatanidzwa nedanho phagocytosis uye kazhinji basa kuparadzwa inokuvadza tupukanana. Kana utachiona Anaplasma zvinowanzoitika zviratidzo kazhinji richiratidzwa pavhiki mushure gupa ikaruma - transporter utachiona. Anenge nguva dzose, murwere anorwara nefivha, chills, tsandanyama marwadzo (myalgia), vakawanda simba, kurukutika, kutemwa. Dzimwe nguva panewo chikosoro, kurutsa, uye / kana nekuvhiri- ngika. Uyezve, granulocytic anaplasmosis rakafanana chirwere zvakadai kwevanhu monocytic ehrlichiosis, chokuti migumisiro miedzo ropa kwakaratidza chete zvibereko zvimwe chiropa makemikari (hepatic transaminase). Kazhinji undiagnosed uye kupererwa neropa anokonzerwa vanokara kudzikisa huwandu masero matsvuku eropa ari achiparadzira ropa. Pasina kurapwa kunoitika pangozi yokuita renal kukundikana. Mune US, zviitiko kwevanhu granulocytic anaplasmosis inonyanyoshandiswa huri kuchamhembe kwakadziva uye vokumadokero inoti.

fivha sennetsu

Monocytic ehrlichiosis munhu (Mach) kusiyaniswa kubva fivha sennetsu - zvikuru havaratidzi anozivikanwa uye kushoma chaizvo zvirwere kungova subtype kuti ehrlichiosis kwevanhu kunokonzerwa utachiona uye zvakakodzera ainzi - Ehrlichia sennetsu. Mavhiki mashomanana pashure pokuiswa chirwere kuva zviratidzo zvakafanana zvavo zviratidzo Mach: rakapinza kuwedzera muviri tembiricha, nomusoro, tsandanyama marwadzo (myalgia). Vamwe varwere vave kuda kurutsa, kurutsa kana kurasikirwa kudya kusvikira neanorexia. Uyezve, migumisiro nemiedzo ropa zvinogona kuonekwa kuti kuderedza huwandu machena eropa count (leucopenia) uye pathological kuwedzera Vhoriyamu chiropa makemikari. Mutakuri (kana keriya) sennetsu fivha haisi chaizvo yakasimbiswa; mamwe masayendisiti zvinoratidza kuti zvingava Zvikwekwe, nepo vamwe vaongorori vanoti chirwere ichi chinogona kuva utachiona mushure kudya hove mbishi. Panguva iyoyo, zvirwere vakanga vakachengeta chete kumabvazuva Japan uye Malaysia.

Lyme borreliosis

Lyme borreliosis - ane zvirwere zvinokonzerwa nemabhakitiriya, spirochetes mhuri Borrelia. Vatakuri vredosnosnyh tupukanana vari Ixodes scapularis. Kazhinji, chirwere anonyanya vakaratidzawo nechitarisiko dzvuku kuzvimba paganda, izvo pakutanga nezviso sezvinoita vanomutswa dzeraundi nzvimbo zviduku saizi (papules). Papule anotanga nokukurumidza kukura uye pakupedzisira rinosvika masendimita anopfuura mashanu panguva dhayamita. Pashure pane symptomatology, zvinoratidza uye monocytic ehrlichiosis munhu. Mukana chirwere pamusoro Lyme borreliosis dererei zvikuru pane ngozi ndibate Mach, asi differential chirwere chinoramba rinofanirawo danho kuziva utachiona. Varwere Lyme borreliosis kakawanda vanotsutsumwa nefivhiri (kwete unopinza uye ngozi, sezvo muna Mach), chills, myalgia, nomusoro, utera, kurukutika, uye kurwadziwa kana kuomarara huru majoini (chirwere chearthritis), kazhinji zviri namabvi. The symptomatology anogona kutora chimiro idzokororo zvinogara. In Muzviitiko zvakaipisisa, kana akasiya untreated akaona chetsinga zvirwere uye nezvirwere zvomwoyo tsandanyama. Maererano nenhamba, vakawanda Lyme borreliosis rinowanikwa kuchamhembe kwakadziva kumabvazuva United States. Zvisinei, pane zviitiko neutachiona uye mune dzimwe nyika, kusanganisira China, Japan, Australia uye dzimwe nyika dzokuEurope.

piroplasmosis munhu

Monocytic ehrlichiosis munhu, mukana chirwere iyo achiri kupfuura mukana wokutapukirwa nevamwe utachiona, hakusi chete nengozi zvirwere kutakurwa zvikwekwe. Piroplasmosis munhu (dzimwe mazwi - babesiosis) - utachiona kunokonzerwa chete-celled Micro-zvinenge kubva mhuri Babesia. Kakawanda chirwere ichi chinobata mhuka, asi pano neapo pane zviitiko vanhu utachiona nayo. Zvikurukuru, zvinofungidzirwa kuti zvikwekwe vari vatakuri Babesia kuti anogona parasitize nomuviri womunhu. Piroplasmosis sezvinoita monocytic ehrlichiosis munhu wokutanga zviratidzo: varwere vanotsutsumwa nefivhiri, chills, kutemwa uye tsandanyama kurwadziwa, kuda kurutsa, kurutsa. Uyezve, pane zvakadai kanganisika mananara sezvo kuparadzwa vakurumidze masero matsvuku muropa riparadzirwe (hemolytic kupererwa neropa), zvemamiriro kuderera nhamba dzavo (thrombocytopenia), kuderera mune zvachose chena eropa count (leucopenia), uye akawedzera chirwatata (splenomegaly). Vanhu vane chimwe inogutsa utano zvingaratidza anosiyana softness kana ndisipo zvachose. Kwazvo nyaya piroplasmosis munhu kuchengetwa varwere vakambotadza akavhiyiwa kuti kubvisa chirwatata (splenectomy) kana kuva simba rokuzvidzivirira. Kakawanda chirwere babesiosis evanhu ari kuchamhembe United States, asi pane nyaya vasabatwa yayo munyika dzokuEurope.

American chishambwe typhus

Monocytic ehrlichiosis munhu anofanira kusiyaniswa kubva American chishambwe ricketsiosis - isingawanzowanikwi zvirwere zvinokonzerwa nemabhakitiriya mhuri Rickettsia. Vector kuzvidzora ndiye zvipembenene kuti anogona kombera monocytic womunhu ehrlichiosis. Kana typhus vakacherechedza kwazvo nomusoro uye tsandanyama pari, fivha, chills, kurasikirwa zvevhiki muchadenga. Kazhinji, pashure maviri - mazuva matanhatu mushure gupa ikaruma pane ganda mapundu, zvikurukuru kufukidza yemichindwe, pamaoko, inotsikwa pasi petsoka, muzvitsitsinho uye emberi. Gare gare, asi mapundu kuchiso, mutumbi uye ezasi gumbo. Dzimwe nguva pane kuda kurutsa, kurutsa uye abdominal kurwadziwa. Mune zvimwe zviitiko, kana hosha haina chirwere munguva, kana pasina zvakakwana kurapwa, zviratidzo tick nezvipembenene US ricketsiosis kungava upenyu pangozi. Panomuka chirwere zvinonyorwa siyana dziri US.

Diagnostics

Rokuongorora yevanhu monocytic ehrlichiosis, chirwere rinogona kukonzera zviratidzo nengozi, unofanira kushandisa zvakakwana zvokurapa kuongororwa, Kuongororwa zvirwere-vakasununguka uye unyanzvi rabhoritari nemiedzo. miedzo ropa kakawanda kunoratidza mifananidzo kuratidzwa kwevanhu monocytic ehrlichiosis: kuderera mune matsvuku eropa count (thrombocytopenia), zvinoderedza zvimwe chena sero count (leucopenia), uye mawa kuwedzera padanho chiropa chaiwo makemikari (semuenzaniso, serum aspartate aminotransferase uye alanine aminotransferase). Mune zvimwe zviitiko, somugumisiro Murabhoritari nemiedzo akawana pathological cerebrospinal mvura. Uyezve, chipfuva X-ray anogona kuona kanganisika kuchinja mumapapu (semuenzaniso pulmonary infiltrates kana zvakawandisa mvura kuwanda).

Research ropa zodzera pasi Erekitironi-danda maikorosikopu anogona kuona kuunganidza utachiona vari vacuoles mamwe masero (kunyanya monocytes), asi mukutanga zvokukura chirwere masumbu dzakadaro havasi kuoneka nguva dzose. Mune zvimwe zviitiko, mamwe kushandiswa rabhoritari miedzo kuti kuona zvariri mhando neutachiona uye kuzosimbisa zviratidzo.

nemiedzo kushandiswa dzakadaro dzinosanganisira Somuenzaniso, kunanga immunofluorescence nzira nokuda Detective pathologies, unosanganisira kudzidza serum anogadzirwa pachishandiswa ropa murwere. Antibodies - mapuroteni zvinoberekwa mamwe masero machena eropa - inobatsira muviri kurwisa muchetura uye kunokuvadza tusingaoneki. Kana kushandisa kunanga immunofluorescence staining kwevanhu dzakananga antibodies wakanyorwa pamwe fluorescent madhayi, serum akaiswa pasi ultraviolet nemwaranzi uye kuongorora pasi maikorosikopu kuziva itirana antibody ichatii chaicho tusingaoneki.

mabatiro

Kana yasimbiswa chirwere kuti "munhu monocytic ehrlichiosis," pane kurapa chirwere ichi? Kakawanda, vanachiremba akarayira mureza chipimo chemushonga kuti tetracycline inorwisa mabhakitiriya. Serimwe rinogona kutsiva ARV dzimwe nguva rinoshandiswa pahwaro doxycycline. In Muzviitiko zvakaipisisa, murwere vangada cherechedzo nyanzvi muchipatara. Kuwedzera nemishonga, zvinokwanisika kuti kutora chero mushonga chiremba wacho mvumo kuti aivabatsira hwokufananidzira zviratidzo chirwere.

dziviriro

Kana uchigara enzvimbo, nharaunda iri inogarwa Zvikwekwe angangokuvadza ngozi, kusanganisira vatakuri kwemabhakitiriya mhuri Ehrlich, zviri chinodiwa kutora zvakakodzera matanho okuzvidzivirira. Kana uri kusiya nyika, rangarira kuti iwe pakudaro simudza pedambudziko roku- chirwere chakakomba akadai monocytic ehrlichiosis munhu. Photo mites vari yasimbiswa vatakuri utachiona, zvichaita Zvisinei tirambe takamuka,, kuziva zvaigona muvengi kumeso hakuna kukwana. Vanopfeka refu bhurukwa, Shirts uye T-shirts pamwe refu maoko. Zvakakosha kupfeka heti, zvakanakisisa - paupamhi-akazara heti, sezvo mites zhinji vanogara mumiti. Sarudza chiedza-mavara mbatya, sezvo zviri nyore kuona kwezvinhu. Shandisa chaiwo zvishandiso-dzinga uye kuva nechokwadi zvose ganda uye zvipfeko kazhinji vanogona kuongorora. Most gupa ikaruma kuitika muna romusoro uye mutsipa.