Isikhunta Esimnyama

Ukutheleleka ngesikhunta esimnyama noma i-mucormycosis akuvamile kodwa kuyingozi. Ukutheleleka kuvame kakhulu kulabo abakhubazekile amasosha omzimba noma abasebenzisa amanani eqile emithi ye-steroid. Ukutheleleka kwefungal okumnyama kunengozi enkulu yokufa futhi kungaholela emiphumeleni esongela ukuphila uma kungelashwanga ngokushesha. Kubangelwa iqembu lesikhunta elibizwa ngokuthi i-mucormyocetes futhi lingena emzimbeni ngokuhogela ama-spores. Ingasakazeka kunoma iyiphi ingxenye yomzimba bese ibizwa ngokuthi i-Disseminated mucormycosis 

Yini Isikhunta Esimnyama? 

Ukutheleleka kwefungal okumnyama, okuvame ukubizwa ngokuthi i-mucormycosis, isimo esingavamile kodwa esiyingozi. Kubangelwa isikhunta esibizwa ngokuthi ama-mucormycetes, ngokuvamile esithinta ukona, amaphaphu, isikhumba, nobuchopho. Ukuchayeka ezinhlamvu zesikhunta kungenzeka ngokuhogela umoya noma ngokuthinta inhlabathi ethelelekile, isinkwa esibolayo, noma imifino, inqwaba yomquba, noma ezinye izinto.

Yiziphi izimpawu ze-Black fungus (Mucormycosis)?

Izimpawu zesikhunta esimnyama zibonakala kuye ngokuthi zikhula kuphi, esikhumbeni, ebuchosheni noma uhlelo lokuphefumula. Izimpawu ezilandelayo zesikhunta esimnyama zingabonisa ukugula kokuphefumula okuphezulu noma okuphansi

• Isikhukhula
• Ukuvaleka kwamakhala
• Fever
• bekhanda
• ubuhlungu besifuba
• Ukuphefumula kanzima noma ukuphefumula
• Izilonda ezimnyama ebhulohweni lamakhala noma ngaphakathi kwendawo yomlomo

I-mucormycosis ingavela noma kuphi emzimbeni njenge-a ukugula kwesikhumba. Kungase kubangele ukulimala kwesikhumba kodwa kungasakazeka ngokushesha kwezinye izindawo. Izimpawu zesikhunta esimnyama esikhumbeni zifaka:

• Blisters
• Izilonda
• Fever
• I-Edema
• ububomvu
• Izicubu zesikhumba ezimnyama
• Amathumba abe mnyama 
• Izilonda ezibuhlungu

Isikhunta esimnyama singathinta namehlo. Nazi ezinye izimpawu zokuqala zesikhunta esimnyama emehlweni:

• Umbono ophundlekile
• Ama-clots egazi
• Umbono kabili
• Ukulila 
• bekhanda
• Malaise
• Ukubamba
• Izimfihlo eziphuma egazini

Isikhunta esimnyama singathinta uhlelo lokugaya ukudla

• Uhudo
• Izitulo ezinegazi
• I-nausea nokuhlanza
• Kuhlanza igazi 
• Ubuhlungu besisu 

Yiziphi izimbangela ze-Black fungus (Mucormycosis)?

Ukuchayeka esikhunjeni sesikhunta esimnyama kungenye yezimbangela eziyinhloko zesikhunta esimnyama. Lezi zinambuzane zitholakala emaqabunga, ezinqwabeni zomquba, enhlabathini nasezikhunini ezibolile, isinkwa esidala, kanye nemifino. Ukuhogela isikhunta esisemoyeni endaweni enegciwane kungabangela i-mucormycosis, Ngenxa yalokho, lezi zindawo ezilandelayo zingase zithinteke:

• Amehlo
• Face
• Amapulazi
• Izono
• Skin
• Isistimu yezinzwa emaphakathi (kancane kancane)

Ukwengeza, ukusika noma ukushiswa kwesikhumba kungabeka umuntu kusikhunta (ukuchayeka kwesikhumba). Kulezi zimo, ukusha noma isilonda ekugcineni singenwa yigciwane. Nakuba isikhunta esiningi singaba khona endaweni ngokwemvelo, akuwona wonke umuntu ovezwayo ozoba nokutheleleka kwefungal. Uma amasosha omzimba esengozini, umuntu angase abe nalolu hlobo lokutheleleka. Izimo zempilo ezilandelayo zingase zandise amathuba okuthola ukhunta:

• Cancer
• Ukushisa
• HIV / AIDS
• Abantu abasebenzisa ama-immunosuppressants
• Isifo sikashukela esingalawuleki
• Ukufakelwa kwesitho kwakamuva
• Ukufakelwa kwe-stem cell
• I-Neutropenia
• Ukwelashwa ngamakhemikhali
• Ukusetshenziswa kwe-steroid isikhathi eside

Yiziphi izinhlobo ze-Black fungus disease Mucormycosis)?

I-Mucormycosis ihlukaniswa ngezigaba ezilandelayo, kuye ngokuthi ingxenye yomzimba ethinta yona:

• I-Rhinocerebral: Kuthinta ukona nobuchopho
• Amaphaphu: Kuthinta amaphaphu
• I-Cutaneous: Kuthinta isikhumba
• Amathumbu: Kuthinta isisu namathumbu
• Kusatshalaliswe: Kuthinta izingxenye eziningi zomzimba, njengamaphaphu, isikhumba, ukona, ubuchopho, ulwelwesi lwangaphakathi lwamagumbi enhliziyo, amavalvu enhliziyo, nezinso.

Izingozi Zokukhunta Okumnyama

Ukuvimbela lesi sifo esingavamile kubalulekile kubantu abanamasosha omzimba asengozini, okungaba umphumela wezimo ezifana nesifo sikashukela, umdlavuza, ukufakelwa kwesitho noma i-stem cell, i-neutropenia, ukusetshenziswa isikhathi eside kwe-corticosteroid, ukusetshenziswa kwezidakamizwa ngomjovo, ukugcwala kwe-iron, noma ukulimala kwesikhumba ngenxa yokuhlinzwa, ukushiswa, noma amanxeba. Kubalulekile ukuthatha izinyathelo zokuvimbela ukugwema ukuvela kwalesi sifo kubantu abangenawo amandla omzimba.

Ukuvimbela Isikhunta Esimnyama

Ukuvimbela ukhunta omnyama, owaziwa nangokuthi i-mucormycosis, kuhilela izinyathelo ezimbalwa ezibalulekile:

• Lawula isifo sikashukela: Njengoba isifo sikashukela esingalawuleki siyingozi enkulu, kubalulekile ukugcina amazinga kashukela egazini ebangeni elivamile. Ukuqapha njalo nokulandela uhlelo lokulawula isifo sikashukela kubalulekile.
• Izinqubo Zezokwelapha Eziyinyumba: Ukuqinisekisa ukuhlanzeka okuqinile ngesikhathi sokungenelela kwezokwelapha, ikakhulukazi ukuhlinzwa, nokugcina indawo eyinyumba kungasiza ekuvimbeleni izifo zefungal.
• Ukusetshenziswa okufanele kwe-Steroid: Uma i-corticosteroids idingeka, kufanele inqunywe futhi isetshenziswe ngaphansi kokuqondisa kodokotela. Umthamo kanye nobude besikhathi kufanele kuqashelwe ngokucophelela ukuze kuvinjelwe ukusetshenziswa ngokweqile.
• Ukunakekelwa Kwenxeba Le-Aseptic: Kubantu abanokulimala kwesikhumba ngenxa yokuhlinzwa, ukusha, noma amanxeba, ukunakekelwa okufanele kanye ne-aseptic inxeba kubalulekile ukuvimbela ukungcoliswa kwesikhunta.
• Ukuhlanzeka komuntu siqu: Ukugcina inhlanzeko yomuntu siqu, kuhlanganise nokugeza izandla njalo, kungasiza ekunciphiseni ingozi yokutheleleka kwefungal.
• Ukuphathwa kwensimbi: Ezimweni lapho ukugcwala kwe-iron noma i-hemochromatosis kuwukukhathazeka, ukulawula amazinga e-iron ngokusebenzisa isiqondiso sezokwelapha kubalulekile ukuvimbela izinkinga.
• Usekelo Lwesistimu Yamasosha omzimba: Ukuqinisa nokugcina amasosha omzimba anempilo kubalulekile. Lokhu kungahlanganisa ukudla okulinganiselayo, ukuvivinya umzimba njalo, ukulala ngokwanele, futhi, kwezinye izimo, ukugonyelwa izifo ezithile.

Izindlela zokwelapha i-mucormycosis

Ngaphambi kokuqala ukwelashwa kwesikhunta esimnyama, udokotela uzohlola umzimba futhi abuze ngomlando wezokwelapha wesiguli uma besola i-mucormycosis. Kubalulekile ukwazisa udokotela uma isiguli besiseduze nokudla okudala noma ezinye izindawo lapho kuvame ukutholakala khona izinhlamvu zesikhunta. Lokhu ngokuvamile kwenziwa ukuze kuqedwe noma yiziphi ezinye izimo ezingaba khona. Ukuhlola okulandelayo kokuxilonga kungase ku-odwe udokotela:

• Uphawu oluvame kakhulu olwethulayo lokuxilongwa emtholampilo a bekhanda. I-tissue necrosis iphinde ibe uphawu lokutheleleka kwesikhunta esimnyama, esingabonakala ngokubheka i-eschar (utwayi olumnyama) emlonyeni noma emakhaleni. Ukuba khona kokubomvu kwamehlo, ukuphuma, ukuvuvukala, ukulahlekelwa umbono, ubuhlungu obukhulu ebusweni, nokuba ndikindiki kwendawo kufanele kubangele ukusola kwalesi simo.
• Izindlela zokuthwebula izithombe ezifana ne-CT scan yobuchopho kanye nezono ze-paranasal zisiza ekutholeni isifo sikabhejane-orbital.
• Ukuhlolwa kwe-Histopathological kanye ne-microbiological kwenziwa ukuze kutholakale ukhunta ezicutshini.
• Ukuhlolwa okuncane kwesicubu ukuze kubonakale ukhunta futhi kuhlolwe ukuthi amabala athile akhona kuyisinyathelo esibalulekile ekuxilongweni, ngokuya kokuhlolwa kwe-histopathological kanye ne-microbiological.
• Ukuhlolwa kwamangqamuzana, njengokulandelana kwe-DNA yezifunda ezithile zofuzo, ukuhlaziya ijika elincibilikayo lemikhiqizo ye-PCR, ukusabela okujwayelekile kwe-polymerase chain reaction (PCR), kanye nokuhlaziywa kwe-restriction fragment polymorphism analyses (RFLP), kungasetshenziswa ukuthola i-Mucorales, i-pathogen ebangela isifo sokhunta omnyama. Kodwa-ke, lokhu kuhlola akuvamile ukwenziwa njengoba ukuhlolwa kwe-microscopic ngokuvamile kwanele.

Uma i-mucormycosis ixilongwa, udokotela angase anikeze ukwelashwa okusheshayo kokutheleleka kwefungal emnyama, okuvame ukubandakanya izidakamizwa ze-antifungal ezilawulwa nge-intravenous (IV) noma amaphilisi omlomo. Le mithi ihlose ukuqeda ukhunta, ukuvimbela ukukhula kwayo, nokulawula ukutheleleka. Ezigabeni zokuqala, udokotela angase anikeze imithamo ephezulu emithanjeni kuze kube yilapho ukutheleleka kulawulwa. Uma umuthi onqunyiwe udala imiphumela emibi engakhululekile njengesilungulela noma ubuhlungu besisu, kubalulekile ukwazisa udokotela ukuze akwazi ukulungisa imithi noma umthamo ngendlela efanele.

Yize kunamakhambi ahlukahlukene asekhaya okwelashwa kwesikhunta esimnyama ekhaya, angakusiza kuphela ekudambiseni izimpawu futhi aqinise amasosha omzimba.

Nini ukuvakashela udokotela for black fungal izifo?

Uma izimpawu zingathuthuki noma ziphikelela, kubalulekile ukufuna usizo lwezokwelapha. Udokotela uzohlola futhi aphathe lesi simo, anikeze izidakamizwa ezifanele ze-antibacterial kanye ne-antifungal.

Isiphetho 

Ukuxilongwa kusenesikhathi kanye nokwelashwa kubalulekile ukuze ululame ngempumelelo ku-mucormycosis. Kunengozi yokuthi ukutheleleka kungase kudlulele kwezinye izingxenye zomzimba, futhi ezimweni ezimbi kakhulu, kungaholela ekufeni. Ngakho-ke, kubalulekile ukuphatha i-mucormycosis ngokushesha ukuvimbela noma yiziphi izinkinga. Nakuba i-mucormycosis ingavamile, kufanele iphathwe ngokushesha ngangokunokwenzeka ukuze ugweme ukuthuthukiswa kwezinye izimo ezihambisanayo. Ukuze akhiphe noma yiziphi izimbangela eziyinhloko noma izifo ezengeziwe ezihlobene nesikhunta esimnyama, udokotela uhlola kahle isiguli.

Imibuzo Evame Ukubuzwa

1. Ingabe isifo sesikhunta esimnyama (mucormycosis) siyabulala? 

Isifo sefungal esimnyama, esaziwa nangokuthi i-mucormycosis, isifo esiyingozi esingaba yingozi empilweni uma singelashwa ngesikhathi. Ngakho-ke, uma othile eba nezimpawu ezinjengokuvaleka kwamakhala, imfiva, noma izimpawu ezinjengomkhuhlane, kubalulekile ukufuna usizo lwezokwelapha.

2. Kuthatha isikhathi esingakanani ukwelashwa kwe-mucormycosis? 

Ngokusekelwe ezifundweni zamanje kanye nokubhekwa, kuthathe isiguli izinsuku ezingu-102 ukuthi silulame ku-mucormycosis eyinhloko kanye nezinsuku ezingu-33 kusukela ku-refractory mucormycosis.

3. Ingabe isikhunta esimnyama singakugulisa? 

Ukhunta olumnyama ngokuvamile alunangozi, kodwa lungabangela ukugula okubi kakhulu kubantu abanamasosha omzimba abuthakathaka noma ezinye izimo zezokwelapha ezifana nesifo sikashukela, i-HIV, noma i-AIDS.

4. Imuphi umuthi ongcono kakhulu wesikhunta esimnyama? 

Odokotela ngokuvamile banikeza imithi ye-antifungal, kanye neminye imigomo, ukwelapha ukhunta olumnyama. Ukwengeza, kukhona amakhambi athile asekhaya angasiza iziguli zizizwe zingcono.

5. Kwenzekani uma ngishiya ukhunta omnyama lungelashwa? 

Uma singelashwa, lesi simo singaba sibi kakhulu futhi singabangela nokufa kwesiguli. Ngakho-ke, kuhle ukuthi uthintane nodokotela ukuze uthole ukwelashwa okufanele nokululama.

CARE Medical Team

51