Ehrlichiosis

I-Ehrlichiosis sisifo esosulelwa kukulunywa kwekhakana.

I-Ehrlichiosis ibangelwa ziintsholongwane ezizezosapho ekuthiwa zii rickettsiae. Iibhaktheriya ze-Rickettsial zibangela izifo ezinobungozi emhlabeni jikelele, kubandakanywa i-Rocky Mountain spotted fever kunye ne-typhus. Zonke ezi zifo zisasazeka ebantwini ngorhatya, intakumba okanye ukulunywa zintwala.

Oososayensi baqala ukuyichaza i-ehrlichiosis ngo-1990. Zimbini iintlobo zesifo e-United States:

• I-ehrlichiosis yomntu monocytic (HME) ibangelwa yintsholongwane ye-rickettsial I-Ehrlichia chaffeensis.
• I-granulocytic ehrlichiosis (HGE) ikwabizwa ngokuba yi-granulocytic anaplasmosis (HGA). Kubangelwa yintsholongwane ye-rickettsial ebizwa Anaplasma phagocytophilum.

Iibhaktheriya ze-Ehrlichia zinokuqhutywa yile:

• Inja yaseMelika ikhathaza
• Ikhonkco lexhama (Ixodes scapularis), ezinokubangela nesifo seLyme
• Lone Star uphawu

E-United States, i-HME ifumaneka ikakhulu kumazantsi asembindini nakumazantsi mpuma. I-HGE ifumaneka ikakhulu kwi-Northeast nakwi-Midwest ephezulu.

Imiba yomngcipheko we-ehrlichiosis ibandakanya:

• Ukuhlala kufutshane nendawo enamakhalane amaninzi
• Ukuba nesilo-qabane esinokuzisa uphawu ekhaya
• Ukuhamba okanye ukudlala kwingca ephezulu

Ixesha lokufukama phakathi kokulunywa ngamakhalane naxa iimpawu zisenzeka zimalunga neentsuku ezisi-7 ukuya kwezi-14.

Iimpawu zinokubonakala ngathi ngumkhuhlane (umkhuhlane), kwaye zinokubandakanya:

• Umkhuhlane kunye nokubanda
• Intloko ebuhlungu
• Ubuhlungu bemisipha
• Isicaphucaphu

Ezinye iimpawu ezinokubakho:

• Urhudo
• Iindawo ezinobungakanani obuphakathi kwentloko yokuphuma kwegazi esikhumbeni (petechial rash)
• Irhashalala elibomvu (maculopapular rash), engaqhelekanga
• Imvakalelo yokugula ngokubanzi (malaise)

Irhashalala livela ngaphantsi kwesinye kwisithathu samatyala. Ngamanye amaxesha, esi sifo sinokuphosakela ngenxa yomkhuhlane obonakalayo weRocky Mountain, ukuba irhashalala ikhona. Iimpawu zihlala ziphakathi, kodwa abantu ngamanye amaxesha bayagula ngokwaneleyo ukuba babone umboneleli wezempilo.

Umboneleli uya kwenza uvavanyo lomzimba kwaye ajonge iimpawu zakho ezibalulekileyo, kubandakanya:

• Ifuthe legazi
• Inqanaba lentliziyo
• Ubushushu

Olunye uvavanyo lubandakanya:

• Gcwalisa ubalo lwegazi (CBC)
• Ibala leGranulocyte
• Uvavanyo oluchanekileyo lwe-anti-fluorescent antibody
• Uvavanyo lwempendulo yePolymerase (PCR) yesampulu yegazi

Antibiotics (tetracycline okanye doxycycline) zisetyenziselwa ukunyanga esi sifo. Abantwana akufuneki bathathe i-tetracycline ngomlomo de kube sele ekhule onke amazinyo abo, kuba inokutshintsha umphelo umbala wamazinyo akhulayo. I-Doxycycline esetyenziselwa iiveki ezi-2 okanye ngaphantsi ihlala ingalahli amazinyo omntwana ngokusisigxina. IRifampin ikwasetyenzisiwe kubantu abangakwaziyo ukuyinyamezela i-doxycycline.

I-Ehrlichiosis ayifane ibulale. Ngee-antibiotics, abantu bahlala bephucula ngaphakathi kweeyure ezingama-24 ukuya kuma-48. Ukuchacha kungathabatha iiveki ezi-3.

Ukunganyangwa, olu sulelo lunokukhokelela ku:

• Coma
• Ukufa (kunqabile)
• Umonakalo wezintso
• Umonakalo wemiphunga
• Omnye umonakalo kumalungu
• Ukuhlutha

Kwiimeko ezinqabileyo, i-tick bite ingakhokelela ekusulelekeni okungaphezulu kwesinye (ukusuleleka kwintsholongwane). Kungenxa yokuba amakhalane anokuthwala ngaphezu kohlobo olunye lwento ephilayo. Izifo ezimbini zezi:

• Isifo seLyme
• I-Babesiosis, isifo esisifunxayo esifana nesifo seengcongconi

Biza umboneleli wakho ukuba uyagula emva kokulunywa ngamakhalane kutshanje okanye ubukhe kwiindawo apho amakhalane aqhelekile. Qiniseka ukuba uxelela umboneleli wakho malunga nokuvezwa kwekhalane.

I-Ehrlichiosis isasazeka ngokulunywa ngamakhalane. Kufuneka kuthathwe amanyathelo okuthintela ukulunywa ngamakhalane, kubandakanya:

• Nxiba iibhulukhwe ezinde nemikhono emide xa uhamba ngebrashi enzima, ingca ende, kunye nemimandla eshinyeneyo.
• Tsala iikawusi zakho ngaphaya kwebhulukhwe ukunqanda amakhalane ukuba angarhubuluzi unyuse umlenze wakho.
• Gcina ihempe yakho ibotshwe kwiibhulukhwe zakho.
• Nxiba iimpahla ezinemibala ekhanyayo ukuze amakhalane abonakale ngokulula.
• Tshiza impahla yakho ngezinto ezigxotha izinambuzane.
• Jonga iimpahla zakho kunye nesikhumba rhoqo ehlathini.

Emva kokubuyela ekhaya:

• Susa iimpahla zakho. Jonga ngokusondeleyo yonke indawo yolusu, kubandakanya ne-scalp. Amakhalane anokunyuka ngokukhawuleza emzimbeni.
• Amanye amakhalane makhulu kwaye kulula ukuwafumana. Olunye uhlobo lwamakhalane lunokuba luncinci, jonga ngononophelo kuwo onke amabala amnyama okanye emdaka eluswini.
• Ukuba kuyenzeka, cela umntu akuncedise ekuhloleni amakhalane emzimbeni wakho.
• Umntu omdala kufuneka ahlolisise abantwana ngenyameko.

Uphononongo lubonisa ukuba uphawu kufuneka lunamathele emzimbeni wakho kangangeeyure ezingama-24 ukudala isifo. Ukususwa kwangoko kunokuthintela usulelo.

Ukuba ulunywe likhalane, bhala phantsi umhla kunye nexesha elilunywe ngalo. Zisa olu lwazi, kunye nokukhathaza (ukuba kunokwenzeka), kumboneleli wakho ukuba uyagula.

Umntu monocytic ehrlichiosis; HME; I-ehrlichiosis yegranulocytic yomntu; HGE; I-granulocytic anaplasmosis; HGA

• Ehrlichiosis
• Iintsholongwane

UDumler JS, Walker DH. I-Ehrlichia chaffeensis (umntu monocytotropic ehrlichiosis), Anaplasma phagocytophilum (i-granulocytotropic anaplasmosis), kunye nezinye i-anaplasmataceae. Ku: Bennett JE, Dolin R, Blaser MJ, ii-eds. Mandell, Douglas, kunye neBennett's Principles and Practice of Infectious Diseases. Umhla we-9. IPhiladelphia, PA: Elsevier; 2020: isahluko 192.

I-Fournier PE, uRaoult D. Rickettsial usulelo. Ku: IGoldman L, iSchafer AI, ii-eds. Amayeza eGoldman-Cecil. Ngomhla wama-26. IPhiladelphia, PA: Elsevier; 2020: isahl 311.