I-Leptospirosis yisifo i-World Health Organisation esifake esigabeni sezifo eziyingozi ze-zooanthropose. Cishe uhhafu wezilwane ezigulayo nengxenye eyodwa kwezintathu zabantu abanegciwane ziyafa ngenxa yayo.
I-Leptospirosis ezinjeni kwenzeka kaningi kunezinye izilwane ezifuywayo. Kuholela ekungasebenzi kahle kwezinhlelo eziningi zomzimba, ikakhulukazi imithambo yegazi, isibindi, izinso. Ngisho nangesikhathi esifanele, ukwelashwa okusebenzayo akuqinisekisi umphumela ophumelelayo.
Incazelo kanye nezici zesifo
Izilwane eziningi ezincelisayo zingagula nge-leptospirosis futhi zithwale ukutheleleka. Amagundane namagundane ayingozi ikakhulukazi kulokhu. Lapho sebethelelekile, baba ukusakazeka kwalesi sifo impilo yabo yonke. Umuntu utheleleka ngokudla, ngenxa yokuxhumana nezinja ezigulayo noma ezisanda kutholwa.
Ngemuva kokungena kuma-tubules we-renal epithelial, ukwahlukaniswa kwamaseli wegciwane kukhulu kakhulu. Ngenxa yokutheleleka, kufa amaseli abomvu egazi, i-anemia iqala. I-pigment bilirubin iyanqwabelana - lesi sifo siqeda amaseli wesibindi, singene esigabeni se-icteric. Isilwane esingazitholi izidakamizwa zokulwa nalesi sifo siyafa ngenxa yokwehluleka ukusebenza kwezinso.
I-Etiology
Ama-causative agents we-leptospirosis akhonjwa futhi achazwa ososayensi bezinto eziphilayo baseJapan ngo-1914. Ekuqaleni, babekwa njengama-spirochetes; ngemuva konyaka, ekilasini lama-spirochetes, umndeni wabo ozimele uLeptospiraceae nohlobo lweLeptospira bakhonjwa bona.
Amagciwane we-Pathogenic anomzimba omude, osontekile waba ngumoya. Imikhawulo yomzimba ivame ukugogeka njengohlamvu "C". Ubude bububanzi obungu-6-20 µm, ubukhulu bungu-0.1 µm. Ukuhamba okuphezulu nosayizi omncane kakhulu kunomthelela ekusakazekeni okusheshayo kuwo wonke umzimba ngemuva kokutheleleka.
Kunezinhlobo eziningi zamagciwane e-Leptospira. Akuzona zonke eziyingozi ezilwaneni nakubantu. Kwesinye isikhathi i-leptospira iziphatha ngobuqili: ayephuli impilo yabathwali babo, kepha lapho bengena emzimbeni wesinye isilwane noma umuntu, babonisa ingqikithi yabo ye-pathogenic.
Izifo ezinjeni zibangelwa izinhlobo ezimbili: iLeptospira Icterohaemorrhagiae neLeptospira canicolau. Amagciwane ahlala esebenza lapho engena endaweni yangaphandle. Emachibini, emadanyini, emhlabathini omanzi, angaba khona izinyanga ezimbalwa.
Imvamisa, inja ingangenwa yi-leptospirosis ngemuva kokuphuza noma ukubhukuda echibini elinegciwane.
Izinduku yizona eziphethe kakhulu izinhlobo zeLeptospira Icterohaemorrhagiae. Inja ingatheleleka ngokuthintana namanzi aqukethe umchamo wamagundane, noma ngqo ngamagundane athathiwe namagundane. I-Leptospirosis ebangelwa yilezi zinhlobo zamagciwane cishe iqinisekisiwe ukuthi iholele kwi-jaundice.
Izimpawu ze-leptospirosis enjeni ukuthuthuka kancane kancane. Izinga lokushisa lesilwane liyakhuphuka. Inja iphuza njalo futhi ichama kaningi. Izilonda zingavela emlonyeni wakhe, olimini lwakhe. Uhudo luqala ngegazi nokuhlanza, i-jaundice izibonakalisa. Inja iziphatha ngokudabukisayo, kuyabonakala ukuthi ihlupheka ngobuhlungu bangaphakathi.
I-Leptospirosis ebangelwa ukuhlukahluka kwe-Leptospira canicolau iyahluka kokwehluka kokuqala enkambweni ebucayi, ngokungabikho noma ubuthakathaka be-jaundice. Imvamisa, ukuhlasela kwamagciwane kwenzeka ngomchamo wezinja ezigulayo noma ezisanda kutholwa.
Imithombo yokutheleleka
Izinja ezinempilo zingatheleleka nge-leptospirosis ngokuphuza amanzi emadamini, zicoshe ukudla phansi. Ukuxhumana nezinto lapho izilwane ezigulayo zishiye amathe noma umchamo kungaholela emiphumeleni emibi. Ukubhukuda emachibini nasemachibini kusongela ukufuduka kweLeptospira kusuka emanzini kuya emzimbeni wenja. Izilwane zezilwane azikushiyi ngaphandle amathuba okutheleleka ngokulunywa kwamazeze nemikhaza.
Ukutheleleka kungena ngezilonda ezinamafinyila ezilimele, izilonda zanoma imuphi umzimba emzimbeni noma emgodini wamathumbu. Ukudluliswa ngokocansi kanye nokutheleleka ngohlelo lokuphefumula akubekelwa eceleni. Kukhona imigomo yokulwa ne-canine leptospirosis, kepha akuvimbeli ngokuphelele ukuthi kungenzeka kuhlaselwe.
Izinja ezinamasosha omzimba angakhubazekile maningi amathuba okuthi zigule uma zigcinwa ziminyene, zingahlanzekile. Imvamisa izilwane ezinhlanhlathayo, ezingondlekile, ezithintana namagundane ziyatheleleka. Izinja zasemakhaya zinamathuba amaningi okuthi zigule kunezinja zasemadolobheni.
Ukutheleleka kuqukethe izigaba ezi-2: i-bacteremic futhi inobuthi. Esigabeni sokuqala, i-leptospira ingena egazini, yande futhi isakaze kulo lonke uhlelo lokujikeleza kwegazi, ingene esibindini, ezinso nakwezinye izitho zomzimba.
Ukuqala kwesigaba sesibili kuboniswa yi-lysis (ukubola) kwe-leptospira ngokwakhiwa kwama-endotoxin. Okubhekiswe kakhulu kubuthi ngamangqamuzana e-vascular epithelial. Ngenxa yalokho, ubuqotho bama-capillaries buyaphulwa. Ukopha kwasendaweni kuqala, isici se-leptospirosis.
Ubuthi obukhishwe yi-leptospira bucekela phansi izitsha ezincane zezitho zangaphakathi. Amasayithi we-necrosis avela ezinso, ukuwohloka okunamafutha kuqala esibindini, futhi ukuphuma kwegazi kwenzeka ebuchosheni. Kuvela izimpawu ze-jaundice.
Ulwelwesi lomlomo nolamehlo luphuzi lubonisa ukutheleleka nge-leptospirosis
Cishe isonto ngemuva kokutheleleka, inja egulayo enomchamo namathe iqala ukusabalalisa i-leptospira, iba umthombo wokutheleleka. Ukuhlukaniswa kwamagciwane e-pathogenic kungahlala amasonto ambalwa noma iminyaka eminingana isilwane selulame ngokuphelele. Ngakho-ke, inja idinga ukuhlala yodwa.
Lapho unakekela imidlwane nezinja ezinegciwane, kufanele uthathe izinyathelo zokuqapha: sebenzisa amagilavu, uvikele amagciwane ezintweni, amathuluzi lapho igazi lingase lithole khona, izimfihlo zenja. Umnikazi wesilwane kumele aqaphe isimo sakhe. Uma uzizwa ungaphilile, xhumana nodokotela.
Izimpawu nezimpawu zesifo
Ukwehla komsebenzi, ukukhathala, ukuncipha kwesifiso - owokuqala izimpawu ze-leptospirosis ezinjeni... Uma lokhu kulandelwa ukoma okungalawuleki, ukuphefumula okwandayo, ukukhuphuka kwezinga lokushisa - udinga ukuxhumana nodokotela wezilwane.
Ngemuva kwezinsuku ezingu-2-5, i-leptospirosis ikhombisa izimpawu zayo ezithile: umkhuhlane, isifo sohudo nokuhlanza kwegazi. Kungezwe kubo i-necrosis yezindawo zolwelwesi lwamafinyila, ukuchama kaningi, ukuvela kwezilonda emlonyeni wenja.
Kunezimpawu eziningi ze-leptospirosis, hhayi zonke ezingaba khona kumuntu othile ogulayo. Kwezinye izimo, izimpawu zicashile. Ukuhlolwa ngudokotela wezilwane, ukuhlolwa kwelabhorethri kunganikeza impendulo ngokuqala kwenqubo yokutheleleka.
I-Leptospirosis ingakhula ngokuya ngezimo ezimbalwa:
- kufihliwe,
- okungapheli,
- okubukhali.
Ngesimo esifihliwe, esifihlekile sesifo, izinga lokushisa lenyuka kancane. Umsebenzi wenja uyancipha, inkanuko iba yimbi. Ngemuva kwezinsuku ezingu-2-3, izimpawu ziyanyamalala. Inja ibukeka iphilile. Kepha izivivinyo zaselebhu zokutholakala kwamagciwane e-Leptospira ziyadingeka ekwelashweni ngama-antibiotic.
Kuyaqabukela, lesi sifo sithathe isimo sokuvilapha, nesingelapheki. Izimpawu zayo ukukhuphuka okuncane kokushisa, ukwanda kwama-lymph node ku-groin nangaphansi komhlathi. Umchamo uphenduka ube mnyama ophuzi, onsundu. Ijazi ngemuva lingahle linciphe. Inja iba namahloni, ayikubekezeleli ukukhanyisa okukhanyayo. Inzalo yesilwane esinje izalwa ifile.
Izinja ezincane zivame ukugula kakhulu. Kuyacaca ekuziphatheni kwenja ukuthi inobuhlungu obukhulu. Izinga lokushisa likhuphukela ku-41.5 ° C. Umchamo uba mnyama, isifo sohudo siqala ngokuba khona kwegazi. Izindawo ezinamafinyila ziphuzi. Kwezinye izimo, lesi sifo sikhula ngokushesha okukhulu, i-denouement kungenzeka ezinsukwini ezingama-2-3.
Izimo zeLatent, ezingamahlalakhona, ezibukhali zokuthuthukiswa kwesifo zingaba ngezinhlobo ezimbili: i-hemorrhagic (ukopha, i-anicteric) ne-icteric. Izinhlobonhlobo zinezici eziningi ezifanayo, kepha ziyafana nezinja zemikhakha yobudala obuhlukile.
Ifomu le-hemorrhagic leptospirosis
Kubonakala ngokuphuma kolwelwesi lwamafinyila lwangaphandle nangaphakathi. Lokhu kungenxa yomphumela wama-endotoxin ezindongeni zemikhumbi emincane. Cishe uhhafu wezilwane eziphethwe i-leptospirosis eyophayo ingafa. Umphumela uncike ekutholakaleni nasekuthuthukisweni kwezifo ezihambisanayo kanye namandla okuqhubeka kwesifo. Ifomu libukhali, mancane amathuba okuthi alulame.
Kwezinye izimo, izimpawu zithatha uhlamvu "olufiphele": isifo kancane kancane siphenduka isimo sokuvilapha. Inja ihlala ingasebenzi, izimpawu ezithile ze-leptospirosis ziyancipha. Ngemuva kwezinsuku ezimbalwa noma amasonto, izimpawu zokutheleleka zizobuya. Lesi sifo siqhubeka ngamagagasi.
Cishe ngosuku lwesithathu, ulwelwesi lwamafinyila luqala ukopha, kufaka phakathi nezitho zangaphakathi. Lokhu kungabonakala ngokuba khona kwamahlule egazini lapho kukhishwa inja. Izinga lokushisa lingaphupha, isifo sohudo sithathelwe indawo ukuqunjelwa. Isimo esijwayelekile sesilwane siba sibi. Inja ifa ingalashwa.
Uhlobo lwe-Icteric lwe-leptospirosis
Izilwane ezisencane zithinteka kakhulu kuleli fomu. I-Leptospirosis yezinja esithombeni, ngalokhu kuthuthuka kwemicimbi, ihlukaniswa ukungcola kwezindawo ezinamafinyila nezesikhumba ngemithunzi ephuzi. Lokho akusho ukuthi akunakwenzeka ukubonakaliswa kokopha. I-hemorrhage ne-jaundice kungahlangana.
Ngaphezu kokwanda kwe-bilirubin egazini, kune-edema yezicubu zesibindi, ukuwohloka nokufa kwe-parenchyma, kanye nokubhujiswa kwama-erythrocyte. I-jaundice enamandla ayiholeli njalo ekungasebenzi kahle kwe-hepatic. Ukwehluleka okukhulu kwezinso kwenzeka kaningi.
Ukuxilongwa
I-Anamnesis, izimpawu zenza sikwazi ukuxilonga ngokuzethemba. Kepha ucwaningo lwelabhoratri ludlala indima enkulu. Indlela esetshenziswa kakhulu ukuhlaziywa kwe-serological. Ngosizo lwalesi sifundo, zonke izinhlobo ze-leptospira ye-pathogenic ziyabonakala.
Ngaphandle kwezindlela zendabuko, zesimanje ukuhlaziywa kwe-leptospirosis ezinjeni kufaka izivivinyo ezi-2:
- i-fluorescence antibody ne-antigen yokuhlola,
- ukusabela kwe-polymerase chain (ukukhulisa ama-molecule e-DNA).
Lezi zindlela zingasetshenziswa ukuhlola umchamo wesilwane esigulayo kanye namasampuli wezicubu. Lapho uthatha amasampuli futhi uhlaziya, iqiniso kufanele licatshangwe ukuthi kusukela lapho kuqala lesi sifo, kuze kube ukuvela kwe-leptospira emchameni, kudlula izinsuku ezimbalwa. Amasampula wezicubu ze-Biopsy angumthombo othembekile wolwazi.
Ukusabela kwamaketanga e-Polymerase kuyindlela entsha yokubuyabuyelela (ukukhulisa) kwama-molecule e-DNA, okuvumela ukuthi ukhombe ngokuzethemba umenzeli wesifo. Ukuzwela kokuhlolwa kungaholela kuma-alamu angamanga lapho amasampuli athathwe ukuze ahlaziywe angcoliswe. Le ndlela yintsha impela, ayifakwanga njalo emkhakheni wokuhlonza imitholampilo yezilwane.
Ukwelashwa
Ngisho kuqale ngesikhathi ukwelashwa kwe-leptospirosis ezinjeni akuqinisekisi umphumela omuhle. Ezinye izilwane zelashwa ngokuphelele, ezinye ziyafa, kanti ezinye zingase zihlupheke impilo yazo yonke ngenxa yemiphumela yokutheleleka.
Ukwelashwa kwe-Leptospirosis kuxazulula izinkinga ezimbalwa:
- ukuqedwa kwama-causative agents of infection Leptospira emzimbeni;
- Ukujwayeleka kokusebenza komzimba wesilwane, kufaka phakathi ukususwa kwezimpawu zokudakwa;
- ukwandisa amandla omzimba wesilwane.
Ngokushesha ngemuva kokuqinisekisa ukuxilongwa, ukukhishwa komzimba emzimbeni kuqala ukuze kuhlanzwe amagciwane nobuthi obukhiqizwe yibo. Inkambo yokwelashwa eyisisekelo yimithi elwa namagciwane. Kusheshisa ukwelashwa kwesifo sesibindi nezinso futhi kunciphisa uketshezi lomchamo.
Ama-antibiotic asusa amabhaktheriya ezinso. Ngemuva kwalokho i-leptospira iyeka ukusabalala emchameni. Ngaphezu kwalokho, ukwelashwa okuyinkimbinkimbi kusetshenziselwa ukubuyisela ukusebenza kwesibindi, izinso, imithambo yegazi, inhliziyo: i-hepatoprotectors, amavithamini, ukudla, izikhuthazi zenhliziyo.
Kunzima ngokwedlulele ukufeza ikhambi eliphelele le-leptospirosis yenja.
Ukuvimbela
Izindlela zokuvimbela zizosiza ekulweni hhayi ne-leptospira kuphela, kepha futhi nokulwa nezifo eziningi zezifo ezithathelwanayo:
- Ukugoma ngesikhathi esifanele nokugoma izinja.
- Ukulawulwa kwamagundane.
- Ukuhlanzeka kwezindawo lapho kugcinwa khona izinja, ikakhulukazi ezindaweni zokukhosela amakati nezinja ezilahlekile.
Izinja nemidlwane zingachitha amabhaktheriya e-pathogenic izinyanga eziningi ngemuva kokululama. Abanikazi bezinja ezinezifo kufanele balibheke leli qiniso bese behlukanisa abafundi babo kuze kube yilapho izivivinyo zikhombisa ukungabikho kwe-leptospira.
