Ehrlichiosis

Ehrlichiosis yog ib tug mob los ntawm kev zuam los ntawm zuam.

Ehrlichiosis tshwm sim los ntawm cov kab mob uas yog tsev neeg hu ua rickettsiae. Cov kab mob Rickettsial ua rau ntau tus mob loj thoob plaws ntiaj teb, suav nrog Rocky Mountain pom pom muaj kub taub hau thiab mob qog. Txhua tus kabmob no kis tau rau tibneeg tau yog zuam, dev mub, lossis mite tom.

Thawj cov kws tshawb fawb tau piav qhia txog ehrlichiosis hauv xyoo 1990. Muaj ob hom kab mob ntawm Tebchaws Meskas:

• Tib neeg monocytic ehrlichiosis (HME) yog tshwm sim los ntawm tus kab mob rickettsial Ehrlichia chaffeensis.
• Tib neeg granulocytic ehrlichiosis (HGE) tseem hu ua tib neeg granulocytic anaplasmosis (HGA). Nws tshwm sim los ntawm tus kab mob rickettsial hu ua Anaplasma phagocytophilum.

Cov kab mob Ehrlichia tuaj yeem nqa los ntawm:

• Miskas zuam
• Mos Zes (Ixodes scapularis), uas tuaj yeem ua rau mob Lyme
• Lub Hnub Qub Zuam

Hauv Tebchaws Meskas, HME feem ntau pom nyob rau yav qab teb nruab nrab xeev thiab sab qab teb hnub tuaj. HGE pom pom dav nyob rau Northeast thiab qaum Midwest.

Cov teeb meem pheej hmoo rau tus mob ehrlichiosis suav nrog:

• Nyob ze rau thaj chaw uas muaj zuam ntau
• Muaj ib tug tsiaj uas tuaj yeem coj tus zuam los tsev
• Taug kev lossis ua si hauv nyom siab

Lub sij hawm ncu ntawm tus zuam tom thiab thaum tus tsos mob tshwm sim yog li 7 txog 14 hnub.

Cov tsos mob yuav zoo li ua npaws (khaub thuas), thiab tej zaum yuav suav nrog:

• Ua npaws thiab ua daus no
• Mob taub hau
• Mob ib ce
• Xeev siab

Lwm qhov tsos mob tshwm sim:

• Zawv plab
• Zoo qhov chaw ntawm lub taub hau los ntshav rau hauv daim tawv nqaij (ua pob ua paug)
• Tiaj liab plog liab (maculopapular tawm pob), uas tsis muaj qhov tshwj xeeb
• Hnov mob siab (malaise)

Cov pob yuav tshwm tsawg dua li ib feem peb ntawm cov neeg mob. Qee zaum, tus mob yuav yuam kev rau Mob Rocky Mountain pom qhov kub taub hau, yog tias pom pob khaus. Cov tsos mob feem ntau mob sib khuav, tab sis qee zaus qee tus neeg muaj mob txaus mus ntsib kws kho mob.

Tus kws khomob yuav kuaj ib ce thiab kuaj koj lub cim, uas suav nrog:

• Ua ntshav siab
• Lub plawv dhia
• Ntsig Kub

Lwm yam kev ntsuam xyuas suav nrog:

• Ua kom tiav cov ntshav suav (CBC)
• Granulocyte stain
• Indirect fluorescent antibody kuaj
• Polymerase saw cov tshuaj tiv thaiv (PCR) kuaj cov ntshav ua qauv

Tshuaj tua kab mob (tetracycline lossis doxycycline) yog siv los kho tus mob. Cov menyuam yaus yuav tsum tsis txhob noj tshuaj tetracycline los ntawm qhov ncauj kom txog thaum tag nrho lawv cov hniav tas mus li, vim nws tuaj yeem hloov pauv xim ntawm cov hniav uas loj tuaj. Doxycycline uas siv rau 2 lub lis piam los yog tsawg dua feem ntau tsis cais me nyuam cov hniav tas mus li. Rifampin kuj tseem tau siv rau hauv cov neeg uas tsis tuaj yeem tiv thaiv doxycycline.

Ehrlichiosis tsis tshua muaj neeg tuag taus. Nrog cov tshuaj tua kab mob, cov neeg feem ntau txhim kho hauv 24 txog 48 teev. Cov nyiaj rov qab los yuav siv sijhawm ntev txog 3 asthiv.

Yog tsis kho, tus kab mob no yuav ua rau:

• Coma
• Tuag (tsawg)
• Raum puas
• Lub ntsws ua kev puas tsuaj
• Lwm yam khoom hauv nruab nrog cev puas tsuaj
• Qaug

Muaj qee zaus, zuam tom tau tuaj yeem ua rau ntau tshaj ib qhov mob (kis sib kis). Qhov no vim tias zuam tuaj yeem nqa ntau dua ib hom kev muaj sia. Ob yam mob li no yog:

• Lyme kab mob
• Babesiosis, mob cab uas zoo ib yam li malaria

Hu rau koj tus kws kho mob yog tias koj muaj mob tom qab zuam tom tas los yog koj tau nyob rau thaj chaw uas muaj zuam ntau. Nco ntsoov qhia koj tus kws kho mob txog kev zuam.

Ehrlichiosis kis tau los ntawm zuam tom. Kev ntsuas yuav tsum tau ua los tiv thaiv tus zuam tom, nrog rau:

• Hnav ris ntev thiab tsho ntev thaum taug kev los ntawm kev txhuam hnyav, nyom siab, thiab thaj chaw tuab.
• Rub koj lub thom khwm mus rau sab nraud ris kom tiv thaiv zuam tawm ntawm koj sab ceg.
• Khaws koj lub tsho mus ua koj lub ris.
• Hnav cov khaub ncaws uas pom xim kom cov zuam tawm tau yooj yim.
• Txau koj cov khaub ncaws nrog tshuaj pleev cov tshuaj.
• Xyuas koj cov khaub ncaws thiab tawv nqaij ntau zaus thaum nyob hauv hav zoov.

Tom qab rov qab mus tsev:

• Hle koj cov khaub ncaws. Saib kom zoo ntawm txhua daim tawv nqaij, suav nrog tawv taub hau. Cov zuam tuaj yeem nce ceev kom ntev ntawm lub cev.
• Qee tus zuam loj dua thiab yooj yim rau thaj chaw. Lwm cov zuam tuaj yeem yog qhov me me, yog li ua tib zoo saib ntawm txhua daim tawv dub lossis xim av ntawm daim tawv nqaij.
• Yog tias ua tau, thov ib tus neeg tuaj pab koj kuaj koj lub cev rau zuam tom.
• Ib tus neeg laus yuav tsum kuaj nws cov menyuam kom zoo.

Kev tshawb fawb qhia tias ib tus zuam yuav tsum txuas nrog koj lub cev li 24 teev kom muaj mob. Kev tshem tawm ntxov yuav tiv thaiv tus kab mob.

Yog tias koj zuam tom tau tus zuam lawm, sau hnub thiab lub sij hawm uas raug tom ntawd. Nqa cov ntaub ntawv no, nrog tus zuam (yog tias ua tau), rau koj tus kws kho mob yog tias koj mob.

Tib neeg monocytic ehrlichiosis; HME; Tib neeg granulocytic ehrlichiosis; HGE; Tib neeg granulocytic anaplasmosis; HGA

• Ehrlichiosis
• Tshuaj tua kabmob

Dumler JS, Walker DH. Ehrlichia chaffeensis (tib neeg monocytotropic ehrlichiosis), Anaplasma phagocytophilum (tib neeg granulocytotropic anaplasmosis), thiab lwm yam anaplasmataceae. Hauv: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, thiab Bennett's Cov Ntsiab Cai thiab Kev Coj Ua ntawm Kab Mob KisCov. 9le ed. Philadelphia, PA: Elsevier; 2020: chap 192.

Plaub Leeg PE, Raoult D. Rickettsial tau kab mob. Hauv: Goldman L, Schafer AI, eds. Goldman-Cecil TshuajCov. 26th ed. Philadelphia, PA: Elsevier; 2020: cha 311.