{"id":2281,"date":"2018-11-19T14:07:17","date_gmt":"2018-11-19T14:07:17","guid":{"rendered":"https:\/\/robot.yeupet.vn\/benh-nam-blatomyces-tren-cho-meo\/"},"modified":"2018-11-19T14:07:17","modified_gmt":"2018-11-19T14:07:17","slug":"benh-nam-blatomyces-tren-cho-meo","status":"publish","type":"post","link":"https:\/\/robot.yeupet.vn\/index.php\/2018\/11\/19\/benh-nam-blatomyces-tren-cho-meo\/","title":{"rendered":"B\u1ec7nh N\u1ea5m Blatomyces Tr\u00ean Ch\u00f3 M\u00e8o"},"content":{"rendered":"

1.C\u0103n b\u1ec7nh h\u1ecdc<\/h4>\n

B\u1ec7nh n\u1ea5m blatomyces l\u00e0 b\u1ec7nh nhi\u1ec5m n\u1ea5m to\u00e0n th\u00e2n g\u00e2y ra b\u1edfi n\u1ea5m l\u01b0\u1ee1ng h\u00ecnhBlastomyces dermatitidis<\/em>. Trong t\u1ef1 nhi\u00ean, Blastomyces ph\u00e1t tri\u1ec3n d\u01b0\u1edbi d\u1ea1ng h\u1ec7 s\u1ee3i n\u1ea5m ho\u1ea1i sinh sinh s\u1ea3n h\u1eefu t\u00ednh, s\u1ea3n xu\u1ea5t b\u00e0o t\u1eed l\u00e2y nhi\u1ec5m. \u1ede nhi\u1ec7t \u0111\u1ed9 c\u01a1 th\u1ec3, trong c\u00e1c m\u00f4 sinh v\u1eadt bi\u1ebfn th\u00e0nh d\u1ea1ng n\u1ea5m men v\u00e0 sao ch\u00e9p v\u00f4 t\u00ednh. Ch\u00f3 v\u00e0 ng\u01b0\u1eddi nhi\u1ec5m th\u01b0\u1eddng xuy\u00ean nh\u1ea5t v\u1edbi Blastomyces, nh\u01b0ng m\u00e8o, ng\u1ef1a, s\u01b0 t\u1eed bi\u1ec3n, ch\u00f3 s\u00f3i, ch\u1ed3n, v\u00e0 g\u1ea5u B\u1eafc c\u1ef1c c\u0169ng nh\u01b0 s\u01b0 t\u1eed v\u00e0 h\u1ecd nh\u00e0 m\u00e8o kh\u00f4ng b\u1ecb b\u1eaft gi\u1eef nu\u00f4i trong nh\u00e0 kh\u00e1c nh\u01b0 h\u1ed5, lo\u00e0i b\u00e1o v\u00e0 b\u00e1o tuy\u1ebft \u0111\u00e3 ph\u00e1t tri\u1ec3n b\u1ec7nh blastomycosis trong c\u01a1 th\u1ec3. B\u1ec7nh n\u1ea5m blatomyces \u0111\u00e3 \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh tr\u00ean kh\u1ec9 n\u00e2u.<\/p>\n

\"benh-nam-blatomyces-tren-cho-meo-5\"<\/p>\n

H\u00ecnh 1: D\u1ea1ng s\u1ee3i n\u1ea5m c\u1ee7a Blatomyces<\/p>\n

2. D\u1ecbch t\u1ec5 h\u1ecdc<\/h4>\n

Blastomycosis l\u00e0 b\u1ec7nh ch\u1ee7 y\u1ebfu \u1edf B\u1eafc M\u1ef9, nh\u01b0ng n\u00f3 c\u0169ng \u0111\u00e3 \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh \u1edf ch\u00e2u Phi, \u1ea4n \u0110\u1ed9, Ch\u00e2u \u00c2u, v\u00e0 Trung M\u1ef9.<\/p>\n

S\u1ef1 sinh tr\u01b0\u1edfng c\u1ee7a sinh v\u1eadt trong m\u00f4i tr\u01b0\u1eddng s\u1ed1ng y\u00eau c\u1ea7u ph\u1ea3i c\u00f3 c\u00e1t, \u0111\u1ea5t c\u00f3 t\u00ednh ax\u00edt, v\u00e0 g\u1ea7n n\u01b0\u1edbc. S\u1ed1ng g\u1ea7n k\u00eanh r\u1ea1ch l\u00e0 m\u1ed9t y\u1ebfu t\u1ed1 nguy c\u01a1 cho s\u1ef1 nhi\u1ec5m tr\u00f9ng b\u1ec7nh n\u1ea5m Blastomyces. M\u01b0a hay s\u01b0\u01a1ng d\u00e0y \u0111\u1eb7c xu\u1ea5t hi\u1ec7n t\u1ea1o \u0111i\u1ec1u ki\u1ec7n thu\u1eadn l\u1ee3i cho vi\u1ec7c ph\u00f3ng th\u00edch b\u00e0o t\u1eed nhi\u1ec5m khu\u1ea9n. T\u1ef7 l\u1ec7 ph\u00e2n ph\u1ed1i theo m\u00f9a trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p nh\u01b0 sau: m\u00f9a \u0111\u00f4ng (24%), m\u00f9a xu\u00e2n (18%), m\u00f9a h\u00e8 (36%), v\u00e0 m\u00f9a thu (22%).<\/p>\n

3. Sinh b\u1ec7nh h\u1ecdc<\/h4>\n

Ch\u00f3 d\u01b0\u1eddng nh\u01b0 d\u1ec5 b\u1ecb nhi\u1ec5m tr\u00f9ng h\u01a1n ng\u01b0\u1eddi. M\u00e8o kh\u00f4ng th\u01b0\u1eddng nhi\u1ec5m Blastomyces. B\u1ec7nh kh\u00f4ng li\u00ean quan v\u1ec1 gi\u1ed1ng, tu\u1ed5i t\u00e1c, ho\u1eb7c b\u1ea3n ch\u1ea5t gi\u1edbi t\u00ednh \u0111\u00e3 \u0111\u01b0\u1ee3c c\u00f4ng nh\u1eadn tr\u00ean m\u00e8o. \u1ede ch\u00f3, con \u0111\u1ef1c nhi\u1ec5m th\u01b0\u1eddng xuy\u00ean h\u01a1n so v\u1edbi con c\u00e1i, nh\u1eefng ch\u00f3 gi\u1ed1ng l\u1edbn th\u01b0\u1eddng b\u1ecb nhi\u1ec5m nhi\u1ec1u h\u01a1n ch\u00f3 gi\u1ed1ng nh\u1ecf. T\u1ef7 l\u1ec7 nhi\u1ec5m cao nh\u1ea5t l\u00e0 \u1edf ch\u00f3 2 tu\u1ed5i; h\u1ea7u h\u1ebft c\u00e1c b\u1ec7nh nhi\u1ec5m tr\u00f9ng ph\u00e1t tri\u1ec3n \u1edf ch\u00f3 1-5 tu\u1ed5i.<\/p>\n

Sau khi nhi\u1ec5m tr\u00f9ng Blastomyces ph\u00e1t tri\u1ec3n trong ph\u1ed5i, n\u00f3 ph\u1ed5 bi\u1ebfn kh\u1eafp c\u01a1 th\u1ec3. V\u1ecb tr\u00ed \u0111\u1ecbnh v\u1ecb \u01b0a th\u00edch c\u1ee7a nhi\u1ec5m tr\u00f9ng tr\u00ean ch\u00f3 l\u00e0 da, m\u1eaft, x\u01b0\u01a1ng, h\u1ea1ch b\u1ea1ch huy\u1ebft, m\u00f4 d\u01b0\u1edbi da, l\u1ed7 m\u0169i b\u00ean ngo\u00e0i, n\u00e3o, v\u00e0 tinh ho\u00e0n. V\u1ecb tr\u00ed \u00edt b\u1ecb \u1ea3nh h\u01b0\u1edfng l\u00e0 mi\u1ec7ng, l\u1ed7 m\u0169i, tuy\u1ebfn ti\u1ec1n li\u1ec7t, gan, tuy\u1ebfn v\u00fa, \u00e2m h\u1ed9, v\u00e0 tim.<\/p>\n

4. Ph\u00e1t hi\u1ec7n l\u00e2m s\u00e0ng<\/h4>\n

4.1. Ch\u00f3<\/h4>\n

D\u1ea5u hi\u1ec7u c\u1ee7a b\u1ec7nh th\u01b0\u1eddng xu\u1ea5t hi\u1ec7n trong m\u1ed9t v\u00e0i ng\u00e0y \u0111\u1ebfn m\u1ed9t tu\u1ea7n nh\u01b0ng c\u00f3 th\u1ec3 th\u1ea5y r\u00f5 r\u00e0ng khi l\u00ean \u0111\u1ebfn m\u1ed9t n\u0103m, bao g\u1ed3m: ch\u00e1n \u0103n, s\u1ee5t c\u00e2n, ho, kh\u00f3 th\u1edf, b\u1ec7nh m\u1eaft, qu\u00e8 qu\u1eb7t, ho\u1eb7c t\u1ed5n th\u01b0\u01a1ng da. Kho\u1ea3ng 40% \u0111\u1ebfn 60% s\u1ed1 ch\u00f3 b\u1ecb s\u1ed1t 39,4\u00b0C (103\u00b0F) ho\u1eb7c cao h\u01a1n. \u0110a s\u1ed1 (85%) ch\u00f3 v\u1edbi b\u1ec7nh n\u1ea5m blatomyces c\u00f3 t\u1ed5n th\u01b0\u01a1ng ph\u1ed5i v\u1edbi t\u00ednh \u0111\u1eb7c tr\u01b0ng l\u00e0 kh\u00f4, \u00e2m thanh ph\u1ed5i nghe kh\u00f3 ch\u1ecbu (kh\u00e0n kh\u00e0n).<\/p>\n

\"benh-nam-blatomyces-tren-cho-meo-1\"<\/p>\n

\"benh-nam-blatomyces-tren-cho-meo\"<\/p>\n

H\u00ecnh 2: Sung huy\u1ebft k\u1ebft m\u1ea1c, ch\u1ee9ng sung huy\u1ebft m\u1ed1ng m\u1eaft,<\/p>\n

ph\u1ea3n \u1ee9ng ban \u0111\u1ecf c\u00f3 n\u01b0\u1edbc, v\u00e0 ch\u1ee9ng co \u0111\u1ed3ng t\u1eed<\/p>\n

C\u00f3 \u0111\u1ebfn 40% ch\u00f3 v\u1edbi b\u1ec7nh n\u1ea5m blatomyces c\u00f3 t\u1ed5n th\u01b0\u01a1ng \u1edf m\u1eaft, ph\u1ed5 bi\u1ebfn nh\u1ea5t l\u00e0 vi\u00eam m\u00e0ng b\u1ed3 \u0111\u00e0o: sung huy\u1ebft k\u1ebft m\u1ea1c, ch\u1ee9ng sung huy\u1ebft m\u1ed1ng m\u1eaft, ph\u1ea3n \u1ee9ng ban \u0111\u1ecf c\u00f3 n\u01b0\u1edbc, v\u00e0 ch\u1ee9ng co \u0111\u1ed3ng t\u1eed.<\/p>\n

T\u1ed5n th\u01b0\u01a1ng da, th\u1ea5y trong 20% \u0111\u1ebfn 50% c\u1ee7a ch\u00f3 v\u1edbi b\u1ec7nh: lo\u00e9t h\u1ec7 th\u1ed1ng d\u1eabn l\u01b0u c\u1ee7a ch\u1ea5t l\u1ecfng c\u00f3 m\u1ee7 ho\u1eb7c huy\u1ebft thanh-m\u00e1u. T\u1ed5n th\u01b0\u01a1ng da c\u00f3 th\u1ec3 l\u00e0 th\u1ea5y b\u1ea5t c\u1ee9 n\u01a1i \u0111\u00e2u, m\u1eb7t ph\u1eb3ng m\u0169i, m\u1eb7t, v\u00e0 m\u00f3ng ch\u00e2n, tay c\u00f3 v\u1ebb l\u00e0 n\u01a1i \u0111\u01b0\u1ee3c \u01b0a th\u00edch h\u01a1n. Vi\u00eam m\u00e0ng b\u1ed3 \u0111\u00e0o c\u00f9ng v\u1edbi d\u1ea5u hi\u1ec7u h\u00f4 h\u1ea5p ho\u1eb7c b\u1ec7nh v\u1ec1 da n\u00ean b\u00e1o cho b\u00e1c s\u0129 r\u1eb1ng m\u1ed9t con v\u1eadt c\u00f3 th\u1ec3 c\u00f3 b\u1ec7nh n\u1ea5m blatomyces.<\/p>\n

\"benh-nam-blatomyces-tren-cho-meo-4\"<\/p>\n

H\u00ecnh 3:T\u1ed5n th\u01b0\u01a1ng da c\u00f3 th\u1ec3 l\u00e0 th\u1ea5y b\u1ea5t c\u1ee9 n\u01a1i \u0111\u00e2u,<\/p>\n

m\u1eb7t ph\u1eb3ng m\u0169i, m\u1eb7t, v\u00e0 m\u00f3ng ch\u00e2n\u2026<\/p>\n

Li\u00ean quan \u0111\u1ebfn x\u01b0\u01a1ng x\u1ea3y ra \u0111\u1ebfn 30% \u1edf ch\u00f3 b\u1ecb nhi\u1ec5m b\u1ec7nh. T\u1eadt \u0111i kh\u1eadp khi\u1ec5ng l\u00e0 d\u1ea5u hi\u1ec7u ch\u00ednh \u1edf \u0111\u1ed9ng v\u1eadt b\u1ecb \u1ea3nh h\u01b0\u1edfng v\u00e0 c\u00f3 th\u1ec3 l\u00e0 d\u1ea5u hi\u1ec7u duy nh\u1ea5t c\u1ee7a b\u1ec7nh.<\/p>\n

\"benh-nam-blatomyces-tren-cho-meo-2\"<\/p>\n

H\u00ecnh 4: T\u1ed5n th\u01b0\u01a1ng th\u01b0\u1eddng li\u00ean quan \u0111\u1ebfn x\u01b0\u01a1ng chi
\nv\u00e0 \u0111\u1eb7c tr\u01b0ng b\u1edfi ti\u00eau x\u01b0\u01a1ng<\/p>\n

4.2. M\u00e8o<\/h4>\n

M\u00e8o b\u1ecb b\u1ec7nh c\u00f3 t\u1ed5n th\u01b0\u01a1ng t\u01b0\u01a1ng t\u1ef1 nh\u01b0 ch\u00f3, nh\u01b0ng qu\u00e1 \u00edt m\u00e8o \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 \u0111\u1ec3 c\u00f3 \u0111\u01b0\u1ee3c s\u1ef1 m\u00f4 t\u1ea3 \u0111\u1eb7c \u0111i\u1ec3m \u0111\u00e1ng tin c\u1eady c\u1ee7a c\u00e1c d\u1ea5u hi\u1ec7u n\u1ed5i b\u1eadt. Ch\u1ee9ng kh\u00f3 th\u1edf, t\u0103ng \u00e2m thanh ph\u1ebf qu\u1ea3n \u2013 ph\u1ebf nang, suy gi\u1ea3m th\u1ecb l\u1ef1c, t\u1ed5n th\u01b0\u01a1ng m\u1ea5t n\u01b0\u1edbc \u1edf da, v\u00e0 gi\u1ea3m c\u00e2n \u0111\u00e3 \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n th\u01b0\u1eddng xuy\u00ean nh\u1ea5t.<\/p>\n

\"benh-nam-blatomyces-tren-cho-meo-3\"<\/p>\n

H\u00ecnh 5: M\u00e8o b\u1ecb b\u1ec7nh n\u1ea5m blatomyces c\u00f3 t\u1ed5n th\u01b0\u01a1ng t\u01b0\u01a1ng t\u1ef1 nh\u01b0 ch\u00f3<\/p>\n

5. Ch\u1ea9n \u0111o\u00e1n<\/h4>\n
    \n
  • H\u00ecnh \u1ea3nh y h\u1ecdc: X-quang v\u00e0 si\u00eau \u00e2m l\u00e0 nh\u1eefng ph\u01b0\u01a1ng ph\u00e1p c\u00f3 gi\u00e1 tr\u1ecb trong vi\u1ec7c ph\u00e1t hi\u1ec7n c\u00e1c t\u1ed5n th\u01b0\u01a1ng do n\u1ea5m \u1edf nhi\u1ec1u c\u01a1 quan.<\/li>\n
  • Ph\u00f2ng th\u00ed nghi\u1ec7m: H\u1ea7u h\u1ebft c\u00e1c ch\u00f3 c\u00f3 t\u0103ng b\u1ea1ch c\u1ea7u v\u1eeba ph\u1ea3i (\u0111\u1ebfm 17.000 \u0111\u1ebfn 30.000 t\u1ebf b\u00e0o m\u00e1u tr\u1eafng tr\u00ean \u00b5l) v\u1edbi m\u1ed9t s\u1ef1 thay \u0111\u1ed5i nh\u1eb9 b\u00ean tr\u00e1i, v\u00e0 gi\u1ea3m lympho b\u00e0o l\u00e0 ph\u1ed5 bi\u1ebfn. Ch\u00fang th\u01b0\u1eddng c\u00f3 globulin huy\u1ebft cao v\u00e0 gi\u1ea3m albumin huy\u1ebft. T\u0103ng calci huy\u1ebft c\u1ee7a b\u1ec7nh u h\u1ea1t (t\u1ed5ng c\u1ed9ng [bao g\u1ed3m c\u1ed9ng v\u1edbi ion h\u00f3a]canxi huy\u1ebft thanh = 12,5-17,5 mg \/ dL), c\u00f3 th\u1ec3 x\u1ea3y ra m\u00e0 kh\u00f4ng c\u00f3 t\u1ed5n th\u01b0\u01a1ng x\u01b0\u01a1ng.<\/li>\n
  • X\u00e1c \u0111\u1ecbnh d\u01b0\u1edbi k\u00ednh hi\u1ec3n vi: ki\u1ec3m tra d\u1ecbch h\u00fat c\u1ee7a c\u00e1c h\u1ea1ch b\u1ea1ch huy\u1ebft m\u1edf r\u1ed9ng v\u00e0 ph\u1ebft k\u00ednh v\u00f9ng \u0111\u1eb7c tr\u01b0ng c\u1ee7a t\u1ed5n th\u01b0\u01a1ng da ho\u1eb7c t\u1ebf b\u00e0o h\u1ecdc c\u1ee7a d\u1ecbch ti\u1ebft tho\u00e1t ra.<\/li>\n
  • Th\u1eed nghi\u1ec7m huy\u1ebft thanh h\u1ecdc: \u0111o c\u00e1c kh\u00e1ng th\u1ec3 trong huy\u1ebft thanh, ho\u1eb7c ph\u00e1t hi\u1ec7n kh\u00e1ng nguy\u00ean trong d\u1ecbch c\u01a1 th\u1ec3 t\u1eeb B. dermatitidis c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 h\u1ed7 tr\u1ee3 trong vi\u1ec7c ch\u1ea9n \u0111o\u00e1n b\u1ec7nh n\u1ea5m blatomyces khi sinh v\u1eadt kh\u00f4ng x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c c\u1ee5 th\u1ec3.<\/li>\n<\/ul>\n

    \u00a0<\/p>\n

    6. \u0110i\u1ec1u tr\u1ecb<\/h4>\n

    Li\u1ec7u ph\u00e1p kh\u00e1ng khu\u1ea9n:<\/h4>\n

    Kh\u00e1ng khu\u1ea9n \u0111\u1ed3ng th\u1eddi hi\u1ebfm khi c\u1ea7n thi\u1ebft.<\/p>\n

    Amphotericin B ( AMB ):<\/h4>\n

    L\u00e0 thu\u1ed1c di\u1ec7t n\u1ea5m c\u00f3 hi\u1ec7u qu\u1ea3, t\u00e1c \u0111\u1ed9ng nhanh ch\u00f3ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb nhi\u1ec5m n\u1ea5m kh\u00e1c nhau, bao g\u1ed3m b\u1ec7nh n\u1ea5m blatomyces. V\u00ec AMB g\u00e2y \u0111\u1ed9c th\u1eadn v\u00e0 ph\u1ea3i \u0111\u01b0\u1ee3c ti\u00eam t\u0129nh m\u1ea1ch, n\u00f3 \u0111\u00e3 \u0111\u01b0\u1ee3c thay th\u1ebf b\u1edfi itraconazole (ITZ), hi\u1ec7u qu\u1ea3 nh\u01b0 nhau v\u00e0 an to\u00e0n h\u01a1n. \u1ede ch\u00f3 m\u00e0 kh\u00f4ng th\u1ec3 h\u1ea5p th\u1ee5 thu\u1ed1c c\u1ea5p qua \u0111\u01b0\u1eddng u\u1ed1ng ho\u1eb7c kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi \u0111i\u1ec1u tr\u1ecb b\u1eb1ng ITZ , AMB c\u00f3 th\u1ec3 l\u00e0 m\u1ed9t lo\u1ea1i thu\u1ed1c duy tr\u00ec s\u1ef1 s\u1ed1ng. AMB deoxycholate n\u00ean \u0111\u01b0\u1ee3c c\u1ea5p v\u1edbi li\u1ec1u 0,5 mg\/kg 2 ng\u00e0y 1 l\u1ea7n. Vi\u1ec7c c\u1ea5p thu\u1ed1c ch\u1eadm trong th\u1eddi gian t\u1eeb 2 \u0111\u1ebfn 3 gi\u1edd l\u00e0 c\u00f3 kh\u1ea3 n\u0103ng l\u00e0m gi\u1ea3m \u0111\u1ed9c t\u00ednh tr\u00ean th\u1eadn. N\u1ed3ng \u0111\u1ed9 ur\u00ea huy\u1ebft c\u1ea7n \u0111\u01b0\u1ee3c theo d\u00f5i ch\u1eb7t ch\u1ebd v\u00e0 ng\u01b0ng AMB khi n\u1ed3ng \u0111\u1ed9 nit\u01a1 ur\u00ea huy\u1ebft ti\u1ebfp c\u1eadn 50 mg\/dL. M\u1ed9t li\u1ec1u t\u00edch l\u0169y t\u1eeb 8 \u0111\u1ebfn 10 mg\/kg l\u00e0 c\u1ea7n thi\u1ebft \u0111\u1ec3 ch\u1eefa b\u1ec7nh n\u1ea5m blatomyces. M\u00e8o n\u00ean \u0111\u01b0\u1ee3c c\u1ea5p kh\u00f4ng qu\u00e1 0,25 mg \/ kg 2 ng\u00e0y 1 l\u1ea7n. Ph\u1ee9c h\u1ee3p lipid \u00edt \u0111\u1ed9c h\u1ea1i khi \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb v\u1edbi ch\u00f3 nhi\u1ec5m tr\u00f9ng n\u1ea5m blatomyces to\u00e0n th\u00e2n.<\/p>\n

    \u00a0<\/p>\n

    Itraconazole v\u00e0 Azoles kh\u00e1c:<\/h4>\n

    Tr\u00ean ch\u00f3: ITZ l\u00e0 m\u1ed9t lo\u1ea1i thu\u1ed1c azole c\u1ee7a nh\u00f3m triazole. So v\u1edbi AMB, ITZ d\u1ec5 cung c\u1ea5p h\u01a1n v\u00e0 c\u00f3 \u00edt t\u00e1c d\u1ee5ng ph\u1ee5 h\u01a1n. V\u00ec ITZ \u0111\u01b0\u1ee3c c\u1ea5p qua \u0111\u01b0\u1eddng mi\u1ec7ng, ch\u00f3 c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb t\u1ea1i nh\u00e0. ITZ kh\u00f4ng \u0111\u01b0\u1ee3c b\u00e0i ti\u1ebft trong n\u01b0\u1edbc ti\u1ec3u, v\u00ec v\u1eady n\u00f3 kh\u00f4ng th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong b\u1ec7nh \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u. Fluconazole (FCZ) \u0111\u01b0\u1ee3c b\u00e0i ti\u1ebft trong n\u01b0\u1edbc ti\u1ec3u v\u00e0 c\u1ea7n \u0111\u01b0\u1ee3c xem x\u00e9t trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p n\u00e0y. S\u1eed d\u1ee5ng d\u1ec5 d\u00e0ng, kh\u1ea3 n\u0103ng gi\u1ea3m \u0111\u1ed9c t\u00ednh, v\u00e0 hi\u1ec7u qu\u1ea3 c\u1ee7a ITZ l\u00e0m cho n\u00f3 l\u00e0 thu\u1ed1c \u0111\u01b0\u1ee3c l\u1ef1a ch\u1ecdn \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh n\u1ea5m blatomyces. Nh\u01b0\u1ee3c \u0111i\u1ec3m duy nh\u1ea5t c\u1ee7a \u0111i\u1ec1u tr\u1ecb b\u1eb1ng ITZ l\u00e0 chi ph\u00ed t\u01b0\u01a1ng \u0111\u1ed1i cao c\u1ee7a thu\u1ed1c. \u0110\u1ed1i v\u1edbi ch\u00f3, ITZ n\u00ean \u0111\u01b0\u1ee3c b\u1eaft \u0111\u1ea7u v\u1edbi li\u1ec1u 5 mg\/kg, 12 gi\u1edd\/1 l\u1ea7n trong 5 ng\u00e0y \u0111\u1ec3 t\u1ed1i \u0111a h\u00f3a n\u1ed3ng \u0111\u1ed9 trong m\u00e1u nhanh ch\u00f3ng. Li\u1ec1u d\u00f9ng sau \u0111\u00f3 \u0111\u01b0\u1ee3c gi\u1ea3m xu\u1ed1ng c\u00f2n 5mg\/kg\/ng\u00e0y trong ph\u1ea7n c\u00f2n l\u1ea1i c\u1ee7a \u0111i\u1ec1u tr\u1ecb. \u0110i\u1ec1u tr\u1ecb ITZ n\u00ean \u0111\u01b0\u1ee3c ti\u1ebfp t\u1ee5c trong \u00edt nh\u1ea5t 60 ng\u00e0y v\u00e0 \u00edt nh\u1ea5t 1 th\u00e1ng sau khi t\u1ea5t c\u1ea3 c\u00e1c d\u1ea5u hi\u1ec7u c\u1ee7a b\u1ec7nh c\u00f3 h\u1ed3i ph\u1ee5c.<\/p>\n

    Tr\u00ean m\u00e8o: m\u00e8o b\u1ecb b\u1ec7nh n\u1ea5m blatomyces \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb th\u00e0nh c\u00f4ng v\u1edbi ITZ v\u1edbi li\u1ec1u 5 mg\/kg cho m\u1ed7i 12 gi\u1edd. \u0110\u00e2y l\u00e0 ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb an to\u00e0n, hi\u1ec7u qu\u1ea3 cho h\u1ea7u h\u1ebft m\u00e8o. Ch\u01b0a c\u00f3 nghi\u00ean c\u1ee9u n\u00e0o \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n v\u1ec1 hi\u1ec7u qu\u1ea3 c\u1ee7a li\u1ec1u l\u01b0\u1ee3ng thu\u1ed1c th\u1ea5p h\u01a1n.<\/p>\n

    \u00a0<\/p>\n

    7. C\u00e1c t\u00e1c h\u1ea1i<\/h4>\n

    C\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 ph\u1ed5 bi\u1ebfn nh\u1ea5t c\u1ee7a \u0111i\u1ec1u tr\u1ecb b\u1eb1ng ITZ l\u00e0 ch\u00e1n \u0103n k\u1ebft h\u1ee3p v\u1edbi nhi\u1ec5m \u0111\u1ed9c gan. N\u1ebfu ng\u1ed9 \u0111\u1ed9c x\u1ea3y ra, thu\u1ed1c ph\u1ea3i \u0111\u01b0\u1ee3c d\u1eebng l\u1ea1i cho \u0111\u1ebfn khi ch\u00f3 th\u00e8m \u0103n tr\u1edf l\u1ea1i v\u00e0 c\u00e1c ho\u1ea1t \u0111\u1ed9ng enzyme gan trong huy\u1ebft thanh tr\u1edf v\u1ec1 d\u01b0\u1edbi 100 U\/L. Thu\u1ed1c ph\u1ea3i \u0111\u01b0\u1ee3c t\u00e1i l\u1eadp \u1edf n\u1eefa li\u1ec1u huy\u1ebft thanh v\u00e0 men gan ph\u1ea3i \u0111\u01b0\u1ee3c gi\u00e1m s\u00e1t 2 tu\u1ea7n 1 l\u1ea7n.<\/p>\n

    \u00a0<\/p>\n

    Vi\u00eam da lo\u00e9t ph\u00e1t tri\u1ec3n trong 7,5% c\u1ee7a ch\u00f3 \u0111i\u1ec1u tr\u1ecb v\u1edbi li\u1ec1u 10 mg\/kg\/ng\u00e0y ITZ, nh\u01b0ng n\u00f3 \u0111\u00e3 kh\u00f4ng ph\u00e1t tri\u1ec3n trong b\u1ea5t k\u1ef3 ch\u00f3 \u0111i\u1ec1u tr\u1ecb v\u1edbi li\u1ec1u 5 mg\/kg.<\/p>\n

    \u00a0<\/p>\n

    C\u00e1c t\u1ed5n th\u01b0\u01a1ng \u0111\u01b0\u1ee3c ch\u1eefa l\u00e0nh m\u1ed9t c\u00e1ch nhanh ch\u00f3ng sau khi ITZ \u0111\u00e3 \u0111\u01b0\u1ee3c ng\u1eebng l\u1ea1i. T\u1ed5n th\u01b0\u01a1ng kh\u00f4ng t\u00e1i ph\u00e1t khi ITZ \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng tr\u1edf l\u1ea1i v\u1edbi li\u1ec1u gi\u1ea3m.\u00a0\u0110\u1ecdc th\u00eam\u00a0thu\u1ed1c kh\u00e1ng n\u1ea5m tr\u00ean ch\u00f3 m\u00e8o.<\/p>\n

    \u00a0<\/p>\n

    8. \u0110i\u1ec1u tr\u1ecb t\u00e1i ph\u00e1t<\/h4>\n

    Kho\u1ea3ng 20% \u0111\u1ebfn 25% ch\u00f3 t\u00e1i ph\u00e1t sau khi \u0111i\u1ec1u tr\u1ecb v\u1edbi ITZ, ch\u1ec9 AMB, ho\u1eb7c AMB c\u1ed9ng v\u1edbi ketoconazol. T\u00e1i ph\u00e1t sau khi \u0111i\u1ec1u tr\u1ecb th\u00e0nh c\u00f4ng d\u01b0\u1eddng nh\u01b0 th\u01b0\u1eddng x\u1ea3y ra trong 6 th\u00e1ng \u0111\u1ea7u ti\u00ean sau khi k\u1ebft th\u00fac \u0111i\u1ec1u tr\u1ecb, nh\u01b0ng t\u00e1i ph\u00e1t c\u00f3 th\u1ec3 x\u1ea3y ra l\u00ean \u0111\u1ebfn 3 n\u0103m sau khi ho\u00e0n th\u00e0nh \u0111i\u1ec1u tr\u1ecb. Kh\u1ea3 n\u0103ng t\u00e1i ph\u00e1t l\u00e0 c\u00f3 li\u00ean quan \u0111\u1ebfn m\u1ee9c \u0111\u1ed9 nghi\u00eam tr\u1ecdng c\u1ee7a b\u1ec7nh ph\u1ed5i ban \u0111\u1ea7u. T\u00e1i ph\u00e1t c\u1ee7a b\u1ec7nh c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb hi\u1ec7u qu\u1ea3 v\u1edbi li\u1ec7u tr\u00ecnh 60 \u0111\u1ebfn 90 ng\u00e0y c\u1ee7a ITZ. Blastomyces kh\u00f4ng xu\u1ea5t hi\u1ec7n \u0111\u1ec3 ph\u00e1t tri\u1ec3n s\u1ee9c \u0111\u1ec1 kh\u00e1ng v\u1edbi ITZ. T\u00e1i \u0111i\u1ec1u tr\u1ecb c\u00f3 80% ho\u1eb7c cao h\u01a1n c\u01a1 h\u1ed9i ch\u1eefa b\u1ec7nh.<\/p>\n

    9. Ph\u00f2ng b\u1ec7nh<\/h4>\n

    H\u1ea1n ch\u1ebf \u0111\u1ed9ng v\u1eadt t\u1eeb c\u00e1c h\u1ed3 v\u00e0 s\u00f4ng nh\u1ecf \u1edf nh\u1eefng n\u01a1i c\u00f3 nh\u1eefng con ch\u00f3 kh\u00e1c \u0111\u00e3 b\u1ecb nhi\u1ec5m b\u1ec7nh. Ch\u00f3 ph\u1ea3i tr\u00e1nh xa t\u1eeb c\u00e1c trang n\u01a1i x\u00e2y d\u1ef1ng, n\u01a1i m\u1ecdi ng\u01b0\u1eddi \u0111\u00e3 v\u00e0 \u0111ang \u0111\u00e0o b\u1edbi. Lo\u1ea1i b\u1ecf m\u1ed9t s\u1ed1 c\u00e0nh c\u00e2y \u0111\u1ec3 cho ph\u00e9p \u00e1nh n\u1eafng m\u1eb7t tr\u1eddi v\u00e0o khu v\u1ef1c chu\u1ed3ng ch\u00f3 c\u00f3 th\u1ec3 h\u1eefu \u00edch trong vi\u1ec7c l\u00e0m gi\u1ea3m nguy c\u01a1 nhi\u1ec5m tr\u00f9ng.<\/p><\/p>\n","protected":false},"excerpt":{"rendered":"

    1.C\u0103n b\u1ec7nh h\u1ecdc B\u1ec7nh n\u1ea5m blatomyces l\u00e0 b\u1ec7nh nhi\u1ec5m n\u1ea5m to\u00e0n th\u00e2n g\u00e2y ra b\u1edfi n\u1ea5m l\u01b0\u1ee1ng h\u00ecnhBlastomyces dermatitidis. Trong t\u1ef1 nhi\u00ean, Blastomyces ph\u00e1t tri\u1ec3n d\u01b0\u1edbi d\u1ea1ng h\u1ec7 s\u1ee3i n\u1ea5m ho\u1ea1i sinh sinh s\u1ea3n h\u1eefu t\u00ednh, s\u1ea3n xu\u1ea5t b\u00e0o t\u1eed l\u00e2y nhi\u1ec5m. \u1ede nhi\u1ec7t \u0111\u1ed9 c\u01a1 th\u1ec3, trong c\u00e1c m\u00f4 sinh v\u1eadt bi\u1ebfn th\u00e0nh d\u1ea1ng […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-2281","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/robot.yeupet.vn\/index.php\/wp-json\/wp\/v2\/posts\/2281","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/robot.yeupet.vn\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/robot.yeupet.vn\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/robot.yeupet.vn\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/robot.yeupet.vn\/index.php\/wp-json\/wp\/v2\/comments?post=2281"}],"version-history":[{"count":0,"href":"https:\/\/robot.yeupet.vn\/index.php\/wp-json\/wp\/v2\/posts\/2281\/revisions"}],"wp:attachment":[{"href":"https:\/\/robot.yeupet.vn\/index.php\/wp-json\/wp\/v2\/media?parent=2281"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/robot.yeupet.vn\/index.php\/wp-json\/wp\/v2\/categories?post=2281"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/robot.yeupet.vn\/index.php\/wp-json\/wp\/v2\/tags?post=2281"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}