{"id":21355,"date":"2019-09-17T17:46:34","date_gmt":"2019-09-17T10:46:34","guid":{"rendered":"https:\/\/www.hmm88i.com\/drug\/?p=21355"},"modified":"2019-09-17T17:55:10","modified_gmt":"2019-09-17T10:55:10","slug":"vi-khuan-burkholderia-pseudomallei-gay-benh-whitmore","status":"publish","type":"post","link":"https:\/\/hmm88i.com\/drug\/vi-khuan-burkholderia-pseudomallei-gay-benh-whitmore\/","title":{"rendered":"B\u1ec7nh Whitmore l\u00e0 g\u00ec? Vi khu\u1ea9n Burkholderia pseudomallei g\u00e2y b\u1ec7nh Whitmore nguy hi\u1ec3m nh\u01b0 th\u1ebf n\u00e0o?"},"content":{"rendered":"

Nh\u1eefng ng\u00e0y g\u1ea7n \u0111\u00e2y, \u1edf kh\u1eafp n\u01a1i ch\u00fang ta \u0111\u1ec1u th\u1ea5y \u0111\u01b0a tin v\u1ec1 lo\u1ea1i vi khu\u1ea9n “\u0103n th\u1ecbt ng\u01b0\u1eddi” \u0111\u00e1ng s\u1ee3 v\u00e0 c\u0103n b\u1ec7nh Whitmore m\u00e0 n\u00f3 g\u00e2y ra. Ch\u1ec9 trong v\u00f2ng th\u00e1ng 8, Trung t\u00e2m B\u1ec7nh Nhi\u1ec7t \u0111\u1edbi – B\u1ec7nh Vi\u1ec7n B\u1ea1ch Mai \u0111\u00e3 ghi nh\u00e2n \u0111\u1ebfn 12 tr\u01b0\u1eddng h\u1ee3p nhi\u1ec5m lo\u1ea1i vi khu\u1ea9n n\u00e0y. V\u1eady th\u00ec b\u1ec7nh Whitmore l\u00e0 g\u00ec<\/strong>? Vi khu\u1ea9n\u00a0Burkholderia pseudomallei<\/strong> g\u00e2y ra b\u1ec7nh Whitmore \u0111\u00e1ng s\u1ee3 nh\u01b0 th\u1ebf n\u00e0o v\u00e0 t\u1ea1i sao l\u1ea1i g\u1ecdi n\u00f3 l\u00e0 vi khu\u1ea9n “\u0103n th\u1ecbt ng\u01b0\u1eddi”?<\/p>\n

B\u1ec7nh Whitmore l\u00e0 g\u00ec?<\/h2>\n

B\u1ec7nh Whitmore<\/strong> (hay c\u00f2n g\u1ecdi l\u00e0 Meliodosis) l\u00e0 m\u1ed9t b\u1ec7nh nhi\u1ec5m tr\u00f9ng c\u1ea5p t\u00ednh g\u00e2y ra b\u1edfi vi khu\u1ea9n Burkholderia pseudomallei . G\u1ea7n \u0111\u00e2y b\u1ec7nh xu\u1ea5t hi\u1ec7n tr\u1edf l\u1ea1i \u1edf Vi\u1ec7t Nam v\u00e0 \u0111\u00e3 c\u00f3 nhi\u1ec1u ca m\u1eafc m\u1edbi \u0111\u01b0\u1ee3c ghi nh\u1eadn. C\u00e1c d\u1ea5u hi\u1ec7u v\u00e0 tri\u1ec7u ch\u1ee9ng c\u1ee7a b\u1ec7nh c\u00f3 th\u1ec3 t\u1eeb s\u1ed1t, \u0111\u1ed5i m\u00e0u da, xu\u1ea5t hi\u1ec7n nhi\u1ec1u \u1ed5 \u00e1p xe \u0111\u1ebfn vi\u00eam ph\u1ed5i, vi\u00eam n\u00e3o, vi\u00eam x\u01b0\u01a1ng kh\u1edbp, suy \u0111a t\u1ea1ng v\u00e0 c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn t\u1eed vong. B\u1ec7nh Whitmore c\u00f3 th\u1ec3 b\u1ecb ch\u1ea9n \u0111o\u00e1n nh\u1ea7m v\u1edbi c\u00e1c b\u1ec7nh kh\u00e1c nh\u01b0 Nhi\u1ec5m khu\u1ea9n huy\u1ebft do t\u1ee5 c\u1ea7u, Lao to\u00e0n th\u1ec3 khi ch\u01b0a c\u00f3 c\u00e1c x\u00e9t nghi\u1ec7m vi sinh. B\u1ec7nh d\u1ec5 xu\u1ea5t hi\u1ec7n tr\u00ean c\u00e1c b\u1ec7nh nh\u00e2n c\u00f3 b\u1ec7nh n\u1ec1n nh\u01b0 \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng, t\u0103ng huy\u1ebft \u00e1p v\u00e0 sau khi c\u00f3 v\u1ebft th\u01b0\u01a1ng h\u1edf ti\u1ebfp x\u00fac v\u1edbi b\u00f9n \u0111\u1ea5t.<\/p>\n

<\/div>\n
\"B\u1ec7nh
B\u1ec7nh Whitmore g\u00e2y tri\u1ec7u ch\u1ee9ng nh\u01b0 th\u1ec3 “\u0103n th\u1ecbt ng\u01b0\u1eddi”<\/figcaption><\/figure>\n

Vi khu\u1ea9n Burkholderia pseudomallei l\u00e0 g\u00ec?<\/h2>\n

Burkholderia pseudomallei<\/strong> l\u00e0 m\u1ed9t vi khu\u1ea9n Gram \u00e2m, l\u01b0\u1ee1ng c\u1ef1c, hi\u1ebfu kh\u00ed, h\u00ecnh que di \u0111\u1ed9ng, th\u01b0\u1eddng s\u1ed1ng trong \u0111\u1ea5t \u1edf c\u00e1c v\u00f9ng nhi\u1ec7t \u0111\u1edbi v\u00e0 c\u1eadn nhi\u1ec7t \u0111\u1edbi tr\u00ean th\u1ebf gi\u1edbi, l\u00e0 nguy\u00ean nh\u00e2n g\u00e2y ra b\u1ec7nh Whitmore tr\u00ean ng\u01b0\u1eddi v\u00e0 \u0111\u1ed9ng v\u1eadt.<\/p>\n

B.pseudomallei<\/strong> c\u00f3 chi\u1ec1u d\u00e0i t\u1eeb 2 \u2013 5 mcm v\u00e0 \u0111\u01b0\u1eddng k\u00ednh t\u1eeb 0.4 \u2013 0.8 mcm, c\u00f3 kh\u1ea3 n\u0103ng t\u1ef1 di chuy\u1ec3n b\u1eb1ng ti\u00ean mao. Vi khu\u1ea9n c\u00f3 th\u1ec3 ph\u00e1t tri\u1ec3n trong c\u00e1c m\u00f4i tr\u01b0\u1eddng nh\u00e2n t\u1ea1o \u0111\u1eb7c bi\u1ec7t l\u00e0 c\u00e1c m\u00f4i tr\u01b0\u1eddng c\u00f3 ch\u1ee9a betaine v\u00e0 arginine, sinh ra c\u1ea3 n\u1ed9i \u0111\u1ed9c t\u1ed1 v\u00e0 ngo\u1ea1i \u0111\u1ed9c t\u1ed1, vai tr\u00f2 c\u1ee7a \u0111\u1ed9c t\u1ed1 trong b\u1ec7nh Whitmore ch\u01b0a \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh ho\u00e0n to\u00e0n.<\/p>\n

\"Vi
Vi khu\u1ea9n burkholderia pseudomallei<\/figcaption><\/figure>\n

Ch\u1ea9n \u0111o\u00e1n vi khu\u1ea9n h\u1ecdc: B. pseudomallei d\u1ec5 ph\u00e1t tri\u1ec3n tr\u00ean nhi\u1ec1u m\u00f4i tr\u01b0\u1eddng (th\u1ea1ch m\u00e1u, th\u1ea1ch MacConkey, EMB\u2026), nu\u00f4i c\u1ea5y th\u01b0\u1eddng c\u00f3 k\u1ebft qu\u1ea3 sau 24 \u2013 48 gi\u1edd cho khu\u1ea9n l\u1ea1c nh\u0103n nheo, c\u00f3 m\u00e0u kim lo\u1ea1i v\u00e0 c\u00f3 m\u00f9i \u0111\u1ea5t. Tr\u00ean ti\u00eau b\u1ea3n cho m\u00e0u gram \u00e2m theo ph\u01b0\u01a1ng ph\u00e1p nhu\u1ed9m gram. C\u00f3 th\u1ec3 ch\u1ea9n \u0111o\u00e1n b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p PCR tuy nhi\u00ean ch\u01b0a \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng trong l\u00e2m s\u00e0ng.<\/p>\n

S\u1ee9c \u0111\u1ec1 kh\u00e1ng: B. pseudomallei nh\u1ea1y c\u1ea3m v\u1edbi nhi\u1ec1u ch\u1ea5t kh\u1eed tr\u00f9ng th\u00f4ng th\u01b0\u1eddng : benzalkonium chloride, kali permanganat, iod, c\u1ed3n 70o<\/sup>. B\u1ecb ti\u00eau di\u1ec7t b\u1edfi nhi\u1ec7t \u0111\u1ed9 cao 74o<\/sup>C trong 10 ph\u00fat ho\u1eb7c b\u1eb1ng tia UV. Kh\u1eed tr\u00f9ng b\u1eb1ng clo kh\u00f4ng c\u00f3 hi\u1ec7u qu\u1ea3 tin c\u1eady.<\/p>\n

Kh\u1ea3 n\u0103ng g\u00e2y b\u1ec7nh: B. pseudomallei l\u00e0 m\u1ed9t vi khu\u1ea9n g\u00e2y b\u1ec7nh c\u01a1 h\u1ed9i, th\u01b0\u1eddng x\u00e2m nh\u1eadp v\u00e0o c\u01a1 th\u1ec3 qua c\u00e1c v\u1ebft th\u01b0\u01a1ng h\u1edf khi ti\u1ebfp x\u00fac v\u1edbi b\u00f9n \u0111\u1ea5t, c\u00f3 kh\u1ea3 n\u0103ng tr\u00f9ng h\u1ee3p actin t\u1eeb t\u1ebf b\u00e0o n\u00e0y qua t\u1ebf b\u00e0o kh\u00e1c v\u00e0 ti\u1ebft ra c\u00e1c \u0111\u1ed9c t\u1ed1 nguy hi\u1ec3m. T\u1ef7 l\u1ec7 t\u1eed vong do b\u1ec7nh Whitmore l\u00e0 t\u1eeb 20 \u2013 50% cho d\u00f9 c\u00f3 \u0111i\u1ec1u tr\u1ecb, t\u1ef7 l\u1ec7 t\u1eed vong cao c\u00f3 th\u1ec3 do b\u1ec7nh \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n mu\u1ed9n d\u1eabn \u0111\u1ebfn giai \u0111o\u1ea1n n\u1eb7ng, xu\u1ea5t hi\u1ec7n c\u00e1c bi\u1ebfn ch\u1ee9ng nh\u01b0 s\u1ed1c nhi\u1ec5m khu\u1ea9n, suy \u0111a t\u1ea1ng<\/p>\n

\"Vi
Vi khu\u1ea9n burkholderia pseudomallei<\/figcaption><\/figure>\n

V\u1eafc xin ph\u00f2ng b\u1ec7nh<\/h2>\n

Hi\u1ec7n ch\u01b0a c\u00f3 v\u1eafc xin \u0111\u1eb7c hi\u1ec7u ph\u00f2ng b\u1ec7nh, n\u1ebfu x\u1ea3y ra c\u00e1c d\u1ea5u hi\u1ec7u nghi nhi\u1ec5m B. pseudomallei c\u1ea7n \u0111\u1ebfn c\u00e1c c\u01a1 s\u1edf y t\u1ebf ngay \u0111\u1ec3 \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb.<\/p>\n

Tri\u1ec7u ch\u1ee9ng c\u1ee7a b\u1ec7nh Whitmore<\/h2>\n

Tri\u1ec7u ch\u1ee9ng c\u1ee7a b\u1ec7nh Whitmore th\u01b0\u1eddng kh\u00e1c nhau tu\u1ef3 thu\u1ed9c v\u00e0o lo\u1ea1i nhi\u1ec5m tr\u00f9ng, c\u00e1c lo\u1ea1i Whitmore bao g\u1ed3m ph\u1ed5i, m\u00e1u, nhi\u1ec5m khu\u1ea9n t\u1ea1i ch\u1ed7 v\u00e0 lan truy\u1ec1n.<\/p>\n

– C\u00e1c v\u1ebft lo\u00e9t th\u01b0\u1eddng g\u1eb7p \u1edf gan, ph\u1ed5i, l\u00e1ch v\u00e0 tuy\u1ebfn ti\u1ec1n li\u1ec7t, \u00edt xu\u1ea5t hi\u1ec7n tr\u00ean x\u01b0\u01a1ng, kh\u1edbp, h\u1ea1ch b\u1ea1ch huy\u1ebft v\u00e0 n\u00e3o.<\/p>\n

– Nhi\u1ec5m tr\u00f9ng ph\u1ed5i: D\u1ea5u hi\u1ec7u ph\u1ed5 bi\u1ebfn nh\u1ea5t c\u1ee7a Whitmore l\u00e0 nhi\u1ec5m tr\u00f9ng ph\u1ed5i, c\u00f3 th\u1ec3 x\u1ea3y ra \u0111\u1ea7u ti\u00ean ho\u1eb7c l\u00e0 h\u1eadu qu\u1ea3 c\u1ee7a nhi\u1ec5m khu\u1ea9n huy\u1ebft, t\u1eeb nh\u1eb9 nh\u01b0 vi\u00eam ph\u1ebf qu\u1ea3n ho\u1eb7c n\u1eb7ng h\u01a1n l\u00e0 vi\u00eam ph\u1ed5i v\u00e0 c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn s\u1ed1c nhi\u1ec5m khu\u1ea9n. C\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ee7a nhi\u1ec5m tr\u00f9ng ph\u1ed5i c\u00f3 th\u1ec3 bao g\u1ed3m:<\/p>\n