Ho tlosoa ha Leech Letlalo, Leihlo, kapa 'Metso, le Botfly/Tumbu Fly Larva Extraction.¶

Batho ba tsamaeang ka maoto, batho ba sesang le ba tsamaeang ho pholletsa le meru ea tropike, melapo ea metsi a hloekileng le savannas hangata ba kopana le li-ectoparasites tse tharo tse khethehileng tse nang le lisele tse bonolo: ho fepa mali ** leeches ea metsing le ea lefatše ** (* Hirudinea , ho akarelletsa * Hirudo, Haemadipsatane, *Limnatis, Discullas fepe) maboko a furuncular myiasis (botfly ea batho ba Amerika Bohareng le Boroa Dermatobia hominis le ntsintsi ea African Tumbu kapa mango Cordylobia anthropophaga), 'me e ankora ka botebo liboseleise tse thata tse ixodid. Boemong bo bong le bo bong, mekhoa e mabifi ea ho tlosa batho e baka kotsi e fetang ea kokoana-hloko ka boeona. *Ho hahola leech le epa ka ho toba letlalong, ho le chesa ka sakerete kapa lebone, kapa ho le tšela letlalong ka letsoai, ntho e lelekang likokoanyana, kapa joala * ho etsa hore leech le tsosolose mala a lona ka matla, le nang le smbiotic Aeromonas hydrophila le *Aeromonas veronii, le tsoetsoe ke libaktheria e tharo ka kotloloho mahlahahlaha a hlabang ka hare ho letlalo. Ho hobe le ho feta, ho noa metsi a molapo a sa hloekisoang kapa ho sesa matangoaneng a teng ho lumella li-mucosal leeches tsa metsing hore li khomarele ka har'a ** nko, 'metso (pharynx kapa larynx), kapa leihlo , ho baka ho khohlela ho sa hlalosoang ha mali (hemoptysis), hoarseness, stridor, le tšitiso ea moea e sokelang bophelo. Ka mokhoa o ts'oanang, ** ho pepeta botfly lethopa ka menoana ** ho ka phunya seboko sa mokokotlo ka tlas'a letlalo, ho etsa hore 'mele oseloa granulomas kapa anaphylaxis e be matla, athe **ho bipetsa moea oa larvka jelly e teteaneng ea petroleum kapa bacon fat ho e qobella ho khutlela morao. Haeba 'metso o ka hare kapa leech ea nko e baka ho hema ka lerata (stridor), ho fetoha ha lentsoe, kapa ho tsoa mali a mangata, letsetsa sebakeng sa heno. dinomoro tsa tshohanyetso hanghang. Hape hlahloba litataiso tsa banab'eno ho ho loma letshwao le sekgo, leihlo la lintho tse tsoang kantle ho naha le likotsi, dintho tse kantle tsebeng kapa nkong, le cellulitis le makhopho a letlalo.

Taba ea mantlha ea skin leech ke ho ** thellela lenala, karete ea mokoloto, kapa pampiri e thata ka mahlakoreng ho ipapisitse le letlalo ka tlas'a mofero o mosesane (molomo) pele** ho pshatla vacuum tiiso ka bonolo pele o sunya motsu o ka morao; bakeng sa ocular, nasal, kapa throat leech, batla ho tlosoa ha meriana ea tšohanyetso ho sebelisa **marotholi a lidocaine a lihlooho kapa nosetso ea hypertonic saline **; le botfly kapa Tumbu fly larva, e kenyelletsa lesoba la phefumoloho le nang le jeli e teteaneng ea petroleum (Vaseline) kapa sekhomaretsi kahoo hypoxia e qobella tšenyane hore e khase ho ea holimo ho ea holimo bakeng sa ho ntša matla.

Etsa sena hona joale¶

1. Bakeng sa Leech ka hare ho 'Metso, Nose, kapa Airway (e bakang ho khohlela mali, ho sisinyeha ha 'metso, lentsoe le hlabang kapa stridor): boloka motho ea lutseng a otlolohile 'me u letsetse nomoro ea hau ea tšohanyetso hang-hang. Letsetsa 911 United States le Canada, 112 ho pholletsa le European Union, 999 United Kingdom, 00 dinomoro tsa tshohanyetso. Le ka mohla u se ke ua fihla ho menoana e foufetseng kapa li-tweezers tsa ntlo ka morao molaleng: pharyngeal leech e tšohileng kapa laryngeal leech e ka oela ka ho toba pakeng tsa likhoele tsa lentsoe ka har'a trachea, e bakang asphyxiation e matla.
2. *Bakeng sa Leech le khomaretsoeng letlalong: LE KA mohla u se ke ua hula leech ka 'mele oa eona, 'me U SE KE U KA e chesa ka mollo, lighter, kapa sakerete, kapa ua tšela letsoai, asene, DEET, sesepa kapa joala holim'a eona ha e ntse e khomaretsoe.
3. Senya The Narrower Anterior (Oral) Sucker Tial Pele U Sebelisa Lenala la Monoana kapa Credit Card: Sheba haufi-ufi lintlheng tse peli tsa leech. The e bophara, e chitja pheletsong ke ankora feela (posterior sucker); molala o moqotetsane, o tapeed, o momahaneng ke oral sucker e ka pele* e nang le mehlahare e meraro e sehang. Beha lenala la hao la monoana, ntlha ea karete ea mokoloto, kapa pampiri e mennweng e thata e bataletse letlalong la hao haufi le molomo o moqotetsane, mme **u sutumelle ka thōko ka bonolo tlas’a molomo oa molomo o monyang ** ho fihlela moea o kena ’me molomo o tsoa o hlephile. Ebe o theola lenala la hau ka tlas'a moanya o ka morao o sephara 'me u suthise lepi.
4. Hlatsoa ho longoa ha leech e bōpehileng joaloka Y ka sesepa le metsi a hloekileng, 'me u sebelise khatello e tiileng ka gauze e sa hloekang ka metsotso e 15 ho isa ho e 30. Hobane mathe a leech a kenya hirudin (e matla ka ho fetisisa ea tlhaho ea thrombin inhibitor e tsejoang) le calin (e thibelang platelet aggregation ho collagen ea mali e khanyang), lihora tse 2 ho isa ho tse 24** ka mor'a hore leech e tsamaee. Ho phalla hona ha nako e telele ke phello ea lik'hemik'hale ea lehae ea anticoagulant, eseng bothata ba ho tsoa mali; tobetsa ka thata ka lesela la gauze 'me u tlanye ho apara khatello sebakeng seo.
5. Bakeng sa Leech e khomaretsoeng Leihlong (Conjunctiva kapa Cornea): U SE KE UA hula leech ka li-tweezers kapa menoana, 'me U SE KE UA tšela letsoai la tafole ea kichineng kapa asene ka leihlong. E-ea hang-hang sepetlele kapa tleliniking moo ngaka e ka kenyang **marotholi a mahlo a thethefatsang mahlo (0.5% le litracaine kapa itracaine kapa terrigate) sterile hypertonic saline (3% ho isa ho 5% NaCl), e holofatsang masenke a leech nakong ea metsotsoana e 60 kahoo e phaphametse ntle le ho tabola cornea kapa iris.
6. Bakeng sa Botfly (Dermatobia hominis) kapa Tumbu Fly (Cordylobia anthropophaga) Larva (Breathing Boil with a Central Pore): LE KA mohla u se ke ua pepeta leqhubu ka menoana ea hao joaloka pimple. Ho e-na le hoo, koala lesoba le bohareng la phefumoloho ka lesela le teteaneng la petroleum water jelly (Vasew, vaseline) Lihora tse 3 ho isa ho tse 24. Kaha e hanetsoe ke oksijene, leruane le khutlisa tube ea eona e ka morao ea ho phefumoloha (li-spiracles) ho tsoa ka lesoba hore e fihle moeeng, e lumella ngaka kapa mopholosi hore a e tšoare ka matla a nyopa 'me a ntše tšenyane eohle e ntse e tiile.

Sefate sa qeto: leech vs botfly/Tumbu fly myiasis vs retained tick granuloma¶

flowchart TD
    A["Sekoahelo sa likokoana-hloko tse bonolo kapa nodule ea letlalo le phefumolohang"] --> B{"Ke sebaka sefe sa likokoana-hloko le sa anatomical se amehang?"}
    B -->|Leech on external skin (leg, ankle, torso, arm)| C["External Cutaneous Leech: tsebahatsa moanya o moqotetsane o ka pele"]
    B -->|Leech in eye, nose, or throat (hemoptysis, epistaxis, hoarseness, stridor)| D["Ka hare Mucosal / Airway kapa Ocular Leech (Limnatis / Dinobdella)"]
    B -->|Boil-like nodule with central pore, bubbles under water, intermittent stabbing pain| E["Furuncular Myiasis: Botfly (Dermatobia) kapa Tumbu Fly (Cordylobia) larva"]
    B -->|Firm itchy red/purple bump weeks after a tick bite, or broken tick mouthparts| F["Tick Bite Granuloma vs Retained Tick Hypostome"]
    C --> G["Tsamaisa lenala la monwana kapa karete ea mokoloto ka thoko ka tlas'a monya o moqotetsane oa ka pele, ebe o hatella monya ka morao."]
    G --> H["Hlatsoa ka sesepa le metsi; sebelisa khatello e tiileng ea gauze bakeng sa metsotso e 15 ho isa ho e 30 (hirudin oozing e nka lihora tse 2 ho isa ho tse 24)"]
    H --> I{"Ho holisa bofubelu, boladu kapa feberu ka lihora tse 24 ho isa ho tse 72?"}
    I -->|Yes: Aeromonas infection| J["Tlhokomelo ea bongaka: Ciprofloxacin ea molomo kapa TMP-SMX (penicillins/cephalexin ha e atlehe khahlano le Aeromonas)"]
    I -->|No| K["Lula u hloekile 'me u tlamiloe ho fihlela lero le emisa"]
    D --> L["Dula o otlolohile; LE KA mohla hula ka bofofu; ea ho ED bakeng sa lidocaine spray/drops kapa 3% ho 5% hypertonic saline release"]
    E --> M["LE KA mohla pepeta ka menoana; tlotsa Vaseline e teteaneng / petroleum jelly holim'a lesoba le bohareng la ho hema"]
    M --> N{"Amerika Bohareng/Boroa (Botfly with backward spines) vs Africa (Tumbu e fofa ka 'mele o boreleli)?"}
    N -->|Tumbu fly (Africa)| O["Larva e hlaha ka hare ho lihora tse 1 ho isa ho tse 3 tsa Vaseline; ho ntsha maikutlo ka bonolo kapa ho ntsha ka matlapa"]
    N -->|Botfly (Americas)| P["Kamora ho koaloa ha lihora tse 3 ho isa ho tse 24, tšoara mohatla o hlahang ka forceps (kapa etsa ente ea lidocaine / cruciform incision)"]
    F --> Q["U SE KE UA cheka li-crater tse tebileng tsa letlalo ka linale; likarolo tsa molomo oa tick li lla ka tlhaho; steroid cream/ente bakeng sa granuloma"]

Papiso ea Clinical le Anatomical: Leeches, Botflies, Tumbu Flies, le Hard Ticks.¶

Lits'oants'o tsa Letlalo la Kantle: Anatomy, Hirudin Bleeding, le Safe Detachment¶

Mokhoa oa ho Bolella Molomo Qetellong ho tloha Mohatleng oa Mohatla¶

Leech e fepa e na le li-suckers tse peli, e 'ngoe pheletsong e' ngoe le e 'ngoe ea' mele oa eona o arohaneng, 'me ho li kopanya ka tatellano e nepahetseng ho thibela ho boloka mohlahare le ho khutlisa baktheria:

1. Mohatla (Mohatla) Sucker: Motheo oa ka bophara, o bohlasoa oa leech o na le molomo le mehlahare; e sebetsa feela joalo ka ankora ea mochini.
2. Anterior (Oral) Sucker: The **moqotetsane, o tepeletseng, o ntse o hlahloba ka pele ** matlo mehlahare e meraro e nang le mesifa (gnathomeres), le leng le le leng le na le meno a 60 ho isa ho a 100 a maekroskopo a li-angles tse 120-degree tse boneng ho se utloise bohloko lintlha tse tharo tse harelaneng ka hare-hare naleli e nchocho.

Tloso e Sireletsehileng ea Letlalo la Kantle ka Mehato ka Mohato¶

1. **Tshehetsa letlalo tautly ** hantle haufi le ** e moqotetsane ka pele (anterior) qetellong ** ea leech.
2. Thellelisa ntlha e bataletseng ka mahlakoreng ka tlas'a mofeng oa molomo o ka pele: U sebelisa monoana oa hau o motona kapa ntlha ea karete ea mokitlane ea polasetiki e tšoaretsoeng letlalong la hao, sututsa butle ka mahlakoreng ka tlas'a moqomo oa molomo o moqotetsane ntle le ho pepeta 'mele o ruruhileng.
3. Roba vacuum seal ebe o theola seantša se ka morao: Ka mor'a metsotsoana e 1 ho isa ho e 2, moea o kena ka phaposing ea ho huloa, mehlahare e meraro e ikhula ka bo eona, 'me hlooho ea itihela. Ebe o theola lenala la hau ka tlas'a moanya o ka morao o sephara 'me u suthise lepi.

Hobaneng ha Leech Loma e Tsoa Mali ka Lihora Tse 24 (le Mokhoa oa ho E emisa)¶

• The Anticoagulant Cocktail in Leech Saliva: Leech mathe a enta hirudin (e tlamang ka mokhoa o ke keng oa thijoa ho motho thrombin [Factor IIa] ho thibela maqeba a fibrin), calin (e leng lijase tse pepesitsoeng subendothelial collagen fibers kahoo ** li-platelet tsa hae ha li khone ho tsamaea ka mor'a lihora), li-vasodilator.
• Ho Laola Hirudin Oozing ka Nako e Telele: Kakaretso ea tahlehelo ea mali e bakoang ke ho longoa ha leech letlalong (5 ho isa ho 15 mL e metsoeng hammoho le 15 ho isa ho 30 mL ea ho tsoa ha metsi ka mor'a ho koaheloa) ha ho kotsi ho motho e moholo ea phelang hantle, leha e tsoakane le mofufutso ka sokising. ** Hlatsoa sekoahelo se bōpehileng joaloka Y ka sesepa le metsi a hloekileng ** (kapa povidone-iodine), ** tobetsa ka thata ka pente e sa hloekang ea gauze bakeng sa metsotso e 15 ho isa ho e 30 ** ha u ntse u phahamisa leoto, 'me u tlanye moaparo oa khatello ea snug (kapa pentšele ea styptic / gauze ea hemostatic) sebakeng sa lihora tse 12 ho isa ho tse 24.

Likokoana-hloko tse ka hare tsa Mucosal: Leihlo, Nko, Pharynx, Larynx le genitourinary Tract.¶

Ho pholletsa le Asia mahaeng (India, Nepal, Vietnam, Thailand, China, Taiwan, Philippines), Bochabela bo Hare, Afrika, le Mediterranean, metsing mucosal leeches (Limnatis nilotica, Dinobdella ferox, le Myxobdella africana) li lula lilibeng le matangoaneng.

• Litsela tsa ho Kena le Matšoao: Ho noa metsi a molapo a sa hloekisoang ka kotloloho kapa ho sesa ho lumella li-leeches tsa bana (5 ho isa ho 10 mm) hore li ikamahanye le nasal cavity, nasopharynx, mahalapa a bonolo, epiglottis, lithapo tsa lentsoe, conjunctiva ea leihlo, kanale ea tsebe, botšehali, botšehali, kapa matsatsi a 2 ho isa ho tse 2. lisenthimithara (2 ho isa ho tse 5). Linko li baka ho tsoa mali ka nkong ka lehlakoreng le le leng (epistaxis) le maikutlo a ho soahlamana; pharyngeal leeches kapa laryngeal leeches li baka ho khohlela kapa ho tšoela ka mathe mali (hemoptysis), maikutlo a tsoang kantle ho naha, ho lla, le ho hema ka tšohanyetso kapa ho felloa ke matla ha leech e ruruhileng e kena ka har'a glottis.
• Protocol e Sireletsehileng ea Meriana (Le ka mohla U se ke Ua Hula ka Bofofu ka Li-tweezers):
• Ocular Leech (Conjunctiva kapa Cornea): Kenya 1 ho 2 marotholi a sterile topical ophthalmic anesthetic (0.5% proparacaine, 0.5% tetracaine, kapa 2% lidocaine) kapa nosetsa ka klzzwxh:0084. Nakong ea metsotana e 30 ho isa ho e 120, li-suckers tse shoeleng litho li itokolla ka botsona hore li tlosoe hamonate ka matlapa a bohlasoa, 'me li lateloe ke tlhahlobo ea lebone la slit-lamp le *moxifloxcin kapa ciprofloxacin** marotholi a mahlo (a koahelang Aeromonas).
• Nasal kapa Nasopharyngeal Leech: Lulisa mokuli ** o otlolohile o sekamela pele**. Hlakola **4% ho 10% ea lidocaine ea lihlooho ** (kapa u tšele pledget ea k'hothone e kolobisitsoeng ka **4% lidocaine e nang le oxymetazoline ** kapa ** 5% hypertonic saline **) ka nko ka metsotso e 2 ho isa ho e 5, ebe o ntša leech e shoeleng litho tlas'a endoscopy ka alligator forceps.
• Laryngeal kapa Tracheal Leech: E ntšitsoe ka ED kapa Kamoreng ea Opereishene tlas'a video e tobileng laryngoscopy kapa bronchoscopy ka mor'a ho sebelisa topical lidocaine spray (kapa cryoprobe) ka ho toba leech.

Furuncular Myiasis: Botfly (Dermatobia hominis) le Tumbu Fly (Cordylobia anthropophaga)¶

Mokhoa oa ho Lemoha Lethopa le Phefumolohang (Furuncular Myiasis)¶

Baeti ba khutlang ho tsoa Amerika Bohareng kapa Boroa (Dermatobia hominis botfly) kapa Sub-Saharan Africa (Cordylobia anthropophaga Tumbu fly) hangata ba e-na le nodule e khubelu e kang lethopa e hlolehang ho ntlafala ha lithibela-mafu tse nooang. Litlhahiso tse 'nè li tiisa hore ho na le leruane le phelang:

1. Punctum e Bohareng (Lesoba la ho Phefumoloha): Leroba le hloekileng, le chitja 1 ho isa ho 3 millimeter (0.04 ho isa ho 0.12 inch) le masoba a bohareng tlhōrōng ea dome eo ho seng mohla makhopho a koaloang.
2. Teko ea Lerumo le Kentsoeng ka Metsing: Ho inela setho ka tlas'a metsi kapa ho beha lerotholi la saline kapa oli ea minerale holim'a lesoba ho senola mapulumo a manyane a morethetho a nyolohang metsotsoana e meng le e meng e 10 ho isa ho e 30 le mohatla o ka morao o mosoeu o nang le li-spiracles tse peli tse lefifi tse tsubehang ho hema.
3. Mahlaba a ho Hlaba Bosiu: Ha leruane la spiny botfly le ntse le bilika le ho phunya lisele ka har'a mokoti oa lona, ​​le baka mahlaba a tšohanyetso, a bohale a motlakase kapa a ho hlaba nale (haholo-holo bosiu) le maikutlo a ho soahlamana.
4. Sello se Hlakileng sa Serosanguinous: Leroba le lla marotholi a mokelikeli o hlakileng kapa o tsoang maling ho e-na le boladu bo botenya ba baktheria.

Hobaneng U LOKELANG ho Petetsa Larva ea Botfly ka menoana ea hau¶

Amerika Bohareng le Boroa botfly ea batho (Dermatobia hominis) larva e na le 'mele o ka pele oa bulbous o pota-potiloeng ke **mekhako e metšo e boima, e shebileng morao ** e e notlelang ka har'a letlalo joalo ka sehae se metsu. Ho petetsa botlaaseng ba leqhubu ho ke ke ha sutumelletsa sebokoane sa botfly se sa hupeloang ka lesobeng le lenyenyane la limilimithara tse peli; ho e-na le hoo, ho petetsa **e silakanya le ho phatlola tšenyane e phelang ka tlas'a letlalo la hao **, e leng se etsang hore ho be le **necrotizing e matla ea 'mele oa linaheng tse ling granuloma, abscess ea bobeli, kapa systemic anaphylaxis **.

Mehato ka Mehato ea ho Emola Larvae ea Botfly le Tumbu Fly¶

1. Mokhoa oa 1: Mokhoa oa ho Suffocation / Asphyxiation Occlusion Technique (Mola oa Pele): Hobane li-larvae ka bobeli li phefumoloha feela ka ** li-spiracles tse peli tse ka morao ** ka har'a pore ea letlalo, li jala mokoloko o teteaneng oa 5-millimeter (0.2 inch) oa petroleum e tšoeu, parafine ea linotsi, mafura a mafura a beew, jelly ea beeswax, oli ea linotsi, mafura a linotsi * ka ho feletseng holim'a pore 'me u koahele ka **tape e thibelang metsi **.
2. African Tumbu Fly (Cordylobia anthropophaga): E hlahella ka har'a dome ea Vaseline nakong ea metsotso e 30 ho isa ho lihora tse 3; tšoara ka li-forceps tse hloekisitsoeng (kapa u tobetse setsi ka bonolo ka mehatlafatsi e 'meli ea lehong ea maleme) 'me u thelle fatše u ntse u le teng.
3. American Human Botfly (Dermatobia hominis): Lula u koalehile ka 3 ho isa ho lihora tse 24 ho fihlela hypoxia e qobella larva ho mena mokokotlo oa eona le ho khutlisetsa mohatla oa eona ka har'a kepisi ea Vaseline, ebe e tšoara ka tieo ka hemostats kapa forceps ea meno ebe e ntša ka ho tsukutla butle, ho tsitsitseng. Le ka mohla u se ke ua siea sebōkō se shoeleng se bipetsane ka har'a letlalo ka mor'a lihora tse 24.
4. Mokhoa oa 2: Ho Suction ea Venom Extractor kapa Hydrostatic Lidocaine Injection: Pompo e monyang seringe ka mokhoa oa seringe (Sawyer Extractor) holim'a lesoba e ka ntša leruane le sa sebetseng, kapa ngaka e ka kenya **nale ea gauge e 25 motheong oa leqhubu ka tlas'a sekoti sa 2% ho ea ho 2% kapa L 4% le ho kenya lidocaine, e holofatsang mokokotlo oa sebokoane sa botfly le ho sebelisa khatello e ntle ea mokelikeli oa hydrostatic ho phunya tšenyane ka ho toba ka lesobeng.
5. Mokhoa oa 3: Anesthesia ea Lehae + Sekoaelo se Senyenyane sa Cruciform: Bakeng sa li-larvae tse kholo tsa morao-rao (tse fetang 15 ho isa ho 20 mm), ngaka e kenya lidocaine ea 1%, e etsa 3 ho isa ho 4 mm nick e atolosa lesoba, e ntša seboko se sa tsitsang ka lisebelisoa tsa hemostats, nosetso ea salate, nosetso ea salate. prophylaxis **.

Tlhokomeliso e Khutšoanyane mabapi le likarolo tsa Molomo oa Letšoao le Letšoao la Tick Bite Granulomas¶

Ha u tlosa tick e thata e kentsoeng (Ixodes, Amblyomma, Dermacentor), tšoara letshwao haufi le bokaholimo ba letlalo ka hohle kamoo ho ka khonehang ka li-tweezers tse nang le ntlha e ntle ebe u hula ka ho toba holimo (kapa Australia haufi le lebōpo le ka bochabela moo Ixodes holocyclus e bakang anaphylaxis le ho holofala ha li-tick. letshwao la motho e moholo sebakeng sa lona pele ka ho sebedisa ether-containing cryospray** mme o e tlohelle e theohe ntle le ho pepeta).

• Ho thoe'ng haeba likarolo tsa molomo oa tick (hypostome) li robeha letlalong? U SE KE UA cheka li-crater letlalong ka linale tsa ho rōka, lehare kapa ka lithipa tsa pokotho. Ho fapana le 'mele oa tick (o nang le litšoelesa tsa mathe le mala moo likokoana-hloko tsa Lyme Borrelia le Rickettsia li phelang), libaktheria tse nyenyane tse robehileng* khoune e setseng karolong e ka holimo ea epidermis ** e ke ke ea fetisetsa lefu leha e le lefe la Lyme kapa ho holofala ha tick . Ho cheka letheba le lenyenyane le letšo ka nale ho baka tšenyo e tebileng ea lisele le tšoaetso ea bobeli ea Staphylococcus; Hlatsoa sebaka seo ka sesepa le metsi, tšela povidone-iodine kapa setlolo sa lithibela-mafu, 'me ka tlhaho letlalo le hle le thethe joalo ka lekhalo le lenyenyane la patsi ka matsatsi a 5 ho isa ho a 14.
• Tick Bite Granuloma ke Eng? Ka linako tse ling libeke tse 2 ho isa likhoeling tse' maloa ka mor'a ho longoa ke tick, leqhubu le tiileng, le boreleli, le bofubelu bo bosootho kapa le pherese le hlohlonang haholo (0.5 ho isa ho 1.5 cm) le tsoela pele sebakeng sa ho loma (tick bite granuloma kapa cutaneous lymphoid hyperplasia). Ena ke karabelo e ntle ea 'mele ea ho itšireletsa mafung ho liprotheine tsa samente tsa tick salivary, eseng lefu la Lyme (le bakang lekhopho le ntseng le hola, erythema migrans), 'me le rarolla ka* topical topical corticosteroid cream** kapa ente e le 'ngoe ** intralesional triamcinolone** ke ngaka ea dermatologist.

Linomoro tsa libaka tsa tšohanyetso le liprothokholo tsa mekhatlo¶

• United States le Canada: Letsetsa 911 bakeng sa tshohanyetso efe kapa efe ya pharyngeal kapa airway leech kapa tshwaetso e matla ya systemic. Baeti ba khutlang ba nang le batho ba belaelloang ba Dermatobia hominis (botfly) kapa Cordylobia anthropophaga (Tumbu fly) myiasis e ka hlahlojoa sepetlele Lefapheng la Tšohanyetso kapa tleliniking ea Travel Medicine / Dermatology; baoki ba ka buisana le **CDC Parasitic Diseases Hotline (404-718-4745) **.
• Australia le New Zealand: Letsetsa 000 Australia kapa 111 New Zealand. Bakeng sa li-leeches tsa "terrestrial rainforest leeches" (Gnathobdellida), koala seanya se ka pele ka lenala, sebelisa khatello ea mali, 'me u shebe Aeromonas. Bakeng sa Liboseleise tsa Australian Paralysis (Ixodes holocyclus), latela ANZCOR Tataiso 9.4.3 / ASCIA: le ka mohla u se ke ua sebelisa li-tweezers ho petetsa letshwao la motho e moholo le phelang; e hatsele ka sefafatsi se nang le ether pele.
• United Kingdom le European Union: Letsetsa 999 UK kapa 112 ho pholletsa le EU. Baeti ba khutlang ho tsoa Latin America kapa Afrika ba nang le furuncular myiasis kapa li-mucosal leeches UK ba ka fetisetsoa ho Hospital for Tropical Diseases (HTD, London) kapa likarolo tsa libaka tsa mafu a tšoaetsanoang.
• India, Nepal, Asia Boroa-bochabela, le Asia Bochabela: Letsetsa 112 / 108 India, 102 Nepal, 1669 Thailand, 115 Vietnam, kapa 119 Taiwan, Japane, le Korea Boroa. Literekeng tsa mahaeng tse lithabeng moo metsi a phallang a jeoang, mokuli leha e le ofe ea hlahisang epistaxis e sa hlalosoang khafetsa, hemoptysis, kapa stridor o lokela ho hlahlojoa hang-hang ka nko le pharyngeal bakeng sa Dinobdella ferox kapa Limnatis nilotica a sebelisa topical lidocaine kapa hypertonic saline extraction.
• Afrika e ka Borwa ho Sahara le Latin America: Letsetsa EMS ea lehae (192 Brazil, 911 Costa Rica, Mexico, le Kenya, 10177 / 112 Afrika Boroa). Ho thibela Tumbu fly (Cordylobia anthropophaga) myiasis in endemic Sub-Saharan Africa, **kamehla aene liaparo tsohle, lithaole le lilakane ka mahlakoreng ka bobeli ka tšepe e chesang ** ka mor'a ho li omisa ka ntle (kapa ho li omisa ka tlung ka se omisang se futhumetseng), kaha mocheso oa tšepe o bolaea mahe a sa bonahaleng a fofang a Tumbudamp a behiloeng holim'a lesela.

Lipotso tse botsoang khafetsa¶

Ke hobane'ng ha u sa lokela ho chesa lepi ka lebone kapa ua tšela letsoai ho eona ho etsa hore e theohe?¶

Ho feta karolo ea 80 lekholong ea li-leech li na le libaktheria tsa symbiotic Aeromonas hydrophila ka har'a tšilo ea tsona ea lijo ho sila mali. Ha u chesa leech e khomaretsoeng ka sakerete kapa lebone, u tšela letsoai, asene, kapa moriana o lelekang likokoanyana holima DEET, kapa u e hulanya ka 'mele oa eona, kheo e sithabetseng e khutlisetsa mpeng ea eona ka matla ka ho toba leqebeng le bulehileng pele e ntša mehlahare ea eona. Sena se baka karolo ea 20 lekholong ea tšoaetso e tebileng ea letlalo la Aeromonas le makhopho. Ho e-na le hoo, sutumelletsa lenala la hao kapa karete ea ho reka ka mokitlane ka thōko ho letlalo ka tlas'a karolo e ka pele e tšesaane (molomo) pele ho senya tiiso e monyang ka mokhoa o hloekileng.

Ke hobane'ng ha leech e longoa e lula e tsoa mali lihora tse ngata ka mor'a hore leech e felile, 'me na ho kotsi?¶

Ha leech e loma, mathe a eona a kenya hirudin (e thibelang mali ho thetheha ka matla) le calin (protheine e koahelang likhoele tsa collagen methapong ea mali e sehiloeng e le hore liplatelete tsa hao li se ke tsa khomarelana). Kaha calin e lula e ntse e tlameletsoe marakong a manyenyane a methapo ea mali, hangata leech e longoa e ntša mali a tšesaane lihora tse 2 ho isa ho tse 24 ka mor'a hore leech e ntšoe. Le hoja likhaba tse 'maloa tsa mali tse kopantsoeng le metsi kapa mofufutso li ka fetola sock eohle e khubelu e khanyang, tahlehelo ea sebele ea mali e nyenyane ebile ha e kotsi; hlatsoa leqeba ka sesepa le metsi 'me u hatelle ka thata ka lesela le hloekisitsoeng la gauze metsotso e 15 ho isa ho e 30.

Ke joang motho a ka etsang hore leech le khomarele 'metsong, nkong, kapa leihlong, 'me lingaka li e tlosa joang?¶

Libakeng tsa mahaeng tsa Asia, Afrika, Bochabela bo Hare le Mediterranean, malinyane a manyenyane a metsing (a kang Limnatis nilotica le Dinobdella ferox) a lula lilibeng tsa metsi a hloekileng, melapong le matangoaneng. Ho noa metsi a molatsoana a sa sefshoang ka ho toba matsohong a koetsoeng kapa ho sesa ho lumella leech le lenyenyane hore le itšoarelle ka har’a nko, ka morao ho ’metso, lithapong tsa lentsoe, kapa leihlo, moo le hōlang ka libeke tse ngata ’me le baka ho tsoa mali ka nko, ho khohlela mali, lehoatata kapa ho thijoa ke moea hoo ho ka behang bophelo kotsing. Lingaka ha ho mohla li hulang leech e phelang ea mucosal; ho e-na le hoo, ba fafatsa lidocaine tse thethefatsang maqeba kapa motsoako oa letsoai oa hypertonic holim'a leech, e holofatsang li-suckers tsa eona ka metsotsoana e 60 kahoo e lokolloa ka mokhoa o sireletsehileng.

Ke hobane'ng ha ho le kotsi ho pepeta botfly pheha ka menoana ea hau?¶

Larva ea batho ba Amerika Bohareng kapa Boroa (Dermatobia hominis) e bōpehile joaloka teardrop 'me e koahetsoe ke mehele e metšo e thata, e shebileng ka morao, e e notlelang ka tlas'a letlalo joalo ka sekoti se metsu. Haeba u penya le ho pepeta leqhubu joalo ka lehlohlojane, tšenyane e sephara ea spiny e ke ke ea khona ho kenella lesobeng la eona le lenyenyane la 1 ho isa ho 2-millimeter e phefumolohang, ho e-na le hoo, e phatloha ka tlas'a letlalo la hao, e leng se bakang tšoaetso e matla ea 'mele osele kapa ho kula. Ho kwahela lesoba la ho hema ka tutulu e tenya ya Vaseline (petroleum jelly) kapa theipi e sa keneleng metsi ho kgaola oksijene ya yona, ho qobella seboko hore se hlephise lesapo la mokokotlo le ho kgutlela ka ntle ho lesoba ho leba bokahodimong moo ditshwana di ka e ntshang kaofela.

Nka tseba joang phapang lipakeng tsa lethopa la MRSA le botfly kapa Tumbu fly larva kamora leeto la tropike?¶

Litlhahiso tse tharo tse khethollang leruane la ntsintsi (furuncular myiasis) le hlapa e tloaelehileng ea baktheria: (1) Leqhubu la larva ea ntsintsi le na le lesoba le hloekileng, le chitja, le bulehileng hantle bohareng (mofeng oa eona oa ho hema) le llang ka mokhoa o hlakileng kapa o nang le mali hanyenyane ho e-na le boladu bo botenya bo bosehla; (2) Hangata u ka utloa ho sisinyeha ka tšohanyetso, ho hlaba kapa ho soahlamana ka har'a leqhubu (haholo-holo bosiu); ’me (3) Haeba u tšela lerotholi la metsi kapa oli ea liminerale holim’a lesoba le bohareng kapa u qoelisa letsoho ka tlas’a metsi, u tla bona lipululana tsa moea tse nyolohang lesobeng le mohatla o mosoeu oa leruarua o tsubella holimo ho hema.

Hobaneng ha lingaka li re u tlameha ho aena liaparo tsa hau Afrika ho thibela libōkō tsa Tumbu fly (manngoe fly)?¶

Ho fapana le botfly ea Amerika (e khomaretsang mahe a eona menoang), ntsintsi ea Tumbu ea Afrika ( Cordylobia anthropophaga ) e behela mahe a eona a sa bonahaleng mobung o mongobo o mongobo kapa ka ho toba liaparong tse mongobo, liaparo tsa ka hare, lithaole le lilakane tse fanyehiloeng ka ntle terateng ea liaparo hore li omelle. Ha u apara hempe kapa marikhoe a makgutshwane a sa aenwang, mocheso wa mmele wa hao o qhotsa dibokwana tse nyenyane, tse phunyang ka mokokotlong, dibonong kapa diropeng. Ho hatella liaparo tsohle tse omisitsoeng ka ntle ka tšepe e chesang (kapa ho sebelisa mochini o omisang metsi o chesang) ho bolaea karolo ea 100 lekholong ea mahe pele liaparo li ama letlalo la hao.

Mehloli le tataiso ea semmuso¶

• Litsi tsa Taolo le Thibelo ea Mafu (CDC, United States): CDC Yellow Book: Dermatologic Itinerary and Ectoparasites (Furuncular Myiasis from Dermatobia hominis and Cordylobia anthropophaga, Leeches, and Ticks) le DPDx Laboratory Identification of Myiasis.
• Mokhatlo oa Bongaka ba Lehoatateng (WMS): Litaelo tsa Boikoetliso ba Kliniki bakeng sa Tsamaiso ea Maqeba le ho Tlosoa ha Ectoparasite ea Wilderness (Hirudinea Leech Detachment, Aeromonas Prophylaxis, le Myiasis Extraction).
• Mokhatlo oa Lefatše oa Bophelo (WHO): Maeto a Machabeng le Bophelo bo Botle: Tšoaetso ea Letlalo la Vector-Borne le Parasitic (Myiasis le Aquatic Leech Hirudiniasis).
• Australian Resuscitation Council (ANZCOR) le Australasian Society of Clinical Immunology and Allergy (ASCIA): Taelo 9.4.3: Envenomation from Tick Bites (Freeze-Don't-Squeeze Protocol for Ixodes holocyclus).
• Tšebeletso ea Sechaba ea Bophelo (NHS, United Kingdom) le Sepetlele sa Mafu a Tropike: Litaelo tsa Tleliniki mabapi le ho Khutlisetsa Baeti ba nang le Furuncular Myiasis, Tick Bites, le Leech Wounds.

Litataiso tse amanang¶

• Letshwao le sekgo se loma thuso ya pele
• Ho hasana ha cellulitis, li-red lymphangitis streaks, le makhopho a letlalo
• Ntho e tsoang kantle ho naha, ho phatloha ha cornea, le ho ntša mahlo
• Ntho e kantle tsebeng kapa nkong le kokoanyana e phelang ka kanaleng ya tsebe
• Linomoro tsa maemo a tshohanyetso ho ea ka linaha