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Tổn thương da và niêm mạc ở trẻ nhiễm HIV?  

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09:08 24/08/2014

Mụn, nhọt ngoài da, chốc, viêm loét,ban dạng nước...là những tổn thương da thường gặp ở trẻ nhiễm HIV/AIDS. Đây là 1 trong những bệnh nhiễm trùng hay gặp và có liên quan .. [..]

Mụn, nhọt ngoài da, chốc, viêm loét,ban dạng nước...là những tổn thương da thường gặp ở trẻ nhiễm HIV/AIDS. Đây là 1 trong những bệnh nhiễm trùng hay gặp và có liên quan chặt chẽ với tình trạng suy giảm miễn dịch.

 

Biểu hiện nhiễm khuẩn tại chỗ

Biểu hiện: mụn, nhọt ngoài da, chốc, viêm loét, đến viêm cơ, xương hoặc áp-xe. Trẻ có thể có biểu hiện sốt. Tác nhân gây bệnh: do vi khuẩn (thường do tụ cầu, liên cầu tan huyết), do nấm (Candida, Penicillium marneffei...) do virut (HSV, VZV, HPV) và các loại khác như ghẻ, dị ứng, côn trùng. Có thể dùng các thuốc amoxiciclin hoặc oxacilin  hoặc thuốc chống virus acyclovir (khi do VZV, HPV). Tiêm hoặc uống tùy theo mức độ nặng của bệnh.

Ban dạng phỏng nước

Zona (giời leo) do Herpes zoster (HZV): phỏng nước, đau rát ở một bên cơ thể, dọc theo tiết đoạn thần kinh da, thường là vùng liên sườn, ngực, đầu, mặt.

Thủy đậu do Varicella zoster- VZV: phỏng nước nhiều lứa tuổi, khắp cơ thể, khi vỡ để lại vết loét.

Herpes simplex (HSV): nhiều mụn nước vỡ tạo thành loét trợt rồi đóng vẩy. Khu trú quanh miệng, hậu môn, sinh dục. Nếu lan đến thực quản gây khó nuốt, nuốt đau, có thể lan đến khí - phế quản. Hay tái phát. Có thể có biến chứng viêm não.



 

Điều trị: bôi xanh-methylen, milian tại chỗ chống bội nhiễm.

Thuốc chống virut tại chỗ ít có hiệu quả, gây kích thích tổn thương. Thuốc toàn thân có tác dụng tốt nhất đối với HZV trong vòng 72 giờ đầu có nốt phỏng. Thể nhẹ, chức năng miễn dịch tốt uống acyclovir trong 7 ngày. Thể nặng, zona lan tỏa tiêm tĩnh mạch acyclovir 7-14 ngày. Phòng tái phát 1 lần trở lên trong một tháng dùng acyclovir kéo dài.

Nhiễm nấm Candida

Nhiễm nấm Candida thường có suy giảm miễn dịch nặng, bệnh dai dẳng, hay tái phát.

Candida miệng: tạo thành mảng, đám giả mạc trắng, dễ bong ở lưỡi, lợi, trong má, vòm họng. Dùng clotrimazol viên ngậm, miconazol, nystatin đánh lưỡi.

Candida họng, thực quản: có triệu chứng khó nuốt, nuốt đau. Dùng fluconazol 6mg/kg/ngày thứ nhất, sau đó 3-6mg/kg/ngày trong 2-3 tuần.

Candida da: biểu hiện dát đỏ lan tỏa, đóng vẩy, xung quanh có sẩn vệ tinh, có thể có mụn mủ hay viêm nang lông mủ. Bệnh nấm Candida xâm nhập dùng amphotericin B trong 2-3 tuần.

Nguồn tổng hợp

Chú ý : Trên đây là những thông tin  mà các bạn có thể tham khảo, để được tư vấn về tâm lý và sức khỏe, hãy gọi đến tổng đài 1900.6180 để  nhận được tư vấn trực tiếp từ các bác sĩ.


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