Meningitis - isifo sephepha

Isifo sokudumba kwenwebu yengqondo sisifo sezicubu ezigubungele ingqondo kunye nomqolo womqolo (iincindi zeminwe).

Isifo sokudumba kwenwebu yobuchopho kubangelwa Isifo sephepha seMicobacterium. Le yintsholongwane ebangela isifo sephepha (TB). Iibhaktheriya zisasazeka kwingqondo kunye nomqolo ukusuka kwenye indawo emzimbeni, ngokuqhelekileyo umphunga.

Isifo sokudumba kwenwebu yengqondo enqabileyo kunqabile eMelika. Uninzi lweziganeko ngabantu abatyelele eMelika bevela kwamanye amazwe apho ixhaphakileyo i-TB.

Abantu abanoku kulandelayo banethuba eliphezulu lokufumana isifo sephepha lokudumba kwenwebu yesifo sephepha:

• Intsholongwane kaGawulayo / uGawulayo
• Sela utywala ngokugqithileyo
• Isifo sephepha emiphungeni
• Amandla omzimba abuthathaka

Iimpawu zihlala ziqala kancinci, kwaye zinokubandakanya:

• Umkhuhlane kunye nokubanda
• Ukutshintsha kwemeko yengqondo
• Isicaphucaphu nokugabha
• Ubuntununtunu ekukhanyeni (photophobia)
• Intloko ebuhlungu
• Intamo elukhuni (meningismus)

Ezinye iimpawu ezinokuthi zenzeke kwesi sifo zingabandakanya:

• Ukuphazamiseka
• Ukuqengqeleka kweefonti (amabala athambileyo) kwiintsana
• Ukuhla kwengqondo
• Ukutya okungalunganga okanye ukucaphuka ebantwaneni
• Ukuma okungaqhelekanga, kunye nentloko nentamo egobele ngasemva (opisthotonos). Oku kufumaneka rhoqo kwiintsana.

Umboneleli wezempilo uyakukuvavanya. Oku kuhlala kubonisa ukuba unale ilandelayo:

• Ukukhawuleza kwentliziyo
• Ifiva
• Ukutshintsha kwemeko yengqondo
• Intamo elukhuni

Ukugqobhoza i-lumbar (impompo yomqolo) luvavanyo olubalulekileyo ekufumaniseni i-meningitis. Kuyenziwa ukuqokelela isampulu yolwelo lomqolo ukuze luhlolwe. Ngaphezulu kwesampulu enye kunokufuneka ukuba kwenziwe isifo.

Olunye uvavanyo olunokwenziwa lunokubandakanya:

• I-Biopsy yengqondo okanye i-meninges (inqabile)
• Inkcubeko yegazi
• I-x-ray yesifuba
• Uviwo lwe-CSF lokubala kweeseli, iswekile, kunye neeproteni
• Ukuvavanywa kwentloko kwe-CT
• Ibala legram, amanye amabala akhethekileyo kunye nenkcubeko ye-CSF
• Ukuphendula ngetyathanga lePolymerase (PCR) ye-CSF
• Uvavanyo lolusu lwe-TB (PPD)
• Olunye uvavanyo lokujonga i-TB

Uya kunikwa amayeza aliqela okulwa neentsholongwane ze-TB. Ngamanye amaxesha, unyango luqaliswa nokuba umboneleli wakho ucinga ukuba unesi sifo, kodwa uvavanyo alukakuqinisekisi okwangoku.

Unyango luhlala luhlala iinyanga ezili-12 ubuncinci. Amayeza abizwa ngokuba yi-corticosteroids nawo anokusetyenziswa.

Isifo sokudumba kwenwebu yobuchopho emngciphekweni sisongela ubomi ukuba asinyangwa. Ukulandelwa kwexesha elide kuyafuneka ukufumana usulelo oluphindaphindiweyo (ukuphindaphinda).

Xa singanyangwa, esi sifo sinokubangela nayiphi na kwezi zinto zilandelayo:

• Umonakalo wobuchopho
• Ukwakha ulwelo phakathi kolukakayi kunye nengqondo (ukungasebenzi komhlaba)
• Ukuphulukana nokuva
• IHydrocephalus (ulwakhiwo lwamanzi ngaphakathi kolukakayi olukhokelela kukudumba kwengqondo)
• Ukuxhuzula
• Ukufa

Fowunela inombolo yongxamiseko yendawo (enje nge-911) okanye uye kwigumbi likaxakeka ukuba ukrokrela i-meningitis kumntwana omncinci oneempawu ezilandelayo:

• Iingxaki zokondla
• Isikhalo esiphakamileyo
• Ukucaphuka
• Umkhuhlane oqhubekayo ongachazwanga

Fowunela inombolo yongxamiseko yendawo ukuba uvelisa naziphi na iimpawu ezinzulu ezidweliswe apha ngasentla. I-Meningitis inokuba sisifo esisongela ubomi ngokukhawuleza.

Ukunyanga abantu abaneempawu zentsholongwane engasebenziyo (eleleyo) kunokuthintela ukusasazeka kwayo. Uvavanyo lwe-PPD kunye nolunye uvavanyo lwe-TB lunokwenziwa ukuxelela ukuba unolu hlobo losulelo.

Amanye amazwe anezehlo eziphezulu ze-TB anika abantu iyeza lokuthintela ekuthiwa yi-BCG ukunqanda i-TB. Kodwa, ukusebenza kwesi sitofu kunqunyelwe, kwaye akusoloko kusetyenziswa eMelika. Isitofu sokugonya se-BCG sinokunceda ekuthinteleni iintlobo eziqatha ze-TB, ezinjenge-meningitis, kubantwana abancinci kakhulu abahlala kwimimandla esiqheleke kuyo esi sifo.

Isifo sephepha; Imeningitis yesifo sephepha

• Inkqubo ye-nervous central kunye ne-peripheral system

UAnderson NC, uKoshy AA, uRoos KL. Iibhaktiriya, izifo zokungunda kunye nezokuphazamiseka kwenkqubo yemithambo-luvo. Ku: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, ii-eds. I-Neurology kaBradley kwiKlinikhi yokuziqhelanisa. Umhla wesi-7. IPhiladelphia, PA: Elsevier; Ngo-2016: isahluko 79.

I-Cruz AT, i-Starke JR. Isifo sephepha. Ku: UCherry JD, uHarrison GJ, uKaplan SL, uSteinbach WJ, uHotez PJ, ii-eds. Incwadi kaFeigin kunye neCherry yezifo ezosulelayo zabantwana. Ngomhla we-8. IPhiladelphia, PA: Elsevier; I-2019: isahluko 96.

UFitzgerald DW, uSterling TR, uHaas DW. Isifo sephepha seMicobacterium. Ku: Bennett JE, Dolin R, Blaser MJ, ii-eds. UMandell, uDouglas, kunye neMigaqo yeBennett kunye nokuSebenza kwezifo ezosulelayo, uHlelo oluHlaziyiweyo. Ngomhla we-8. IPhiladelphia, PA: Elsevier Saunders; 2015: isahluko 251.