Endocarditis

I-Endocarditis kukukrala kwangaphakathi ngaphakathi kwamagumbi entliziyo kunye nezivalo zentliziyo (endocardium). Kubangelwa yintsholongwane okanye, kunqabile ukuba usulelo lokungunda.

I-Endocarditis inokubandakanya isihlunu sentliziyo, iivalves zentliziyo, okanye ulungelelwaniso lwentliziyo. Abanye abantu abaphuhlisa i-endocarditis bane:

• Isiphene sokuzalwa kwentliziyo
• I-valve yentliziyo eyonakalisiweyo okanye engaqhelekanga
• Imbali ye-endocarditis
• Intliziyo entsha yentsimbi emva kotyando
• I-Parenteral (efakwa ngaphakathi) iziyobisi

I-Endocarditis iqala xa iintsholongwane zingena egazini zize ziye entliziyweni.

• Usulelo lwebacteria sesona sizathu sixhaphakileyo se-endocarditis.
• I-Endocarditis nayo inokubangelwa kukungunda, njengeCandida.
• Ngamanye amaxesha, akukho sizathu sinokufunyanwa.

Iintsholongwane kunokwenzeka ukuba zingene egazini ngexesha:

• Imigca yokungena esembindini
• Ukusetyenziswa kweziyobisi ngenaliti, kusetyenziswa iinaliti ezingahlambulukanga (ezingafunekiyo)
• Utyando lwamva nje lwamazinyo
• Olunye utyando okanye iinkqubo ezincinci kwimpefumlo, kumchamo, ulusu olosulelekileyo, okanye amathambo kunye nezihlunu

Iimpawu ze-endocarditis zingakhula kancinci okanye ngesiquphe.

Umkhuhlane, Ukugodola nokubila ziimpawu eziqhelekileyo. Ngamanye amaxesha banako:

• Yiba khona kangangeentsuku ngaphambi kokuba kuvele ezinye iimpawu
• Yiza uhambe, okanye uqaphele ngakumbi ngexesha lasebusuku

Unokuba nokudinwa, ukuba buthathaka, kunye neentlungu kunye neentlungu kwimisipha okanye kumalungu.

Ezinye iimpawu zingabandakanya:

• Iindawo ezincinci zokopha phantsi kwezikhonkwane (i-splinter hemorrhages)
• Olubomvu, amabala esikhumba angenantlungu ezintendeni nasezintendeni (izilonda zeJaneway)
• Olubomvu, iindawo ezibuhlungu kwiipads zeminwe kunye neenzwane (Osler nodes)
• Ukuphefumla okufutshane kunye nomsebenzi
• Ukudumba kweenyawo, imilenze, isisu

Umboneleli wezempilo unokubona ukukrokra kwentliziyo entsha, okanye utshintsho kwimbombozi yentliziyo edlulileyo.

Uvavanyo lwamehlo lunokubonisa ukopha kwi-retina nakwindawo esembindini yokucoca. Oku kufumanisa kwaziwa njengeendawo zeRoth. Kukho iindawo ezincinci zokuphawula ukopha kumphezulu wamehlo okanye iinkophe.

Uvavanyo olunokwenziwa lunokubandakanya:

• Inkcubeko yegazi ukunceda ekuchongeni ibhaktiriya okanye ukungunda okubangela usulelo
• Gcwalisa inani legazi (CBC), iprotheyini esebenzayo yeC (CRP), okanye inqanaba le-erythrocyte sedimentation (ESR)
• I-echocardiogram ukujonga iivevhe zentliziyo

Kuya kufuneka ubesesibhedlele ukufumana i-antibiotics ngomthambo (IV okanye nge-intravenously). Iinkcubeko zegazi kunye novavanyo ziya kunceda umboneleli wakho akhethe eyona zintsholongwane.

Uya kuthi emva koko ufune unyango lweyeza elide.

• Abantu bahlala befuna unyango iiveki ezi-4 ukuya kwezi-6 ukubulala zonke iintsholongwane ezivela kumagumbi entliziyo kunye neevalvu.
• Unyango lwe-Antibiotic oluqaliswe esibhedlele luyakufuneka luqhubeke ekhaya.

Utyando lokutshintsha i-valve yentliziyo luyafuneka rhoqo xa:

• Usulelo luyaqhekeka ngamaqhekeza amancinci, lubangele ukubetha.
• Umntu uvelisa ukusilela kwentliziyo ngenxa yezivalo zentliziyo ezonakalisiweyo.
• Kukho ubungqina bomonakalo omkhulu kumzimba.

Ukufumana unyango lwe-endocarditis kwangoko kuphucula amathuba eziphumo ezilungileyo.

Iingxaki ezinzulu ezinokubakho zibandakanya:

• Ithumba lobuchopho
• Ukuqhubeka kokulimala kwezivalo zentliziyo, kubangele ukusilela kwentliziyo
• Ukusasazeka kosulelo kwamanye amalungu omzimba
• Ukubetha, ngenxa yamahlwili amancinci okanye amaqhekeza osulelo aqhekeka kwaye aye kwingqondo

Fowunela umboneleli wakho ukuba ubona ezi mpawu zilandelayo ngexesha okanye emva konyango:

• Igazi kumchamo
• Iintlungu zesifuba
• Ukudinwa
• Fever engahambiyo
• Ifiva
• Ubumdaka
• Ubuthathaka
• Ukuthoba umzimba ngaphandle kotshintsho kwindlela otya ngayo

I-American Heart Association icebisa i-antibiotics yothintelo kubantu abasemngciphekweni wokufumana isifo i-endocarditis, enje ngala:

• Ezinye iziphene zokuzalwa kwentliziyo
• Intliziyo yokufakelwa kunye neengxaki ze-valve
• Iintsholongwane zentliziyo yokufakelwa (iipilisi zeentliziyo ezifakwe ngugqirha ogqirha)
• Imbali edlulileyo ye-endocarditis

Aba bantu kufuneka bafumane i-antibiotics xa:

• Iinkqubo zamazinyo ezinokubangela ukopha
• Iinkqubo ezibandakanya ukuphefumla
• Iinkqubo ezibandakanya inkqubo yomchamo
• Iinkqubo ezibandakanya indlela yokugaya
• Iinkqubo kusulelo lolusu kunye nosulelo lwezihlunu ezithambileyo

Usulelo lwevalvu; I-Staphylococcus aureus - i-endocarditis; Enterococcus - endocarditis; IStreptococcus viridans - i-endocarditis; I-Candida - i-endocarditis

• Utyando lwevalvu yentliziyo - ukukhutshwa

• Icandelo lentliziyo phakathi embindini
• Intliziyo - umbono wangaphambili
• Isilonda seJaneway-sisondele
• Isilonda seJaneway emnweni
• Ivaluva zentliziyo

I-Baddour LM, iFreeman WK, iSuri RM, iWilson WR. Izifo zentliziyo. Ku: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, ii-eds. Isifo sentliziyo seBraunwald: Incwadi yesifundo seMpilo yeNtliziyo. Ngomhla we-11. IPhiladelphia, PA: Elsevier; I-2019: isahluko 73.

I-Baddour LM, iWilson WR, iBayer AS, et al. I-endocarditis yesifo kubantu abadala: ukuxilongwa, unyango lwe-antimicrobial, kunye nokulawulwa kweengxaki: ingxelo yesayensi yabasebenzi bezempilo kwi-American Heart Association. Ukujikeleza. Ngo-2015; 132 (15): 1435-1486. IINKCUKACHA: 26373316 www.ncbi.nlm.nih.gov/pubmed/26373316.

IFowler VG, iBayer AS, iBaddour LM. I-endocarditis echaphazelekayo. Ku: IGoldman L, iSchafer AI, ii-eds. Amayeza eGoldman-Cecil. Umhla wama-25. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 76.

IFowler VG, iScheld WM, iBayer AS. I-Endocarditis kunye nosulelo lwe-intravascular. Ku: Bennett JE, Dolin R, Blaser MJ, ii-eds. Mandell, Douglas, kunye neBennett's Principles and Practice of Infectious Diseases. Ngomhla we-8. IPhiladelphia, PA: Elsevier Saunders; 2015: isahluko 82.