I-toxoplasmosis yokuzalwa

I-toxoplasmosis ye-Congenital liqela leempawu ezenzeka xa usana olungekazalwa (olungekazalwa) lusulelwe sisidleleli Toxoplasma gondii.

Usulelo lwe-Toxoplasmosis lunokudluliselwa kumntwana okhulayo ukuba umama wosuleleka ngelixa ekhulelwe. Usulelo lusasazeka kusana olusakhulayo luye kwi-placenta. Uninzi lwexesha, usulelo luthambile kumama. Umfazi usenokungazi ukuba une-parasite. Nangona kunjalo, usulelo losana olukhulayo lunokubangela iingxaki ezinkulu. Iingxaki zimbi kakhulu ukuba usulelo lwenzeka xa ukhulelwe kwangoko.

Ukuya kuthi ga kwisiqingatha seentsana ezosulelwa yi-toxoplasmosis ngexesha lokukhulelwa zizalwa kwangoko (ngaphambi kwexesha). Usulelo lunokonakalisa amehlo omntwana, inkqubo yeemvakalelo, ulusu kunye neendlebe.

Rhoqo, kukho imiqondiso yosulelo ekuzalweni. Nangona kunjalo, iintsana ezinesifo esincinci zisenokungabi nazimpawu zenyanga okanye iminyaka emva kokuzalwa. Ukuba ayinyangwa, uninzi lwabantwana abanolu suleleko baba neengxaki kulutsha lwabo. Iingxaki zamehlo ziqhelekile.

Iimpawu zingabandakanya:

• Ukwandiswa kwesibindi kunye ne-spleen
• Ukuhlanza
• Ukonakala kwamehlo kukudumba kweretina okanye ezinye iinxalenye zeliso
• Iingxaki zokondla
• Ukuphulukana nokuva
• I-jaundice (ulusu olutyheli)
• Ubunzima bokuzalwa okuphantsi (isithintelo sokukhula kwangaphakathi)
• Ukudumba kolusu (amabala amancinci abomvu okanye ukugruzuka) ekuzalweni
• Iingxaki zombono

Ubunzima kunye nenkqubo yovalo yomonzakalo isusela kubunzulu bude ukuya kobunzima, kwaye inokubandakanya:

• Ukuxhuzula
• Ukukhubazeka kwengqondo

Umboneleli wezempilo uya kuluhlola usana olo. Usana lunokuba:

• Udakada odumbileyo kunye nesibindi
• Isikhumba esimthubi (i-jaundice)
• Ukudumba kwamehlo
• Ulwelo kwingqondo (i-hydrocephalus)
• I-lymph nodes ezidumbileyo (i-lymphadenopathy)
• Ubukhulu bentloko enkulu (macrocephaly) okanye encinci kunesiqhelo ubungakanani bentloko (i-microcephaly)

Uvavanyo olunokwenziwa ngexesha lokukhulelwa lubandakanya:

• Uvavanyo lwe-Amniotic fluid kunye nokuvavanywa kwegazi olungekazalwa
• Umxholo we-Antibody
• I-Ultrasound yesisu

Emva kokuzalwa, olu vavanyo lulandelayo lunokwenziwa emntwaneni:

• Izifundo ze-antibody kwi-cord yegazi kunye ne-cerebrospinal fluid
• Ukuvavanywa kwe-CT kwengqondo
• Ukuvavanywa kwengqondo kweMRI
• Iimviwo ze-Neurological
• Uvavanyo lwamehlo oluqhelekileyo
• Uvavanyo lweToxoplasmosis

I-Spiramycin inokunyanga usulelo kumama okhulelweyo.

I-Pyrimethamine kunye ne-sulfadiazine inokunyanga usulelo olungekazalwa olungekazalwa (oluchongwe ngexesha lokukhulelwa)

Unyango lwabantwana abanesifo sokuzalwa se-toxoplasmosis sihlala siquka i-pyrimethamine, i-sulfadiazine, kunye ne-leucovorin unyaka omnye. Iintsana ngamanye amaxesha zinikwa ii-steroids ukuba umbono wazo uyasongelwa okanye ukuba inqanaba leprotein kulwelo lomqolo luphezulu.

Isiphumo sixhomekeke kubungakanani bemeko.

Iingxaki zinokubandakanya:

• IHydrocephalus
• Ubumfama okanye ukukhubazeka okubonakalayo
• Ukukhubazeka okukhulu kwengqondo okanye ezinye iingxaki zemithambo-luvo

Fowunela umboneleli wakho wezempilo ukuba ukhulelwe kwaye ucinga ukuba usengozini yosulelo. (Umzekelo, usulelo lwe-toxoplasmosis lunokudluliselwa kwiikati ukuba ucoce ibhokisi yenkunkuma yekati.) Tsalela umnikezeli wakho ukuba ukhulelwe kwaye khange ufumane unonophelo lwangaphambi kokubeleka.

Abasetyhini abakhulelweyo okanye abaceba ukukhulelwa banokuvavanywa ukufumanisa ukuba basemngciphekweni wosulelo.

Abafazi abakhulelweyo abaneekati njengezilwanyana zasekhaya banokuba semngciphekweni omkhulu. Kuya kufuneka bakuphephe ukunxibelelana nelindle lekati, okanye izinto ezinokungcoliseka zizinambuzane ezivezwe kwilindle lekati (njengamaphela kunye neempukane).

Kwakhona pheka inyama ide yenziwe kakuhle, kwaye uhlambe izandla zakho emva kokuphatha inyama ekrwada ukunqanda ukufumana isifunxi-gazi.

• I-toxoplasmosis yokuzalwa

UDuff P, uBirsner M.Ukusuleleka koomama kunye nosulelo ngexesha lokukhulelwa: intsholongwane. Ku: Gabbe SG, Niebyl JR, Simpson JL, et al, ii-eds. I-Obstetrics: Ukukhulelwa okuqhelekileyo kunye neengxaki. Umhla wesi-7. IPhiladelphia, PA: Elsevier; Ngo-2017: isahluko 54.

UMcLeod R, uBoyer KM. I-Toxoplasmosis (iToxoplasma gondii). Ku: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, ii-eds. Incwadi kaNelson yeNcwadi yePediatrics. Umhla wama-21. IPhiladelphia, PA: Elsevier; 2020: isahluko 316.

IMontoya JG, iBoothroyd JC, iKovacs JA. Toxoplasma gondii. 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 280.