Umkhuhlane wamathambo

I-Rheumatic fever sisifo esinokuthi sikhule emva kosulelo lweqela le-A streptococcus bacteria (njenge-strep throat okanye i-scarlet fever). Inokubangela ukugula kakhulu entliziyweni, kumalungu, kulusu nakwingqondo.

I-rheumatic fever ixhaphakile kumazwe anentlupheko eninzi kunye neenkqubo zempilo ezimbi. Ayifane yenzeke eMelika nakwamanye amazwe ahambele phambili. Xa i-rheumatic fever isenzeka e-United States, ihlala iqheleka kuqhambuko oluncinci. Ukuqhambuka kwamva nje eUnited States kwakungoo-1980.

Irheumatic fever yenzeka emva kokosulelwa yintsholongwane okanye ibacteria IStreptococcus pyogenes okanye iqela A streptococcus. Le ntsholongwane ibonakala ngathi iyakhohlisa amajoni omzimba ekuhlaseleni izicwili ezisempilweni emzimbeni. Ezi zihlunu zidumbile okanye zidumbe.

Ukuphendula okungaqhelekanga kubonakala ngathi kuhlala kusenzeka rhoqo ngomqala okanye ngombala obomvu. Izifo ezosulelayo ezibandakanya amanye amalungu omzimba kubonakala ngathi azibangeli rheumatic fever.

I-rheumatic fever ikakhulu ichaphazela abantwana abaneminyaka emi-5 ukuya kweli-15 abanesifo somqala okanye umqala obomvu. Ukuba iyenzeka, ikhula malunga neentsuku ezili-14 ukuya kwezi-28 emva kwezi zigulo.

Iimpawu zinokuchaphazela iinkqubo ezininzi emzimbeni. Iimpawu eziqhelekileyo zingabandakanya:

• Ifiva
• Iimpumlo
• Intlungu esiswini
• Iingxaki zentliziyo, ezinokuthi zingabinazimpawu, okanye zingakhokelela ekuphefumlweni kunye nentlungu esifubeni

Iimpawu kumalungu angenza:

• Unobangela wentlungu, ukudumba, ukuba bomvu kunye nobushushu
• Zenzeka ikakhulu emadolweni, engqinibeni, emaqatheni nasezihlahleni
• Guqula okanye ususe kwelinye iqabane uye kwelinye

Utshintsho lolusu lunokwenzeka, njenge:

• Irhasi emile okwe-ringi okanye efana nenyoka esiqwini nakumphezulu wengalo okanye wemilenze
• Izigaqa zolusu okanye amaqhuqhuva

Imeko echaphazela ingqondo kunye nenkqubo yovalo, ebizwa ngokuba yiSydenham chorea nayo inokwenzeka. Iimpawu zale meko zezi:

• Ukuphulukana nolawulo lweemvakalelo, kunye nokukhala okungaqhelekanga okanye ukuhleka
• Ukuhamba ngokukhawuleza, ukunyakaza okuchaphazela ikakhulu ubuso, iinyawo kunye nezandla

Umboneleli wakho wezempilo uya kukuvavanya kwaye uza kujonga ngononophelo izandi zentliziyo yakho, ulusu kunye namalungu.

Uvavanyo lunokubandakanya:

• Uvavanyo lwegazi losulelo oluphindaphindiweyo (njengokuvavanywa kwe-ASO)
• Gcwalisa ubalo lwegazi (CBC)
• I-Electrocardiogram (ECG)
• Ireyithi yokulinganisa (ESR - uvavanyo olulinganisa ukuvuvukala emzimbeni)

Zininzi izinto ezibizwa ngokuba ziimpawu ezinkulu kunye nezincinci ezenziweyo ukunceda ukufumanisa isifo samathambo ngendlela esemgangathweni.

Iikhrayitheriya eziphambili zokuchongwa kubandakanya:

• Isifo samathambo kumalungu amaninzi amakhulu
• Ukudumba kwentliziyo
• Amaqhuqhuva phantsi kolusu
• Ukuhamba ngokukhawuleza, ukunyakaza kwe-jerky (chorea, Sydenham chorea)
• Ukudumba kolusu

Iikhrayitheriya ezincinci zibandakanya:

• Ifiva
• Ephakamileyo ESR
• Intlungu edibeneyo
• ECG engaqhelekanga

Uya kufunyaniswa une-rheumatic fever ukuba:

• Dibana neendlela ezimbini eziphambili, okanye i-1 enkulu kunye ne-2 yeekhrayitheriya ezincinci
• Unemiqondiso yosulelo lwe-strep oludlulileyo

Ukuba wena okanye umntwana wakho ufunyenwe une-rheumatic fever enamandla uya kunyangwa ngamayeza okubulala iintsholongwane. Injongo yolu nyango kukususa yonke i-strep bacteria emzimbeni.

Emva kokuba unyango lokuqala lugqityiwe, amayeza amaninzi amiselweyo. Injongo yala mayeza kukuthintela i-rheumatic fever ekuphindaphindeni.

• Bonke abantwana baya kuqhubeka ne-antibiotics kude kube yiminyaka engama-21.
• Ulutsha kunye nabantu abadala abancinci kuya kufuneka bathathe ii-antibiotics ubuncinci iminyaka emi-5.

Ukuba wena okanye umntwana wakho uneengxaki zentliziyo xa kwenzeka isifo samathambo, amayeza okubulala iintsholongwane anokufuneka ixesha elide, mhlawumbi ubomi.

Ukunceda ukulawula ukudumba kwezicubu ezivuthayo ngexesha lomkhuhlane we-rheumatic fever, amayeza anjenge-aspirin okanye i-corticosteroids anokufuneka.

Ngeengxaki zokuhamba okungaqhelekanga okanye isimilo esingaqhelekanga, amayeza ahlala esetyenziselwa ukunyanga ukuxhuzula anokumiselwa.

I-rheumatic fever inokubangela iingxaki ezinkulu zentliziyo kunye nomonakalo wentliziyo.

Iingxaki zentliziyo yexesha elide zinokwenzeka, ezinje:

• Ukonakala kwezivalo zentliziyo. Lo monakalo unokubangela ukuvuza kwivelufa yentliziyo okanye ukunciphisa okucothisa ukuhamba kwegazi kwivelufa.
• Ukonakala kwizihlunu zentliziyo.
• Ukumelwa yintliziyo.
• Usulelo lwe-lining yangaphakathi yentliziyo yakho (endocarditis).
• Ukudumba kwenwebu ejikeleze intliziyo (pericarditis).
• Isingqisho senhliziyo esikhawulezayo nesingazinzanga.
• I-Sydenham chorea.

Biza umnikezeli wakho ukuba wena okanye umntwana wakho uvelisa iimpawu zerheumatic fever. Ngenxa yokuba ezinye iimeko ezininzi zineempawu ezifanayo, wena okanye umntwana wakho uya kudinga uvavanyo ngononophelo lonyango.

Ukuba iimpawu zomqala womqala ziphuhla, xelela umboneleli wakho. Wena okanye umntwana wakho kuya kufuneka uhlolwe kwaye uphathwe ukuba i-strep throat ikhona. Oku kuya kunciphisa umngcipheko wokuba ne-rheumatic fever.

Indlela ebaluleke kakhulu yokuthintela i-rheumatic fever kukufumana unyango olukhawulezileyo kwi-strep throat kunye ne-scarlet fever.

IStreptococcus - i-rheumatic fever; Umqala womqala - umkhuhlane we-rheumatic fever; IStreptococcus pyogenes - umkhuhlane wamathambo; Iqela le-streptococcus-rheumatic fever

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UShulman ST, uJaggi P. Ku: Bennett JE, Dolin R, Blaser MJ, ii-eds. Mandell, Douglas, kunye neBennett's Principles and Practice of Infectious Diseases. Umhla we-9. IPhiladelphia, PA: Elsevier; 2020: isahl. 198.

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