Endocarditis - abantwana

Umbane wangaphakathi wamagumbi entliziyo kunye neevalvu zentliziyo ubizwa ngokuba yi-endocardium. I-Endocarditis yenzeka xa esi sicwili sidumba okanye sidumbe, amaxesha amaninzi ngenxa yosulelo olusuka kwiiveluvu zentliziyo.

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

• Usulelo lwebacteria sesona sizathu sixhaphakileyo
• Usulelo lomngundo lunqabile ngakumbi
• Kwezinye iimeko, akukho ntsholongwane inokufunyanwa emva kovavanyo

I-Endocarditis inokubandakanya isihlunu sentliziyo, iivalves zentliziyo, okanye ulungelelwaniso lwentliziyo. Abantwana abane-endocarditis banokuba nemeko enje ngezi:

• Isiphene sokuzalwa kwentliziyo
• I-valve yentliziyo eyonakalisiweyo okanye engaqhelekanga
• Intliziyo entsha yentsimbi emva kotyando

Umngcipheko uphezulu kubantwana abanembali yotyando lwentliziyo, olunokushiya iindawo ezirhabaxa kuludwe lwamagumbi entliziyo.

Oku kwenza ukuba kube lula kwiibhaktheriya ukunamathela kumgca.

Iintsholongwane zinokungena kwigazi:

• Ngendlela yokungena okuphakathi okukhoyo okukhoyo
• Ngexesha lotyando lwamazinyo
• Ngexesha lolunye utyando okanye iinkqubo ezincinci zokuhamba komoya kunye nemiphunga, indawo yokuchama, ulusu olosulelekileyo, okanye amathambo kunye nezihlunu
• Ukufuduka kwebhaktheriya ukusuka emathunjini okanye emqaleni

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

Ezinye iimpawu zingabandakanya:

• Ukudinwa
• Ubuthathaka
• Intlungu edibeneyo
• Intlungu yezihlunu
• Ingxaki yokuphefumla
• Ukuhla ukusinda
• Ukuphelelwa ngumdla wokutya

Iingxaki ze-Neurological, ezinje ngokuxhuzula kunye nokuphazamiseka kwengqondo

Iimpawu ze-endocarditis zinokubandakanya:

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

Umboneleli wezempilo womntwana wakho angenza i-transthoracic echocardiography (TTE) ukukhangela i-endocarditis kubantwana abaneminyaka eli-10 okanye engaphantsi.

Olunye uvavanyo lunokubandakanya:

• Inkcubeko yegazi ukunceda ekuchongeni ibhaktiriya okanye ukungunda okubangela usulelo
• Gcwalisa ubalo lwegazi (CBC)
• Iprotheyini esebenzayo yeC (CRP) okanye inqanaba le-sedryation ye-erythrocyte (ESR)

Unyango lwe-endocarditis luxhomekeke:

• Unobangela wosulelo
• Ubudala bomntwana
• Ubunzima beempawu

Umntwana wakho kuya kufuneka abe esibhedlele ukuze afumane i-antibiotics nge-vein (IV). Iinkcubeko zegazi kunye novavanyo ziya kunceda umboneleli akhethe eyona zintsholongwane.

Umntwana wakho uya kudinga unyango lweyeza elide.

• Umntwana wakho uya kuludinga olu nyango kangangeeveki ezi-4 ukuya kwezi-8 ukuze abulale ngokupheleleyo zonke iintsholongwane ezivela kumagumbi entliziyo kunye neevalvu.
• Unyango lwe-Antibiotic oluqale esibhedlele luyakufuna ukuqhubekeka ekhaya xa umntwana wakho esomelele.

Ugqirha lokutshintsha i-valve yentliziyo eyosulelekileyo kunokufuneka xa:

• I-Antibiotic ayisebenzi ukunyanga usulelo
• Usulelo luyaqhekeka ngamaqhekeza amancinci, lubangele ukubetha
• Umntwana ukhula ukusilela kwentliziyo ngenxa yezivalo zentliziyo ezonakalisiweyo
• Ivalvu yentliziyo yonakele kakhulu

Ukufumana unyango lwe-endocarditis kwangoko kuphucula amathuba okususa usulelo kunye nokuthintela iingxaki.

Iingxaki ezinokubakho ze-endocarditis ebantwaneni zezi:

• Ukonakala kwentliziyo kunye nezivalo zentliziyo
• Ithumba kwizihlunu zentliziyo
• Isithintelo esosulelayo kwimithambo yegazi
• Ukubetha, ngenxa yamahlwili amancinci okanye amaqhekeza osulelo aqhekeka kwaye aye kwingqondo
• Ukusasazeka kosulelo kwamanye amalungu omzimba, anje ngemiphunga

Tsalela umnikezeli womntwana wakho ukuba ubona ezi mpawu zilandelayo ngexesha okanye emva konyango:

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

Umbutho wentliziyo yaseMelika ucebisa ukuba uthintele abantwana abasemngciphekweni we-endocarditis, njengale:

• Iziphene ezithile zokuzalwa ezilungisiweyo okanye ezingachanekanga zentliziyo
• Intliziyo yokufakelwa kunye neengxaki ze-valve
• Ivaluva zentliziyo ezenziwe ngumntu (zokufakelwa)
• Imbali edlulileyo ye-endocarditis

Aba bantwana kufuneka bafumane i-antibiotics xa:

• Iinkqubo zamazinyo ezinokubangela ukopha
• Iinkqubo ezibandakanya indlela yokuphefumla, i-urinary tract, okanye i-digestive tract
• Iinkqubo kusulelo lolusu kunye nosulelo lwezihlunu ezithambileyo

Usulelo ivelufa - abantwana; Staphylococcus aureus - endocarditis - abantwana; Enterococcus - endocarditis- abantwana; I-Streptococcus viridians - i-endocarditis - abantwana; Candida - endocarditis - abantwana; I-bacterial endocarditis - abantwana; Isifo esosulelayo endocarditis - abantwana; Izifo zentliziyo yokuzalwa - i-endocarditis - abantwana

• Iipavali zentliziyo-umbono ogqwesileyo

IBaltimore RS, iGewitz M, iBaddour LM, et al; I-American Heart Association iRheumatic Fever, i-Endocarditis, kunye neKomiti yeZifo zeKawasaki yeBhunga kwiZifo zeNhliziyo kwi-Young kunye neBhunga kwi-Cardiovascular and Stroke Nursing. I-endocarditis yesifo ebuntwaneni: Uhlaziyo luka-2015: ingxelo yezenzululwazi evela kwiAmerican Heart Association. Ukujikeleza. Ngo-2015; 132 (15): 1487-1515. IINKCUKACHA: 26373317 www.ncbi.nlm.nih.gov/pubmed/26373317.

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UMarcdante KJ, uKliegman RM. I-endocarditis echaphazelekayo. Ku: UMarcdante KJ, uKliegman RM, ii-eds. UNelson oBalulekileyo kwiPediatrics. Ngomhla we-8. IPhiladelphia, PA: Elsevier; 2019: isahl. 111.

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