Zizindikiro za Maningitis ndi Chithandizo

by Vincent Iannelli, MD, dokotala wodziwika bwino

Kodi Mukuyenera Kudziwa Chiyani Zokhudza Matenda a Maninitis?

Ngati mwamvapo za meningitis, makamaka ngati mwana wanu ali ndi malungo osadziwika, mukhoza kukhala ndi nkhawa. Kodi kwenikweni meningitis ndi chiyani? Kodi zizindikiro ndi ziti? Kodi zimapezeka bwanji ndipo zimachizidwa bwanji?

Popeza kuti meningitis ndi imodzi mwa matenda oopsya a ubwana kwa makolo ambiri, kutenga mphindi kuti mudziwe za zizindikiro za matendawa ndi zofunika kwambiri.

Kumvetsa zizindikirozi kungakuthandizeni kuti musadandaule mopanda pake.

Kodi Meningitis ndi chiyani? -Definition

Matenda a meningitis ndi ofala kwambiri mu ubwana kumene tizilombo toyambitsa matenda timayambitsa ndipo zimayambitsa kutupa kwa meninges-ziwalo zomwe zimayang'ana ubongo. Zimasiyana ndi encephalitis yomwe ili ndi matenda omwe amachititsa kuti tizirombo timene timapanga mu ubongo.

Khosi louma, mutu, ndi malungo zimapezeka ndi meningitis, pamene khosi silikuwoneka. Maningitis, makamaka bacterial meningitis, ndi yochepa kwambiri kuposa kale chifukwa cha chizoloŵezi cha katemera wa ana pazifukwa zomwe zimayambitsa.

Zizindikiro ndi Zizindikiro za Maningitis

Aliyense ndi wosiyana pankhani ya meningitis, koma zizindikiro zofala kwambiri ndi kuphatikiza mutu ndi malungo. Kwa ana ambiri, zizindikiro za meningitis zimafika mofulumira mkati mwa maola ambiri ndipo pafupifupi 15 peresenti ya ana sakudziwa panthaŵi yomwe akudziŵa.

Ana ena akhoza kuyamba kudwala matendawa tsiku limodzi kapena awiri musanatuluke mimba. Zizindikiro zotheka za meningitis m'zinthu zingakhale monga:

Msolo wolimba - Khosi loumala likupezeka mwa ana ambiri omwe ali ndi meningitis. Ngati mwana wanu wamva mutu atabwerera kapena akudandaula pamene mukuyesera kukankhira kumtima kwake, muyenera kupeza chithandizo chamankhwala. Nthawi zambiri madokotala amayesa zovuta izi zomwe zapatsidwa mayina a mankhwala. "Chizindikiro cha Kernig" chimaonedwa kuti ndi chabwino ngati zimapweteka kuwonjezera bondo. "Chizindikiro cha Brudzinski" ndi chokakamizika ngati kuponyedwa kwa khosi (kukakamiza mutu wa mwana kumbali yake) kumapweteka ndipo kumapangitsa mwana kusinthasintha m'chiuno mwake ndi mawondo ake. Khosi loumala limapezeka chifukwa cha kutupa kwa meninges, zomwe zimatambasula kwambiri pamene mutu umatambasula ndipo miyendo imatambasula molunjika.

Mutu waukulu.
Chiwindi - Malungo amatha kukhala ochepa (mwachitsanzo, 100.5 F) kapena apamwamba (kuposa 104 F) malingana ndi mtundu wa meningitis ndi zina. Pafupifupi 75 peresenti ya ana ali ndi malungo oposa 100.4 F.)
Nsowa ndi kusanza.
Chisamaliro kuunika (photophobia.)
Kukhumudwa ndi kusasamala.
Kutopa kapena sedation.
Kugonjetsa - Kugonjetsedwa ndi chizindikiro chofala cha meningitis koma chikhoza kuchitika ndi matenda opatsirana popanda matenda a meningitis, monga kugwidwa koopsa .)
Kusintha kwa maganizo m'maganizo, monga kutaya mtima, kukondweretsa, kulakwa, kapena ngakhale kukongola. Kusintha kwa khalidwe la maganizo kumakhala kofala, kumachitika pafupifupi 70 peresenti ya ana mu phunziro limodzi.
Mankhwala a fontanel omwe amawombera m'mimba mwa ana awo omwe fontanel kapena malo osafewa sanatseke panobe.
Kuthamanga (osati blanching (sikusanduka yoyera pamene iwe umangopitirira pa iyo) kuthamanga kumachitika ndi meningococcal meningitis.)
Makhalidwe anu amtundu monga kholo kuti chinachake chalakwika kwambiri. Musamanyalanyaze chidziwitso chanu monga kholo, monga momwe makolo nthawi zambiri amadziwira kuti chinachake chimakhala cholakwika ndi mwana wawo ngakhale asanamvepo chithandizo chachipatala.

Mwamwayi, ana ena alibe zizindikiro za mtundu wa meningitis ndipo nthawi zina zimakhala zovuta kuzipeza.

Kwa ana, zizindikiro za khosi ndi mutu zimakhala zosaoneka bwino, ndipo zizindikiro zambiri zimaphatikizapo kukhumudwa, kudyetsa bwino, ndi kubisala.

Mitundu ya Meningitis

Nthawi zambiri timayankhula za meningitis ngati kuti ndi matenda amodzi, koma pali tizilombo ting'onoting'ono ting'onoting'ono tomwe timayambitsa matenda a mimba. Mavairasi, mabakiteriya, ndi bowa zonse zimayambitsa matenda a meningitis, ndipo zimayambitsa matendawa.

Zifukwa za Viral Meningitis (Aseptic Meningitis)

Mavairasi amachititsa kuti matenda a meningitis akhale mabakiteriya katatu kapena kanayi. Mawu akuti " aseptic meningitis " amatanthauza meningitis omwe amachititsa chinthu china osati mabakiteriya, ndipo amagwiritsidwa ntchito kwambiri pofotokozera vutolo ya meningitis.

Mavairasi ena omwe angayambitse matenda a mimba ndi awa:

Majekesiti (omwe amayamba chifukwa) - Maningitis omwe amachititsidwa ndi enteroviruses amapezeka pakati pa June ndi Oktoba. Mavairasi ndi mavairasi amene amapezeka m'magazi, ndipo ambiri samayambitsa matenda.
Mavairasi a herpes, kuphatikizapo kachilombo ka nkhuku.
Sakanizani tizilombo toyambitsa matenda.
Amatsitsa HIV.
Tizilombo toyambitsa matenda.
Vuto la West Nile - Vuto la West Nile ndi kachilombo kofalitsidwa ndi udzudzu ndipo ndilofala pakati pa August ndi Oktoba. Kuwonjezera pa zizindikiro za meningitis, anthu omwe ali ndi kachilombo kawirikawiri amakhala ndi zilonda zotupa komanso zotupa. Vuto la West Nile lapezeka tsopano m'ma 46 ndipo pafupifupi theka la anthu amene amayamba matendawa amakhalanso ndi meningitis kapena encephalitis.
Lymphocytic choriomeningitis HIV

Zifukwa za Bacterial Meningitis

Bacterial meningitis sizoloŵera kusiyana ndi matenda a mimba koma imakhala yovuta kwambiri ndi kuthekera kwakukulu kwa mavuto a nthawi yaitali. Chifukwa chachikulu cha meningitis chimasiyanasiyana kwambiri ndi msinkhu.

Tiana (miyezi itatu yoyamba): Zomwe zimayambitsa bakiteriya meningitis m'mabwana ang'onoang'ono ndi awa:

E. coli
Gulu la B strepococcus
Listeria monocytogenes

Ana okalamba ndi ana - Mabakiteriya ambiri omwe amachititsa kuti meningitis mu ana aang'ono asinthe kwambiri zaka makumi angapo zapitazi chifukwa cha katemera. Zamoyo zambiri zimaphatikizapo:

Streptococcus pneumoniae (pneumonococcus) - Pneumococcus ndi chifukwa chachikulu cha bakiteriya meningitis kwa ana.
Neisseria meningitides (meninogococcus) - Meningococcus ndi kachiwiri kawiri kawiri kaamba ka matenda a meningitis kwa ana. Meningococcal meningitis ikhoza kuwonetsa zizindikiro za matenda a meningitis komanso kupwetekedwa kwa petechial (kuthamanga chifukwa cha mitsempha ya magazi yomwe imasokonezeka pakamwa pokhapokha ngati atapanikizika.)
Haemophilus influenzae mtundu wa B (Hib) - H. Flu ndiwo omwe amachititsa kuti anthu azidwala matenda a mimba mpaka zaka za m'ma 1990, koma matendawa tsopano sapezeka chifukwa cha katemera.

Zina mwazifukwa zomwe zimayambitsa matendawa zimakhala ndi matenda a Lyme, syphilis, ehrlichiosis, leptospirosis, chifuwa chachikulu, ndi matenda ena a fungalomu omwe amakhudza dongosolo lalikulu la mitsempha monga cryptococcal meningitis (yomwe imapezeka kwambiri kwa ana omwe ali ndi Edzi.)

Kuzindikira Matenda a Matenda (Matenda a Maningitis)

Pambuyo polemba mwachidule mbiri ndi zakuthupi, kugwiritsidwa ntchito kwapopu (pampopu) kumalimbikitsa ngati dokotala wanu akuda nkhawa ndi matenda a meningitis. Ndondomekoyi ikhoza kuwoneka ngati yoopsa monga kholo, koma njira yowonongeka kwambiri kwa ana. Ndondomekoyi imakhala yabwino kwambiri kuposa momwe ikuwonekera, ndipo zizindikiro zovuta kwambiri za ana ambiri zikuyenera kuti zikhalebebe panthawiyi. Pogwiritsa ntchito kachipangizo kameneka, mchere wamtunduwu umachotsedwa kotero kuti ukhoze kuwunika pansi pa microscope ndi kumera. Nthaŵi zina amatha kugwiritsira ntchito kanthana kake katemera kuti asamangokhalira kupanikizika .

Madzi otuluka pampopu wamtsempha amawoneka pansi pa microscope, yomwe nthawi zina imasonyeza kuti kachilombo kamakhala ndi tizilombo toyambitsa matenda kapena tizilombo toyambitsa matenda (zomwe zimadalira kuwonongeka kwa madzi ndi zina) ndi mabakiteriya otani omwe angakhalepo. Zikondwerero za madzi zimatha kukula mabakiteriya kuti apange matenda oyenera. Ma antibayotiki ambiri amayamba kaye asanakhale ndi zotsatira za chikhalidwe, ndipo amatha kusandulika kukhala mankhwala opha tizilombo omwe amatenga mabakiteriya. "Chisamaliro" chidzagwiritsidwanso ntchito, zomwe ndi mayesero omwe amasonyeza kuti ma antibayotiki amathandiza bwanji makamaka mabakiteriya.

Nthawi zina mayesero ojambula, monga CT kapena MRI pamutu amachitiranso, makamaka kuti athetse zifukwa zina za zizindikiro za m'mimba.

Kusiyanitsa Kusiyanasiyana kwa Matenda a Mitsempha-N'chiyani Chingakhale?

Pali matenda ena ambiri omwe angakhale ndi zizindikiro zobwereza ndi matenda a mimba. Encephalitis amatanthauza kutupa kwa ubongo, m'malo mopweteka kwambiri kapena ubweya wambiri. Kusiyanitsa kwakukulu pakati pa encephalitis ndi meningitis ndiko kuti encephalitis ili ndi zizindikiro zenizeni (zochokera pa ubongo momwe matendawa aliri) ngakhale pali zambiri zomwe zimachitika. Nthawi zina izi zimakhala ngati "meningoencephalitis."

Kuchokera kwa ubongo chifukwa cha matenda kungakhale ndi zizindikiro zofanana, ngakhale kuti kupuma kwa ubongo kumakhala kozizwitsa kawirikawiri. Sinusitis ingayambitse mutu ndi malungo. Pafupifupi ndondomeko iliyonse ya mavairasi, ingathe kuchititsa kumutu ndi malungo, choncho ndikofunika kulankhula ndi dokotala ngati muli ndi chifukwa chilichonse chodandaulira kuti mukudwala matenda oopsa.

Mavuto osagwiritsidwa ntchito nthawi zina amachititsa kuti kuphatikiza ndi kumutu kumaphatikizidwe, mwachitsanzo, matenda a ubongo.

Kuchiza Maningitis

Chithandizo cha meningitis chimadalira mtundu wa zamoyo zomwe zimayambitsa matendawa. Ndi matenda a meningitis, cholinga cha chithandizo chimakhala chithandizo chochirikizira, ndipo mankhwalawa amagwiritsidwa ntchito makamaka pa matenda monga meningitis chifukwa cha kachilombo ka nkhuku.

Chithandizo cha bacterial meningitis nthawi zambiri chimayamba ndi kuphatikiza mankhwala osokoneza bongo omwe amatha kupanga mankhwala ambiri. Kusankhidwa kwa maantibayotiki kungasinthe kamodzi kokha kafukufukuyo atapangidwanso pamodzi ndi "zokhudzidwa," mayeso omwe amachititsa kuti ma antibiotic omwe ali ndi mabakiteriya enieni amapezeka.

M'masiku 90 oyambirira a moyo, cephalosporin (3th generation) imagwiritsidwa ntchito nthawi zambiri (kuphatikizapo ampicillin mwezi woyamba.)

Ana okalamba ndi ana nthawi zambiri amachiritsidwa ndi kuphatikiza kwa cefotaxime kapena ceftriazone pamodzi ndi vancomycin mpaka chinthu chokhumudwitsa chapezeka. Zosankha zina zilipo malingana ndi zomwe zimaganiziridwa kuti ndizofunikira komanso ana omwe angakhale ndi zovuta zowonjezera mankhwala osokoneza bongo.

Meningitis Prophylaxis

Kwa mitundu ina ya meningitis, antibiotic prophylaxis (mankhwala opha tizilombo kuti ateteze matenda) adzalimbikitsidwa kwa olankhulana, monga achibale, abwenzi, ndi opereka chithandizo omwe amatha kuwonekera.

Matenda a meningitis

Choyembekezeredwa cha zotsatira za meningitis chimasiyana malinga ndi tizilombo toyambitsa matenda zomwe zimayambitsa matendawa. Viral meningitis imawoneka bwino kwambiri kuposa mabakiteriya meningitis. Kugonjetsa kwa matendawa kumagwirizananso ndi momwe matendawa amapezeredwe, ndi chithandizo cham'mbuyomo chomwe chimapangitsa kuti thupi liziyenda bwino. Kawirikawiri, pneumococcal meningitis imakhala ndi vuto lalikulu kwambiri.

Zotsatira za nthawi yayitali zokhudzana ndi meningitis zimakhala zofala kwambiri ndi bacterial meningitis kusiyana ndi matenda a meningitis ndipo zingakhale kuphwanya kumva, kulephera kuphunzira, kupweteka, ndi zina zotuluka m'magazi. Kuopsa kwa kumva kutayika kuchokera ku meningitis kumadalira mtundu wa meningitis. Kafukufuku watsopano, komabe, apeza kuti kutaya kwakumva komwe kumakhudzana ndi meningitis, nthawi zambiri, kubwereranso. Maantibayotiki ena amachititsanso zotsatira zanthawi yaitali monga kumva, koma izi sizodziwika kwambiri kuposa kale.

Maningitis, ngakhale lero, akadali matenda aakulu. Ana ambiri amachira ku matenda a meningitis, koma bacterial meningitis imakhalabe ndi chiwerengero cha anthu 5 mpaka 15 peresenti ya kufa chifukwa cha thupi.

Kuteteza Maningitis

Kupewa kwa meningitis kungatenge mitundu yosiyanasiyana.

Mitundu ina ya meningitis, mwachitsanzo, meningococcal meningitis, imayambitsa matenda. Ngati mwakhala muli pafupi ndi munthu yemwe ali ndi matendawa adokotala angakulimbikitseni kuti mutenge antibiotic yothandizira. Mitundu ina ya meningitis, pamene imayambitsa matendawa, sizimayambitsa matenda a meningitis koma zizindikiro zochepa zowopsa za mavairasi.

Mitundu yambiri ya meningitis mu ana imatetezedwa ndi katemera. Monga tanenera poyamba, meningitis chifukwa cha Hemophilis influenzae ndi njira yofala kwambiri ya meningitis kwa ana mpaka zaka zingapo zapitazo. Tsopano katemera ndi katemera wa HIb akupanga mtundu uwu wa meningitis.

Tengani kamphindi kuti mudziwe za katemera wa meningitis omwe alipo kwa ana, kuphatikizapo Hib, Prevnar, ndi vache meningococcal.

Mwinanso mungakonde kudziwa za momwe nkhuku zowatetezera zowonongeka kuphatikizapo kuthamanga kwa umuna zatsikira ku nthawi yowononga katemera mpaka nthawi yathu ino.

Pamunsi pa Zizindikiro za Maningitis Mu Ana (kapena Akuluakulu)

Matenda a maningitis ndimadwala ambiri mwa ana, ngakhale kuti katemera nthawi zonse amachepetsa kwambiri chiopsezo, komanso zotsatira za matendawa nthawi yaitali. Pakalipano, zizindikiro za tizilombo ndizofala.

Zizindikiro zikhoza kuwoneka mofulumira, ndi zizindikiro zonyenga komanso kudyetsa bwino ana, ndi kupweteka mutu, malungo, ndi khosi lolimba mwa ana okalamba. Kufufuza ndi kuchiritsidwa mwamsanga kungathe kuchepetsa kufa komanso kuwonongeka kwa nthawi yaitali kwa matendawa, kotero aliyense amene ali ndi nkhawa za mwana wawo ayenera kulakwitsa ndikupempha chithandizo chamankhwala.

Mankhwala othandiza odwala maantibayotiki angayambe mwamsanga pamene kamphindi kameneka (pamphepete wam'mimba) kapena mabala ena amati matendawa alipo. Kuzindikira chifukwa chenicheni ndi kofunikira pa chithandizo, choncho nkofunika kuti musamupatse mwana mankhwala amodzi kunyumba musanayambe kuthandizidwa chifukwa izi zingasokoneze kuyesedwa kolondola. Ngakhale kutsekemera kwachilombo kumakhala kofala mu thanzi, kungakhale koopsa monga kholo. Funsani mafunso ndipo onetsetsani kuti mumamvetsa zomwe zikuchitika ndi mwana wanu. Zipatala zambiri zamankhwala zimapereka anthu othandizira omwe angakuthandizeni kuthana ndi maganizo pamene mwana wanu akuchiritsidwa.

> Zotsatira:

> Zolinga za Kuletsa ndi Kuteteza Matenda. Viral Meningitis. Kusinthidwa 06/15/16. https://www.cdc.gov/meningitis/viral.html

> Janowski, A., ndi J. Newland. Za Phrensy: Chotsitsimutsa pa Epidemiology ndi Pathogenesis ya Bacterial Meningitis m'mabanja a Ana. F1000Kusaka . 2017 Jan 27. (Epub patsogolo pa kusindikiza).

> Kliegman, Robert M., Bonita Stanton, St Geme III Joseph W., Nina Felice. Schor, Richard E. Behrman, ndi Waldo E. Nelson. Nelson Buku Lophunzitsa za Ana. Kusindikiza kwa 20. Philadelphia, PA: Elsevier, 2015. Print.

> Lundbo, L., ndi T. Benfield. Zinthu Zowopsa kwa Bacterial Meningitis Yomwe Amapezeka M'madera. Matenda Opatsirana (London) . 2017. 49 (6): 433-444.

> Ouchenir, L., Renaud, C., Khan, S. ndi al. Epidemiology, Management, ndi zotsatira za Bacterial Meningitis m'mimba. Matenda . 2017 Jun 9. (Epub patsogolo pa kusindikiza).