I-Pseudomembranous colitis

I-Pseudomembranous colitis isho ukuvuvukala noma ukuvuvukala kwamathumbu amakhulu (ikholoni) ngenxa yokugcwala AmaClostridioides difficile (C ukwehlukana) amabhaktheriya.

Lesi sifo siyimbangela ejwayelekile yohudo ngemuva kokusetshenziswa kwama-antibiotic.

I- C ukwehlukana amabhaktheriya ngokuvamile ahlala emathunjini. Kodwa-ke, amaningi kakhulu ala mabhaktheriya angakhula uma uthatha ama-antibiotics. Amagciwane akhipha ubuthi obuqinile obudala ukuvuvukala nokopha kulwelwesi lwekholoni.

Noma yimaphi ama-antibiotic angadala lesi simo. Izidakamizwa ezibhekene nenkinga isikhathi esiningi yi-ampicillin, clindamycin, fluoroquinolones kanye ne-cephalosporins.

Abahlinzeki bezokunakekelwa kwempilo esibhedlela bangadlulisa la magciwane lisuka komunye umuntu liye komunye.

I-Pseudomembranous colitis ayijwayelekile ezinganeni, futhi ayivamile ezinganeni. Kuvame ukubonakala kubantu abasesibhedlela. Kodwa-ke, kuya ngokuya kujwayelekile kubantu abathatha ama-antibiotic futhi abekho esibhedlela.

Izici zobungozi zifaka:

• Ukuguga
• Ukusetshenziswa kwama-antibiotic
• Ukusetshenziswa kwemithi ethena amandla amasosha omzimba (njengemithi yokwelapha ngamakhemikhali)
• Ukuhlinzwa kwakamuva
• Umlando we-pseudomembranous colitis
• Umlando we-ulcerative colitis kanye nesifo seCrohn

Izimpawu zifaka:

• Amajaqamba esiswini (aphansi ukuya kokubi)
• Izitulo ezinegazi
• Imfiva
• Nxusa ukuba nokunyakaza kwamathumbu
• Uhudo lwamanzi (kaningi izikhathi ezinhlanu kuya kweziyi-10 ngosuku)

Ukuhlolwa okulandelayo kungenziwa:

• Colonoscopy noma sigmoidoscopy eguquguqukayo
• I-Immunoassay ye-C difficile toxin esitokisini
• Ukuhlolwa kwendle okusha okufana ne-PCR

Imithi elwa namagciwane noma omunye umuthi obangela isimo kufanele umiswe. I-Metronidazole, i-vancomycin, noma i-fidaxomicin ivame ukusetshenziselwa ukwelapha le nkinga, kepha eminye imithi ingasetshenziswa futhi.

Izisombululo ze-Electrolyte noma uketshezi olunikezwa ngomthambo kungadingeka ukwelapha ukuphelelwa amandla emzimbeni ngenxa yohudo. Ezimweni ezingavamile, ukuhlinzwa kuyadingeka ukwelapha izifo eziba zimbi kakhulu noma ezingaphenduli kuma-antibiotics.

Imithi elwa namagciwane yesikhathi eside ingadingeka uma ngabe C ukwehlukana ukutheleleka kuyabuya. Ukwelashwa okusha okubizwa nge-fecal microbiota transplant ("stool transplant") nakho kuye kwasebenza ezifweni ezibuyayo.

Umhlinzeki wakho futhi angaphakamisa ukuthi uthathe ama-probiotic uma ukutheleleka kubuya.

Umbono muhle ezimweni eziningi, uma kungekho zinkinga. Kodwa-ke, izifo ezifika ku-1 kwezingu-5 zingabuya futhi zidinga ukwelashwa okwengeziwe.

Izinkinga zingafaka:

• Ukwehla kwamanzi emzimbeni nokungalingani kwe-electrolyte
• Ukugcotshwa kwe- (hole through) ikholoni
• I-megacolon enobuthi
• Ukufa

Shayela umhlinzeki wakho uma unezimpawu ezilandelayo:

• Noma iziphi izitulo ezinegazi (ikakhulukazi ngemuva kokuthatha ama-antibiotic)
• Iziqephu ezinhlanu noma ngaphezulu zohudo ngosuku ngaphezulu kwezinsuku ezi-1 kuye kwezi-2
• Ubuhlungu obukhulu besisu
• Izimpawu zokuphela kwamanzi emzimbeni

Abantu abane-pseudomembranous colitis kufanele batshele abahlinzeki babo ngaphambi kokuthatha ama-antibiotic futhi. Kubalulekile futhi ukugeza izandla kahle ukuvimbela ukudlulisela igciwane kwabanye abantu. Izidakamizwa zokuhlanza utshwala azisebenzi ngaso sonke isikhathi C ukwehlukana.

I-colitis ehambisana namagciwane; I-colitis - i-pseudomembranous; I-Necrotizing colitis; C difficile - pseudomembranous

• Uhlelo lokugaya ukudla
• Izitho zohlelo lokugaya ukudla

UGerding DN, uJohnson S. Clostridial izifo. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 280.

UGerding DN, uVB osemncane. UDonskey CJ. AmaClostridiode difficile (phambilini IClostridium difficle) ukutheleleka. Ku: Bennett JE, Dolin R, Blaser MJ, ama-eds. Mandell, Douglas, kanye neBennett's Principles and Practice of Infectious Diseases. Umhlaka 9. IPhiladelphia, PA: Elsevier; 2020: isahluko 243.

UKelly CP, uhudo oluhambisana ne-Antibiotic kanye clostridioides difficile ukutheleleka. Ku: Feldman M, Friedman LS, Brandt LJ, ama-eds. Sleisenger kanye neFordtran's Gastrointestinal and Liver Disease. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2021: isahluko 112.

UMcDonald LC, uGerding DN, uJohnson S, et al. Imihlahlandlela yokwenziwa kwemitholampilo yokutheleleka nge-clostridium difficile kubantu abadala nasezinganeni: Ukuvuselelwa kwe-2017 yi-Infectious Diseases Society of America (IDSA) kanye ne-Society for Healthcare Epidemiology of America (SHEA). I-Clin Infect Dis. 2018; 66 (7): 987-994. I-PMID: 29562266 pubmed.ncbi.nlm.nih.gov/29562266/.