I-Epiglottitis

I-Epiglottitis ukuvuvukala kwe-epiglottis. Lesi isicubu esimboza i-trachea (i-windpipe). I-Epiglottitis ingaba yisifo esisongela impilo.

I-epiglottis iyisicubu esiqinile, kodwa esiguquguqukayo (esibizwa ngokuthi uqwanga) ngemuva kolimi. Ivala i-windpipe yakho (i-trachea) lapho ugwinya ukuze ukudla kungangeni emoyeni wakho. Lokhu kusiza ukuvimbela ukukhwehlela noma ukuminyana ngemuva kokugwinya.

Ezinganeni, i-epiglottitis ivame ukubangelwa amagciwane Haemophilus influenzae (H imikhuhlane) uhlobo B. Kubantu abadala, imvamisa kungenxa yamanye amagciwane afana I-Strepcoccus pneumoniae, noma amagciwane afana ne-herpes simplex virus kanye ne-varicella-zoster.

I-Epiglottitis manje sekungajwayelekile ngoba umuthi wokugomela uhlobo lwe-H influenzae B (Hib) unikezwa njalo kuzo zonke izingane. Lesi sifo sasivame ukubonakala ezinganeni ezineminyaka engu-2 kuye ku-6. Ezimweni ezingavamile, i-epiglottitis ingenzeka kubantu abadala.

I-Epiglottitis iqala ngomkhuhlane omkhulu nomphimbo obuhlungu. Ezinye izimpawu zingafaka:

• Imisindo yokuphefumula engajwayelekile (stridor)
• Imfiva
• Umbala wesikhumba oluhlaza okwesibhakabhaka (i-cyanosis)
• Ukumunca amathe
• Kunzima ukuphefumula (umuntu angadinga ukuhlala aqonde futhi ancike kancane phambili ukuze aphefumule)
• Kunzima ukugwinya
• Izinguquko zezwi (ukushaqeka)

Izindlela zomoya zingavinjelwa ngokuphelele, okungaholela ekuboshweni kwenhliziyo nasekufeni.

I-Epiglottitis ingaba yisimo esiphuthumayo sezokwelapha. Funa usizo lwezokwelapha ngokushesha. Ungasebenzisi noma yini ukucindezela ulimi phansi ukuzama ukubheka umphimbo ekhaya. Ukwenza kanjalo kungenza isimo sibe sibi kakhulu.

Umhlinzeki wezokunakekelwa kwempilo angahlola ibhokisi lezwi (umphimbo) esebenzisa isibuko esincane esibanjwe ngemuva komphimbo. Noma kungasetshenziswa ithubhu lokubuka elibizwa ngokuthi i-laryngoscope. Lokhu kuhlolwa kwenziwa kangcono egumbini lokuhlinza noma endaweni efanayo lapho izinkinga zokuphefumula okungazelelwe zingaphathwa kalula.

Ukuhlolwa okungenziwa kufaka phakathi:

• Isiko legazi noma isiko lomphimbo
• Qedela ukubalwa kwegazi (CBC)
• Intamo x-ray

Ukuhlala esibhedlela kuyadingeka, imvamisa egunjini labagula kakhulu (i-ICU).

Ukwelashwa kubandakanya izindlela zokusiza umuntu ukuthi aphefumule, kufaka phakathi:

• Ishubhu lokuphefumula (intubation)
• Umoya-mpilo (humidified) oxygen

Ezinye izindlela zokwelashwa zingafaka:

• Ama-antibiotic ukwelapha ukutheleleka
• Imithi elwa nokuvuvukala, ebizwa nge-corticosteroids, yokwehlisa ukuvuvukala komphimbo
• Uketshezi olunikezwa ngomthambo (ngu-IV)

I-Epiglottitis ingaba yisimo esiphuthumayo esisongela impilo. Ngokwelashwa okufanele, umphumela uvame ukuba muhle.

Ukuphefumula kanzima kuyisibonakaliso sekwephuzile, kodwa esibalulekile. I-Spasm ingadala ukuthi imigwaqo yomoya ivaleke ngokuzumayo. Noma, izindlela zomoya zingavinjelwa ngokuphelele. Noma yiziphi zalezi zimo zingaholela ekufeni.

Umuthi wokugoma we-Hib uvikela izingane eziningi kwi-epiglottitis.

Amagciwane avame kakhulu (H umkhuhlane thayipha b) okubangela i-epiglottitis isakazeka kalula. Uma othile emndenini wakho egula ngenxa yale bhaktheriya, amanye amalungu omndeni adinga ukuhlolwa nokwelashwa.

I-Supraglottitis

• Ukwakheka komphimbo
• Umzimba we-Haemophilus influenzae

UNayak JL, Weinberg GA. I-Epiglottitis. 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 63.

URodrigues KK, uRoosevelt GE. Ukuvinjelwa okunamandla okuphefumulayo okuphezulu komoya (i-croup, i-epiglottitis, i-laryngitis, ne-tracheitis yebhaktheriya). Ku: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Incwadi kaNelson Yezingane. Umhlaka 21. IPhiladelphia, PA: Elsevier; 2020: isahluko 412.