Isifo samanzi i-Waterhouse-Friderichsen

I-Waterhouse-Friderichsen syndrome (WFS) iyiqembu lezimpawu ezibangelwa ukwehluleka kwezindlala ze-adrenal ukuthi zisebenze ngokujwayelekile ngenxa yokopha egazini.

Izindlala ze-adrenal yizindlala ezimbili ezimise unxantathu. Indlala eyodwa itholakala ngaphezulu kwesinso ngasinye. Izindlala ze-adrenal zikhiqiza futhi zikhiphe ama-hormone ahlukene umzimba odinga ukuthi usebenze ngokujwayelekile. Izindlala ze-adrenal zingathinteka ezifweni eziningi, ezinjengezifo ezifana ne-WFS.

I-WFS ibangelwa ukutheleleka okunzima ngamagciwane e-meningococcus noma amanye amabhaktheriya, njenge:

• I-streptococcus yeqembu B
• UPseudomonas aeruginosa
• I-Streptococcus pneumoniae
• I-Staphylococcus aureus

Izimpawu zivele kungazelelwe. Kungenxa yebhaktheriya ekhulayo (ephindaphindayo) ngaphakathi komzimba. Izimpawu zifaka:

• Umkhuhlane namakhaza
• Ubuhlungu obuhlangene nobomzimba
• Ubuhlungu bekhanda
• Ukuhlanza

Ukutheleleka ngamagciwane kubangela ukopha emzimbeni wonke, okubangela:

• Ukuqhuma komzimba wonke
• Kusatshalaliswe i-coagulation ye-intravascular lapho amahlule amancane egazi anqamula ukunikezwa kwegazi ezithweni
• Ukushaqeka kwe-Septic

Ukopha kwizindlala ze-adrenal kubangela inkinga ye-adrenal, lapho kungenziwa khona ama-hormone adrenal anele. Lokhu kuholela ezimpawu ezifana:

• Isiyezi, ubuthakathaka
• Umfutho wegazi ophansi kakhulu
• Kushesha kakhulu ukushaya kwenhliziyo
• Ukudideka noma ikhoma

Umhlinzeki wezokunakekelwa kwempilo uzokwenza ukuhlolwa komzimba abuze ngezimpawu zomuntu.

Ukuhlolwa kwegazi kuzokwenziwa ukuqinisekisa ukutheleleka ngegciwane. Ukuhlolwa kungafaka:

• Isiko legazi
• Gcwalisa inani legazi ngokuhluka
• Izifundo zokuvala igazi

Uma umhlinzeki esola ukuthi ukutheleleka kubangelwa yi-meningococcus bacteria, okunye ukuhlolwa okungenziwa kufaka phakathi:

• Ukubhoboza i-Lumbar ukuthola isampula loketshezi lomgogodla ngamasiko
• Isikhumba se-biopsy ne-Gram stain
• Ukuhlaziywa komchamo

Ukuhlolwa okungahle kuhlolwe ukusiza ukuxilonga inkinga enkulu ye-adrenal kufaka:

• Isivivinyo sokukhuthaza i-ACTH (cosyntropin)
• Ukuhlolwa kwegazi leCortisol
• Ushukela wegazi
• Ukuhlolwa kwegazi nge-potassium
• Ukuhlolwa kwegazi le-Sodium
• Ukuhlolwa kwegazi le-pH

Ama-antibiotic aqala ngokushesha ukwelapha ukutheleleka kwamagciwane. Imithi ye-glucocorticoid izophinde inikezwe ukwelapha ukungasebenzi kahle kwe-adrenal gland. Imithi yokweseka izodingeka kwezinye izimpawu.

I-WFS iyabulala ngaphandle kokuthi ukwelashwa kokutheleleka ngamagciwane kuqalwe khona manjalo futhi kunikezwa imishanguzo ye-glucocorticoid.

Ukuvikela i-WFS ebangelwa amagciwane e-meningococcal, umuthi wokugoma uyatholakala.

I-Fulminant meningococcemia - Isifo samanzi se-Waterhouse-Friderichsen; I-Fulminant meningococcal sepsis - Isifo samanzi se-Waterhouse-Friderichsen; I-adrenalitis eyophayo

• Izilonda ze-Meningococcal ngemuva
• Uketshezi lwe-adrenal gland secretion

UStephens DS. Ama-meningitides we-Neisseria. 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 Saunders; 2020: isahluko 211.

INewell-Price JDC, i-Auchus RJ. I-adrenal cortex. Ku: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, abahleli. Incwadi kaWilliams ye-Endocrinology. Umhlaka 14. IPhiladelphia, PA: Elsevier; 2020: isahluko 15.