I-gram-negative meningitis

I-Meningitis ikhona lapho ulwelwesi olumboze ubuchopho nentambo yomgogodla luvuvukala luvuvukala. Le ngubo ibizwa ngokuthi ama-meninges.

Amagciwane ayilohlobo olulodwa lwegciwane elingadala i-meningitis. Ama-bacteria angenayo i-Gram angenalo uhlobo lwama-bacteria aziphatha ngendlela efanayo emzimbeni. Zibizwa nge-gram-negative ngoba ziphenduka zibe pink uma zivivinywa elabhoratri ngesisi esikhethekile esibizwa ngeGram stain.

I-bacterial meningitis ebukekayo ingabangelwa amagciwane ahlukile we-Gram-negative afaka i-meningococcal kanye H imikhuhlane.

Lo mbhalo uhlanganisa i-Gram-negative meningitis ebangelwa amagciwane alandelayo:

• Escherichia coli
• UKlebsiella pneumoniae
• UPseudomonas aeruginosa
• Serratia marsescens

I-Gram-negative meningitis ivame kakhulu ezinganeni kunabantu abadala. Kepha kungenzeka nakubantu abadala, ikakhulukazi labo abanobungozi obubodwa noma ngaphezulu. Izici zobungozi kubantu abadala nasezinganeni zifaka:

• Ukutheleleka (ikakhulukazi esiswini noma kumgudu wokuchama)
• Ukuhlinzwa kobuchopho kwakamuva
• Ukulimala kwakamuva ekhanda
• Ukungajwayelekile komgogodla
• Ukubekwa kwe-Spinal fluid shunt ngemuva kokuhlinzwa kobuchopho
• Ukungajwayelekile kwe-urinary tract
• Ukutheleleka ngomgudu womchamo
• Amasosha omzimba abuthakathaka

Izimpawu zivame ukufika ngokushesha, futhi zingafaka:

• Umkhuhlane namakhaza
• Izimo zengqondo ziyashintsha
• Isicanucanu nokuhlanza
• Ukuzwela ekukhanyeni (photophobia)
• Ikhanda elibuhlungu
• Intamo eqinile (meningismus)
• Izimpawu zesinye, izinso, amathumbu, noma ukutheleleka kwamaphaphu

Ezinye izimpawu ezingenzeka ngalesi sifo:

• Ukuyaluza
• Ama-fontanelles aqhamukayo ezinganeni
• Ukwehla kokuqonda
• Ukungondli kahle noma ukucasuka ezinganeni
• Ukuphefumula ngokushesha
• Ukuma okungavamile, nekhanda nentamo kuguqulwe emuva (opisthotonos)

Umhlinzeki wezokunakekelwa kwempilo uzokwenza ukuhlolwa komzimba. Imibuzo izogxila kwizimpawu nokuvezwa okungenzeka kothile ongase abe nezimpawu ezifanayo, ezifana nentamo eqinile nomkhuhlane.

Uma umhlinzeki ecabanga ukuthi i-meningitis kungenzeka, ukubhoboza i-lumbar (umpompi womgogodla) kungenzeka kwenziwe ukususa isampula loketshezi lomgogodla lokuhlolwa.

Olunye uvivinyo olungenziwa lubandakanya:

• Isiko legazi
• I-x-ray yesifuba
• I-CT scan yekhanda
• Ibala le-Gram, amanye amabala akhethekile

Ama-antibiotic azoqalwa ngokushesha okukhulu. I-Ceftriaxone, i-ceftazidime, ne-cefepime yimithi elwa namagciwane esetshenziswa kakhulu kulolu hlobo lwe-meningitis. Amanye ama-antibiotic anganikezwa, kuya ngohlobo lwama-bacteria.

Uma une-shunt yomgogodla, ingasuswa.

Ukwelashwa kwasekuqaleni kuqalwa, kuba ngcono imiphumela.

Abantu abaningi balulama ngokuphelele. Kepha, abantu abaningi banokulimala okungapheli kobuchopho noma babulawa yilolu hlobo lwe-meningitis. Izingane ezincane nabantu abadala abangaphezu kweminyaka engama-50 banengozi enkulu yokufa. Ukwenza kahle kangakanani kuya ngokuthi:

• Iminyaka yakho
• Ukwelashwa kusheshe kangakanani
• Impilo yakho iyonke

Izinkinga zesikhathi eside zingafaka:

• Ukulimala kobuchopho
• Ukwakhiwa koketshezi phakathi kogebhezi nobuchopho (ukungcola komhlaba)
• Ukwakhiwa koketshezi ngaphakathi kogebhezi okuholela ekuvuvukeni kobuchopho (i-hydrocephalus)
• Ukulahlekelwa ukuzwa
• Ukuquleka

Shayela ku-911 noma inombolo ephuthumayo yendawo noma uye egumbini lezimo eziphuthumayo uma usola i-meningitis enganeni encane enezimpawu ezilandelayo:

• Izinkinga zokondla
• Ukukhala okuphezulu
• Ukuthukuthela
• Umkhuhlane oqhubekayo ongachazeki

I-meningitis ngokushesha ingaba isifo esongela impilo.

Ukwelashwa okusheshayo kwezifo ezihlobene nakho kunganciphisa ubunzima kanye nezinkinga ze-meningitis.

I-gram-negative meningitis

• Isistimu yezinzwa emaphakathi nesistimu yezinzwa ezungezayo
• Ukubalwa kwamaseli e-CSF

Izikhungo Zokulawulwa Nokuvimbelwa Kwezifo iwebhusayithi. I-meningitis yebhaktheriya. www.cdc.gov/meningitis/bacterial.html. Kubuyekezwe u-Agasti 6, 2019. Kufinyelelwe kuDisemba 1, 2020.

UNath A. Meningitis: ibhaktheriya, igciwane nokunye. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 384.

Hasbun R, Van de Beek D, Brouwer MC, Tunkel AR .. I-meningitis enamandla. 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 87.