I-meningitis - isifo sofuba

I-tuberculous meningitis ukutheleleka kwezicubu ezihlanganisa ubuchopho nomgogodla (ama-meninges).

I-tuberculous meningitis ibangelwa Isifo sofuba iMycobacterium. Leli yigciwane elidala isifo sofuba (TB). Amagciwane asakazeka ebuchosheni nasemgogodleni esuka kwenye indawo emzimbeni, imvamisa iphaphu.

I-tuberculous meningitis ayivamile kakhulu e-United States. Izimo eziningi ngabantu abahambela eMelika bevela kwamanye amazwe lapho i-TB ijwayelekile.

Abantu abanokulandelayo banethuba eliphakeme lokuthola i-tuberculous meningitis:

• I-HIV / AIDS
• Phuza utshwala ngokweqile
• I-TB yamaphaphu
• Amasosha omzimba abuthakathaka

Izimpawu zivame ukuqala kancane, futhi zingafaka:

• Umkhuhlane namakhaza
• Izimo zengqondo ziyashintsha
• Isicanucanu nokuhlanza
• Ukuzwela ekukhanyeni (photophobia)
• Ikhanda elibuhlungu
• Intamo eqinile (meningismus)

Ezinye izimpawu ezingenzeka ngalesi sifo zingafaka:

• Ukuyaluza
• Ama-fontanelles aqhamukayo (izindawo ezithambile) ezinganeni
• Ukwehla kokuqonda
• Ukungondli kahle noma ukucasuka ezinganeni
• Ukuma okungavamile, nekhanda nentamo kuguqulwe emuva (opisthotonos). Lokhu kuvame ukutholakala ezinganeni.

Umhlinzeki wezokunakekelwa kwempilo uzokuhlola. Lokhu kuzokhombisa ukuthi unokulandelayo:

• Ukushaya kwenhliziyo okusheshayo
• Imfiva
• Izimo zengqondo ziyashintsha
• Intamo eqinile

Ukubhoboza i-lumbar (umpompi womgogodla) ukuhlolwa okubalulekile ekutholeni i-meningitis. Kwenziwa ukuqoqa isampula loketshezi lomgogodla ukuze luhlolwe. Kungadingeka isampula engaphezu kwesisodwa ukwenza ukuxilongwa.

Olunye uvivinyo olungenziwa lubandakanya:

• I-biopsy yobuchopho noma ama-meninges (angavamile)
• Isiko legazi
• I-x-ray yesifuba
• Ukuhlolwa kwe-CSF kokubalwa kwamaseli, i-glucose, namaprotheni
• I-CT scan yekhanda
• Ibala le-Gram, amanye amabala akhethekile, namasiko e-CSF
• Ukuphendula nge-Polymerase chain (PCR) kwe-CSF
• Ukuhlolwa kwesikhumba kwe-TB (PPD)
• Ezinye izivivinyo zokubheka i-TB

Uzonikezwa imithi eminingana yokulwa namagciwane e-TB. Kwesinye isikhathi, ukwelashwa kuqala noma ngabe umhlinzeki wakho ecabanga ukuthi unalesi sifo, kepha ukuhlolwa akukakuqinisekisi okwamanje.

Ukwelashwa kuvame ukuhlala okungenani izinyanga eziyi-12. Imithi ebizwa nge-corticosteroids nayo ingasetshenziswa.

I-tuberculous meningitis isongela impilo uma ingalashwa. Ukulandelelwa kwesikhathi eside kuyadingeka ukuthola ukutheleleka okuphindaphindiwe (ukuphindaphinda).

Uma singelashwa lesi sifo singadala noma yikuphi kokulandelayo:

• Ukulimala kobuchopho
• Ukwakha uketshezi phakathi kokhakhayi nobuchopho (ukungcola komhlaba)
• Ukulahlekelwa ukuzwa
• I-Hydrocephalus (ukwakheka koketshezi ngaphakathi kogebhezi okuholela ekuvuvukeni kobuchopho)
• Ukuquleka
• Ukufa

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

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

Shayela inombolo yendawo ephuthumayo uma uba nezimpawu ezingathi sína ezibalwe ngenhla. I-meningitis ngokushesha ingaba isifo esongela impilo.

Ukwelapha abantu abanezimpawu zokungenwa yi-TB engasebenzi (elele) kungavimbela ukusabalala kwayo. Ukuhlolwa kwe-PPD nokunye ukuhlolwa kwe-TB kungenziwa ukusho ukuthi unalo yini lolu hlobo lokutheleleka.

Amanye amazwe anezifo eziningi ze-TB anika abantu umuthi wokugoma obizwa nge-BCG ukuvikela i-TB. Kepha, ukusebenza kwalo muthi wokugoma kunomkhawulo, futhi akuvamile ukuthi kusetshenziswe e-United States. Umuthi wokugoma we-BCG ungasiza ekuvikeleni izinhlobo ezinzima ze-TB, ezifana ne-meningitis, ezinganeni ezisencane kakhulu ezihlala ezindaweni lapho isifo sijwayeleke khona.

Isifo sofuba; I-meningitis yesifo sofuba

• Isistimu yezinzwa emaphakathi nesistimu yezinzwa ezungezayo

U-Anderson NC, uKoshy AA, uRoos KL. Amagciwane, ukhunta kanye nezifo eziphazamisayo zesimiso sezinzwa. Ku: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, ama-eds. I-Neurology kaBradley ekwenziweni kwemitholampilo. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2016: isahluko 79.

ICruz AT, iStarke JR. Isifo sofuba. Ku: Cherry JD, Harrison GJ, Kaplan SL, Steinbach WJ, Hotez PJ, abahleli. Incwadi kaFeigin neCherry's Pediatric Infectious Diseases. Umhlaka 8. IPhiladelphia, PA: Elsevier; 2019: isahluko 96.

UFitzgerald DW, uSterling TR, uHaas DW. Isifo sofuba iMycobacterium. Ku: Bennett JE, Dolin R, Blaser MJ, ama-eds. Mandell, Douglas, kanye neBennett's Principles and Practice of Infectious Diseases, uHlelo Olubuyekeziwe. Umhlaka 8. IPhiladelphia, PA: Elsevier Saunders; 2015: isahluko 251.