I-Endocarditis

I-Endocarditis ukuvuvukala kwengaphakathi langaphakathi lamagumbi enhliziyo nama-valve wenhliziyo (endocardium). Kubangelwa igciwane noma, kuyaqabukela ukutheleleka kwefungal.

I-Endocarditis ingabandakanya imisipha yenhliziyo, ama-valve enhliziyo, noma ulwelwesi lwenhliziyo. Abanye abantu abahlakulela i-endocarditis bane:

• Isici sokuzalwa senhliziyo
• I-valve yenhliziyo eyonakele noma engavamile
• Umlando we-endocarditis
• I-valve yenhliziyo entsha ngemuva kokuhlinzwa
• Ukulutha kwezidakamizwa zeParenteral (ngemithambo)

I-Endocarditis iqala lapho amagciwane engena egazini bese eya enhliziyweni.

• Ukutheleleka kwamagciwane kuyimbangela ejwayelekile kakhulu ye-endocarditis.
• I-Endocarditis nayo ingabangelwa isikhunta, njengeCandida.
• Kwezinye izimo, asikho isizathu esingatholwa.

Amagciwane kungenzeka ukuthi angene egazini ngesikhathi:

• Imigqa yokungena emithanjeni emaphakathi
• Ukusetshenziswa kwezidakamizwa zomjovo, kusuka ekusetshenzisweni kwezinaliti ezingcolile (ezingavikelekile)
• Ukuhlinzwa kwamazinyo kwakamuva
• Okunye ukuhlinzwa noma izinqubo ezincane zokuphefumula, umgudu wokuchama, isikhumba esinegciwane, noma amathambo nemisipha

Izimpawu ze-endocarditis zingakhula kancane noma ngokuzumayo.

Imfiva, ukugodola nokujuluka yizimpawu ezivamile. Lokhu kwesinye isikhathi kunga:

• Yiba khona izinsuku eziningi ngaphambi kokuba kuvele ezinye izimpawu
• Woza uhambe, noma uqaphele kakhulu ngesikhathi sasebusuku

Ungase futhi ube nokukhathala, ubuthakathaka, nobuhlungu nezinhlungu emisipheni noma emalungeni.

Ezinye izimpawu zingafaka:

• Izindawo ezincane zokopha ngaphansi kwezipikili (ama-splinter hemorrhages)
• Amabala esikhumba abomvu, angenabuhlungu ezintendeni zezandla naphansi (izilonda zeJaneway)
• Ama-red, ama-node abuhlungu emaphaketheni eminwe nasezinzwaneni (ama-Osler node)
• Ukuphefumula ngomsebenzi
• Ukuvuvukala kwezinyawo, imilenze, isisu

Umhlinzeki wezokunakekelwa kwempilo angabona ukukhononda kwenhliziyo okusha, noma ushintsho enhliziyweni yokububula kwangaphambilini.

Ukuhlolwa kwamehlo kungakhombisa ukopha ku-retina nendawo esemaphakathi yokusula. Lokhu kutholwa kwaziwa njengamabala eRoth. Kungaba nezindawo ezincane, ezikhomba ukopha ebusweni beso noma amajwabu amehlo.

Ukuhlolwa okungenziwa kufaka phakathi:

• Isiko legazi ukusiza ukukhomba amagciwane noma ukhunta okubangela ukutheleleka
• Qedela ukubalwa kwegazi (CBC), amaprotheni asebenza ngo-C (CRP), noma isilinganiso se-erythrocyte sedimentation (ESR)
• I-echocardiogram yokubheka ama-valve enhliziyo

Ungadinga ukuthi ube sesibhedlela ukuthola ama-antibiotic ngomthambo (IV noma ngemithambo yegazi). Amasiko nokuhlolwa kwegazi kuzosiza umhlinzeki wakho akhethe i-antibiotic engcono kakhulu.

Uzobe usudinga ukwelashwa kwama-antibiotic kwesikhathi eside.

• Abantu bavame ukudinga ukwelashwa amasonto ama-4 kuye kwayisithupha ukubulala wonke amabhaktheriya avela emakamelweni enhliziyo nasezivalweni.
• Imithi elwa namagciwane eqalwa esibhedlela izodinga ukuqhubeka ekhaya.

Ukuhlinzwa ukufaka i-valve yenhliziyo kuyadingeka lapho:

• Ukutheleleka kuqhekeka kube yizicucu ezincane, kuphumele kohlangothi.
• Umuntu uba nokuhluleka kwenhliziyo ngenxa yama-valve enhliziyo alimele.
• Kunobufakazi bokulimala okukhulu komzimba.

Ukuthola ukwelashwa kwe-endocarditis zisuka nje kuthuthukisa amathuba omphumela omuhle.

Izinkinga ezinkulu kakhulu ezingakhula zibandakanya:

• Ithumba lobuchopho
• Ukulimala okuqhubekayo kuma-valve enhliziyo, okubangela ukwehluleka kwenhliziyo
• Ukusabalala kokutheleleka kwezinye izingxenye zomzimba
• Unhlangothi, obangelwa amahlule amancane noma izingcezu zokutheleleka kuqhamuka bese kuya ebuchosheni

Shayela umhlinzeki wakho uma ubona lezi zimpawu ezilandelayo ngesikhathi sokwelashwa noma ngemuva kwaso:

• Igazi emchameni
• Ubuhlungu besifuba
• Ukukhathala
• Umkhuhlane ongapheli
• Imfiva
• Ubudikadika
• Ubuthakathaka
• Ukwehla kwesisindo ngaphandle koshintsho ekudleni

I-American Heart Association incoma ama-antibiotic okuvimbela abantu abasengozini ye-endocarditis esithathelwanayo, njengaleyo ene:

• Ukukhubazeka okuthile kwenhliziyo
• Izinkinga zokufakelwa kwenhliziyo nezama-valve
• Ama-valves enhliziyo yokufakelwa (ama-valves enhliziyo afakwe udokotela ohlinzayo)
• Umlando odlule we-endocarditis

Laba bantu kufanele bathole ama-antibiotic uma bene:

• Izinqubo zamazinyo ezingadala ukopha
• Izinqubo ezibandakanya umgudu wokuphefumula
• Izinqubo ezibandakanya uhlelo lwe-urinary tract system
• Izinqubo ezibandakanya umgudu wokugaya ukudla
• Izinqubo zokutheleleka kwesikhumba kanye nokutheleleka kwezicubu ezithambile

Ukutheleleka kwe-valve; IStaphylococcus aureus - i-endocarditis; I-Enterococcus - i-endocarditis; I-Streptococcus viridans - i-endocarditis; I-Candida - i-endocarditis

• Ukuhlinzwa kwe-valve yenhliziyo - ukukhipha

• Inhliziyo - isigaba phakathi nendawo
• Inhliziyo - ukubuka kwangaphambili
• I-Janeway lesion - ukusondela
• Isilonda seJaneway emunweni
• Ama-valve enhliziyo

I-Baddour LM, i-Freeman WK, i-Suri RM, i-Wilson WR. Ukutheleleka kwenhliziyo. Ku: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, ama-eds. Isifo Senhliziyo SikaBraunwald: Incwadi Yemithi Yezinhliziyo Nemithambo. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2019: isahluko 73.

IBaddour LM, iWilson WR, iBayer AS, et al. I-endocarditis enesifo kubantu abadala: ukuxilongwa, ukwelashwa ngama-antimicrobial, kanye nokuphathwa kwezinkinga: isitatimende sesayensi sabasebenzi bezempilo abavela e-American Heart Association. Ukujikeleza. 2015; 132 (15): 1435-1486. PMID: 26373316 www.ncbi.nlm.nih.gov/pubmed/26373316.

IFowler VG, iBayer AS, iBaddour LM. I-endocarditis enesifo. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-25. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 76.

IFowler VG, iScheld WM, iBayer AS. I-Endocarditis kanye nokutheleleka ngemithambo yegazi. Ku: Bennett JE, Dolin R, Blaser MJ, ama-eds. Mandell, Douglas, kanye neBennett's Principles and Practice of Infectious Diseases. Umhlaka 8. IPhiladelphia, PA: Elsevier Saunders; 2015: isahluko 82.