Umkhuhlane we-rheumatic fever

I-rheumatic fever yisifo esingakhula ngemuva kokutheleleka nge-group A streptococcus bacteria (njenge-strep throat noma i-scarlet fever). Kungadala ukugula okunzima enhliziyweni, emalungeni, esikhunjeni, nasebuchosheni.

I-rheumatic fever isavamile emazweni anenhlupheko eningi nezinhlelo zezempilo ezingezinhle. Akuvamisile ukwenzeka e-United States nakwamanye amazwe athuthukile. Lapho i-rheumatic fever yenzeka e-United States, kuvame ukubheduka okuncane. Ukuqubuka kwakamuva e-United States kwakungo-1980.

I-rheumatic fever yenzeka ngemuva kokutheleleka ngegciwane noma ngamagciwane abizwa IStreptococcus pyogenes noma iqembu A streptococcus. Leli gciwane libonakala likhohlisa amasosha omzimba ukuba ahlasele izicubu ezinempilo emzimbeni. Lezi zicubu ziyavuvukala noma zivuvuke.

Lokhu kusabela okungavamile kubonakala cishe kwenzeka njalo nge-strep throat noma i-scarlet fever. Ukutheleleka okuqinile okubandakanya ezinye izingxenye zomzimba akubonakali kubanga imfiva ye-rheumatic.

I-rheumatic fever ihlasela kakhulu izingane ezineminyaka engu-5 kuya kwengu-15 ezine-strep throat noma i-scarlet fever. Uma kwenzeka, ikhula cishe ezinsukwini eziyi-14 kuya kwezingama-28 ngemuva kwalezi zifo.

Izimpawu zingathinta izinhlelo eziningi emzimbeni. Izimpawu ezijwayelekile zingafaka:

• Imfiva
• Ukopha ngamakhala
• Ubuhlungu esiswini
• Izinkinga zenhliziyo, okungenzeka zingabi nazimpawu, noma zingaholela ekuphefumuleni nasezinhlungwini zesifuba

Izimpawu emajoyini zinga:

• Imbangela yobuhlungu, ukuvuvukala, ubomvu, nokufudumala
• Ikakhulu kwenzeka emadolweni, endololwaneni, emaqakaleni nasezihlakaleni
• Shintsha noma hambisa usuka kwelinye ilunga uye kwelinye

Izinguquko zesikhumba nazo zingenzeka, njenge:

• Ukuqhuma kwesikhumba okwenziwe ngendandatho noma okwenyoka esiqwini nasengxenyeni engenhla yezingalo noma yemilenze
• Izigaxa zesikhumba noma amaqhuqhuva

Isimo esiphatha ubuchopho nohlelo lwezinzwa, olubizwa ngeSydenham chorea singenzeka futhi. Izimpawu zalesi simo yilezi:

• Ukulahlekelwa ukulawula imizwelo, ngezikhathi ezithile zokukhala okungajwayelekile noma ukuhleka
• Ukunyakaza okusheshayo, okunyakazayo okuthinta kakhulu ubuso, izinyawo, nezandla

Umhlinzeki wakho wokunakekelwa kwezempilo uzokuhlola futhi uzohlola ngokucophelela imisindo yenhliziyo yakho, isikhumba, namalunga.

Ukuhlolwa kungafaka:

• Ukuhlolwa kwegazi ukuthola ukutheleleka okuphindaphindiwe kwe-strep (njengokuhlolwa kwe-ASO)
• Qedela ukubalwa kwegazi (CBC)
• I-Electrocardiogram (ECG)
• Izinga le-sedimentation (i-ESR - isivivinyo esilinganisa ukuvuvukala emzimbeni)

Kunezici eziningana ezibizwa ngokuthi izindlela ezinkulu nezincane ezenzelwe ukusiza ukuxilonga umkhuhlane wamathambo ngendlela ejwayelekile.

Izindlela eziyinhloko zokuxilongwa zifaka:

• I-arthritis emajoyini amaningi amakhulu
• Ukuvuvukala kwenhliziyo
• Amaqhubu ngaphansi kwesikhumba
• Ukunyakaza okusheshayo, okushisayo (chorea, Sydenham chorea)
• Ukuqhuma kwesikhumba

Imibandela emincane ifaka phakathi:

• Imfiva
• I-ESR ephezulu
• Ubuhlungu obuhlangene
• I-ECG engajwayelekile

Kungenzeka utholakale une-rheumatic fever uma:

• Hlangana nemibandela emi-2 emikhulu, noma i-1 enkulu ne-2 criteria encane
• Yiba nezimpawu zokutheleleka nge-strep edlule

Uma wena noma ingane yakho kutholakala ukuthi unayo i-acute rheumatic fever uzokwelashwa ngama-antibiotics. Inhloso yalokhu kwelashwa ukususa wonke amabhaktheriya e-strep emzimbeni.

Ngemuva kokuthi ukwelashwa kokuqala kuqediwe, kunikezwa ama-antibiotic amaningi. Inhloso yale mithi ukuvimbela i-rheumatic fever ekuphindaphindeni.

• Zonke izingane zizoqhubeka nemithi elwa namagciwane kuze kube yiminyaka engama-21.
• Intsha kanye nabantu abadala kuzodingeka baphuze ama-antibiotic okungenani iminyaka emihlanu.

Uma wena noma ingane yakho ninenkinga yenhliziyo lapho kwenzeka i-rheumatic fever, ama-antibiotic angadingeka isikhathi eside, mhlawumbe impilo yonke.

Ukusiza ukuphatha ukuvuvukala kwezicubu ezivuthayo ngesikhathi somkhuhlane we-rheumatic fever, imithi efana ne-aspirin noma i-corticosteroids ingadingeka.

Ngezinkinga zokuhamba okungavamile noma ukuziphatha okungavamile, imithi evame ukusetshenziselwa ukwelashwa ingahle ibekwe.

I-rheumatic fever ingadala izinkinga ezinkulu zenhliziyo nokulimala kwenhliziyo.

Izinkinga zenhliziyo zesikhathi eside zingenzeka, njenge:

• Ukulimala kwama-valve enhliziyo. Lo monakalo ungadala ukuvuza ku-valve yenhliziyo noma unciphise okwehlisa ukuhamba kwegazi nge-valve.
• Ukulimala kwemisipha yenhliziyo.
• Ukwehluleka kwenhliziyo.
• Ukutheleleka kolwelwesi lwangaphakathi lwenhliziyo yakho (i-endocarditis).
• Ukuvuvukala kolwelwesi oluzungeze inhliziyo (i-pericarditis).
• Isigqi senhliziyo esheshayo futhi esingagxilile.
• ISydenham chorea.

Shayela umhlinzeki wakho uma wena noma ingane yakho iqala izimpawu ze-rheumatic fever. Ngoba ezinye izimo eziningana zinezimpawu ezifanayo, wena noma ingane yakho nizodinga ukuhlolwa ngokucophelela kwezokwelapha.

Uma izimpawu ze-strep throat zikhula, tshela umhlinzeki wakho. Wena noma ingane yakho kuzodingeka nihlolwe futhi niphathwe uma kukhona i-strep throat. Lokhu kuzonciphisa ubungozi bokuba nomkhuhlane wamathambo.

Indlela ebaluleke kunazo zonke yokuvikela umkhuhlane wamathambo ukuthola ukwelashwa okusheshayo kwe-strep throat kanye ne-scarlet fever.

I-Streptococcus - umkhuhlane we-rheumatic fever; I-strep throat - i-rheumatic fever; I-Streptococcus pyogenes - umkhuhlane we-rheumatic fever; Iqembu A streptococcus - rheumatic fever

UCarr MR, uShulman ST. Isifo senhliziyo i-rheumatic. 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 465.

UMayosi BM. Umkhuhlane we-rheumatic fever. Ku: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, ama-eds. Isifo Senhliziyo SikaBraunwald: Incwadi Yemithi Yezinhliziyo Nemithambo. IPhiladelphia, PA: Elsevier; 2019: isahluko 74.

UShulman ST, uJaggi P.Nonsuppurative poststreptococcal sequelae: i-rheumatic fever ne-glomerulonephritis. 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 198.

UStevens DL, uBryant AE, uHagman MM. Ukungenwa yi-nonpneumococcal streptococcal kanye ne-rheumatic fever. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 274.