I-Endocarditis - izingane

Ulwelwesi lwangaphakathi lwamagumbi enhliziyo namavalvu enhliziyo lubizwa nge-endocardium. I-Endocarditis yenzeka lapho lesi sicubu siqala ukuvuvukala noma ukuvuvukala, imvamisa ngenxa yokutheleleka kuma-valve enhliziyo.

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

• Ukutheleleka kwamagciwane kuyimbangela evame kakhulu
• Izifo zefungal zivame kakhulu
• Kwezinye izimo, awekho amagciwane angatholakala ngemuva kokuhlolwa

I-Endocarditis ingabandakanya imisipha yenhliziyo, ama-valve enhliziyo, noma ulwelwesi lwenhliziyo. Izingane ezine-endocarditis zingase zibe nesimo esiyisisekelo njenge:

• Isici sokuzalwa senhliziyo
• I-valve yenhliziyo eyonakele noma engavamile
• I-valve yenhliziyo entsha ngemuva kokuhlinzwa

Ingozi iphezulu ezinganeni ezinomlando wokuhlinzwa kwenhliziyo, ezingashiya izindawo ezinzima emgqeni wamakamelo enhliziyo.

Lokhu kwenza kube lula ukuthi amabhaktheriya anamathele kulayini.

Amagciwane angangena egazini:

• Ngendlela yokufinyelela emaphakathi enesifo semithambo ekhona
• Ngesikhathi sokuhlinzwa kwamazinyo
• Phakathi kokunye ukuhlinzwa noma izinqubo ezincane emikhakheni yomoya nasemaphashini, umgudu wokuchama, isikhumba esinegciwane, noma amathambo nemisipha
• Ukufuduka kwamagciwane kusuka emathunjini noma emphinjeni

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

Ezinye izimpawu zingafaka:

• Ukukhathala
• Ubuthakathaka
• Ubuhlungu obuhlangene
• Ubuhlungu bemisipha
• Ukuphefumula kanzima
• Ukwehla kwesisindo
• Ukuphelelwa isifiso sokudla

Izinkinga ze-neurological, ezinjengokuquleka nokuphazamiseka kwengqondo

Izimpawu ze-endocarditis zingafaka futhi:

• 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)
• Ukuphelelwa umoya
• Ukuvuvukala kwezinyawo, imilenze, isisu

Umhlinzeki wezokunakekelwa kwempilo yengane yakho angenza i-transthoracic echocardiography (TTE) ukuhlola i-endocarditis ezinganeni ezineminyaka engu-10 noma ngaphansi.

Ezinye izivivinyo zingafaka:

• Isiko legazi ukusiza ukukhomba amagciwane noma ukhunta okubangela ukutheleleka
• Qedela ukubalwa kwegazi (CBC)
• Amaprotheni asebenza nge-C (CRP) noma isilinganiso se-erythrocyte sedimentation (ESR)

Ukwelashwa kwe-endocarditis kuncike kulokhu:

• Imbangela yokutheleleka
• Iminyaka yengane
• Ubukhulu bezimpawu

Ingane yakho izodinga ukuthi ibe sesibhedlela ukuthola ama-antibiotic ngomthambo (IV). Amasiko nokuhlolwa kwegazi kuzosiza umhlinzeki ukuthi akhethe i-antibiotic engcono kakhulu.

Ingane yakho izodinga ukwelashwa kwama-antibiotic kwesikhathi eside.

• Ingane yakho izodinga lokhu kwelashwa amasonto ama-4 kuye kwayi-8 ukubulala ngokuphelele wonke amabhaktheriya avela emakamelweni enhliziyo nasezivalweni.
• Imithi elwa namagciwane eqale esibhedlela izodinga ukuqhubeka ekhaya uma ingane yakho isisimeme.

Ukuhlinzwa ukubuyisela i-valve yenhliziyo ethelelekile kungadingeka lapho:

• Ama-antibiotic awasebenzi ukwelapha ukutheleleka
• Ukutheleleka kuqhekeka kube yizicucu ezincane, kuphumele kohlangothi
• Ingane iba nokuhluleka kwenhliziyo ngenxa yama-valve enhliziyo alimele
• I-valve yenhliziyo yonakele kabi

Ukuthola ukwelashwa kwe-endocarditis zisuka nje kuthuthukisa amathuba okususa ukutheleleka nokuvikela izinkinga.

Izinkinga ezingenzeka ze-endocarditis ezinganeni yilezi:

• Ukulimala kwama-valve wenhliziyo nenhliziyo
• Ithumba emisipheni yenhliziyo
• Amahlwili athelelekayo emithanjeni ye-coronary
• Unhlangothi, obangelwa amahlule amancane noma izingcezu zokutheleleka kuqhamuka bese kuya ebuchosheni
• Ukusabalala kokutheleleka kwezinye izingxenye zomzimba, njengamaphaphu

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

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

I-American Heart Association incoma ama-antibiotic okuvimbela izingane ezisengozini ye-endocarditis, njengalezo ezine:

• Ukukhubazeka okuthile kokuzalwa okulungisiwe noma okungalungisiwe kwenhliziyo
• Izinkinga zokufakelwa kwenhliziyo nezama-valve
• Amaphayiphu enhliziyo enziwe ngabantu
• Umlando owedlule we-endocarditis

Lezi zingane kufanele zithole ama-antibiotic uma zine:

• Izinqubo zamazinyo ezingadala ukopha
• Izinqubo ezibandakanya umgudu wokuphefumula, umgudu wokuchama, noma umgudu wokugaya ukudla
• Izinqubo zokutheleleka kwesikhumba kanye nokutheleleka kwezicubu ezithambile

Ukutheleleka kwe-valve - izingane; I-Staphylococcus aureus - endocarditis - izingane; I-Enterococcus - i-endocarditis- izingane; Ama-streptococcus viridians - i-endocarditis - izingane; I-Candida - endocarditis - izingane; I-endocarditis yebhaktheriya - izingane; I-endocarditis enesifo - izingane; Isifo senhliziyo esizelwe - i-endocarditis - izingane

• Ama-valve enhliziyo - ukubuka okuphakeme

IBaltimore RS, uGewitz M, iBaddour LM, et al; I-American Heart Association Rheumatic Fever, i-Endocarditis, neKawasaki Disease Committee yoMkhandlu Wezifo Zenhliziyo Kwabancane kanye noMkhandlu Wezobuhlengikazi Benhliziyo Nemithambo. I-endocarditis enesifo ebuntwaneni: isibuyekezo se-2015: isitatimende sesayensi esivela ku-American Heart Association. Ukujikeleza. 2015; 132 (15): 1487-1515. I-PMID: 26373317 www.ncbi.nlm.nih.gov/pubmed/26373317.

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