Matenda a Waterhouse-Friderichsen

Syndrome ya Waterhouse-Friderichsen (WFS) ndi gulu la zizindikilo zomwe zimadza chifukwa cha kulephera kwa ma adrenal gland kugwira bwino ntchito chifukwa chakutuluka magazi m'mimba.

Zotupitsa za adrenal ndizithunzithunzi ziwiri zooneka ngati makona atatu. Gland imodzi ili pamwamba pa impso iliyonse. Zilonda za adrenal zimatulutsa ndikutulutsa mahomoni osiyanasiyana omwe thupi limafunikira kuti lizigwira bwino ntchito. Matenda a adrenal amatha kukhudzidwa ndi matenda ambiri, monga matenda monga WFS.

WFS imayambitsidwa ndi matenda akulu a bacteria a meningococcus kapena mabakiteriya ena, monga:

• Streptococcus Gulu B
• Pseudomonas aeruginosa
• Streptococcus pneumoniae
• Staphylococcus aureus

Zizindikiro zimachitika mwadzidzidzi. Zimachitika chifukwa mabakiteriya akukula (kuchulukitsa) mkati mwathupi. Zizindikiro zake ndi izi:

• Malungo ndi kuzizira
• Ululu wophatikizana ndi minofu
• Mutu
• Kusanza

Kutenga mabakiteriya kumayambitsa magazi mthupi lonse, zomwe zimayambitsa:

• Ziphuphu za thupi lonse
• Kufalitsa kwamitsempha yamagazi komwe magazi amaundana amatulutsa magazi m'ziwalo
• Kusokonezeka

Kutulutsa magazi m'matumbo a adrenal kumayambitsa vuto la adrenal, momwe mahomoni okwanira a adrenal samapangidwa. Izi zimabweretsa zizindikilo monga:

• Chizungulire, kufooka
• Kuthamanga kwambiri kwa magazi
• Kuthamanga kwamtima kwambiri
• Kusokonezeka kapena kukomoka

Wothandizira zaumoyo adzayesa thupi ndikufunsa za zizindikiro za munthuyo.

Kuyesedwa kwa magazi kudzachitika kuti mutsimikizire matenda a bakiteriya. Mayeso atha kuphatikiza:

• Chikhalidwe chamagazi
• Kuwerengera kwathunthu kwa magazi ndikusiyanitsa
• Maphunziro a magazi

Ngati wothandizirayo akukayikira kuti kachilomboka kamayambitsidwa ndi bakiteriya ya meningococcus, mayeso ena omwe angachitike ndi awa:

• Lumbar kuboola kuti mupeze nyemba zam'mimba pachikhalidwe
• Khungu lachikopa ndi banga la Gram
• Kusanthula kwamkodzo

Mayeso omwe atha kulamulidwa kuti athandizire kupeza mavuto azovuta za adrenal ndi awa:

• Mayeso okondoweza a ACTH (cosyntropin)
• Kuyezetsa magazi kwa Cortisol
• Shuga wamagazi
• Kuyezetsa magazi potaziyamu
• Kuyesedwa kwa magazi
• Kuyesa magazi pH

Maantibayotiki amayambitsidwa nthawi yomweyo kuti athetse matenda a bakiteriya. Mankhwala a Glucocorticoid adzaperekedwanso kuti athetse vuto la adrenal gland. Chithandizo chothandizira chidzafunika pazizindikiro zina.

WFS imapha pokhapokha ngati chithandizo cha bakiteriya chikuyambika pomwepo ndikupatsidwa mankhwala a glucocorticoid.

Pofuna kupewa WFS yoyambitsidwa ndi mabakiteriya a meningococcal, katemera amapezeka.

Fulminant meningococcemia - Matenda a Waterhouse-Friderichsen; Fulminant meningococcal sepsis - Matenda a Waterhouse-Friderichsen; Hemorrhagic adrenalitis

• Zilonda za meningococcal kumbuyo
• Kutulutsa kwa hormone ya adrenal

Stephens DS. Zolemba za Neisseria. Mu: Bennett JE, Dolin R, Blaser MJ, olemba., Eds. Mandell, Douglas, ndi Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier Saunders; 2020: chap 211.

Mtengo Watsopano wa JDC, Auchus RJ. Kachilombo kotchedwa adrenal cortex. Mu: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, olemba. Buku la Williams la Endocrinology. Wolemba 14th. Philadelphia, PA: Elsevier; 2020: mutu 15.