Meningitis - chifuwa chachikulu

Tuberculous meningitis ndi matenda aminyewa yophimba ubongo ndi msana (meninges).

Matenda a meningitis amayamba chifukwa cha Mycobacterium chifuwa chachikulu. Ichi ndi bakiteriya yomwe imayambitsa chifuwa chachikulu (TB). Mabakiteriya amafalikira kuubongo ndi msana kuchokera kumalo ena mthupi, kawirikawiri m'mapapo.

Matenda a meningitis ndi osowa kwambiri ku United States. Nthawi zambiri anthu ndi omwe adapita ku United States kuchokera kumayiko ena kumene TB imafala.

Anthu omwe ali ndi zotsatirazi ali ndi mwayi wambiri wodwala matenda otsekula m'mimba:

• HIV / Edzi
• Imwani mowa mopitirira muyeso
• TB ya m'mapapo
• Kufooka kwa chitetezo cha mthupi

Zizindikiro nthawi zambiri zimayamba pang'onopang'ono, ndipo zimatha kuphatikiza:

• Malungo ndi kuzizira
• Maganizo amasintha
• Nseru ndi kusanza
• Kuzindikira kuwala (photophobia)
• Mutu wopweteka kwambiri
• Khosi lolimba (meningismus)

Zizindikiro zina zomwe zimatha kuchitika ndi matendawa ndi monga:

• Kusokonezeka
• Kukula kwamafuta (malo ofewa) mwa makanda
• Kuchepetsa chidziwitso
• Kudyetsa osauka kapena kukwiya kwa ana
• Kukhazikika kosazolowereka, mutu ndi khosi zitabwerera m'mbuyo (opisthotonos). Izi nthawi zambiri zimapezeka mwa makanda.

Wothandizira zaumoyo adzakufunsani. Izi nthawi zambiri zimawonetsa kuti muli ndi izi:

• Kuthamanga kwa mtima
• Malungo
• Maganizo amasintha
• Khosi lolimba

Kubowola lumbar (mpopi wamtsempha) ndiyeso yofunikira pakuzindikira matenda a meningitis. Amachita kuti atoleko zitsanzo zamadzimadzi a msana kuti awunike. Zoyeserera zingapo zimafunikira kuti mudziwe.

Mayesero ena omwe angachitike ndi awa:

• Zolemba zaubongo kapena ma meninges (osowa)
• Chikhalidwe chamagazi
• X-ray pachifuwa
• CSF kuyesa kuwerengera kwama cell, glucose, ndi protein
• Kujambula kwa CT pamutu
• Utoto wa gramu, mabanga ena apadera, ndi chikhalidwe cha CSF
• Polymerase chain reaction (PCR) ya CSF
• Kuyesa khungu kwa TB (PPD)
• Mayesero ena oyang'ana TB

Mupatsidwa mankhwala angapo omenyera mabakiteriya a TB. Nthawi zina, mankhwala amayambika ngakhale omwe amakupatsani akuganiza kuti muli ndi matendawa, koma kuyesa sikunatsimikizirebe.

Chithandizo chimakhala pafupifupi miyezi 12. Mankhwala otchedwa corticosteroids atha kugwiritsidwanso ntchito.

Tuberculous meningitis imayika pangozi ngati singachiritsidwe. Kutsata kwanthawi yayitali kumafunikira kuti mupeze matenda obwereza (kubwereza).

Osalandira chithandizo, matendawa amatha kuyambitsa izi:

• Kuwonongeka kwa ubongo
• Kumanga kwamadzimadzi pakati pa chigaza ndi ubongo (subdural effusion)
• Kutaya kwakumva
• Hydrocephalus (kuchuluka kwa madzi mkati mwa chigaza chomwe chimatsogolera kukutupa kwa ubongo)
• Kugwidwa
• Imfa

Itanani nambala yadzidzidzi yakomweko (monga 911) kapena pitani kuchipinda chadzidzidzi ngati mukukayikira kuti meningitis ili mwa mwana yemwe ali ndi zizindikiro izi:

• Mavuto akudya
• Kulira kwakukulu
• Kukwiya
• Malungo osaneneka

Itanani nambala yadzidzidzi yakomweko ngati mungakhale ndi zina mwazizindikiro zazikulu zomwe zatchulidwa pamwambapa. Meningitis imatha kukhala matenda owopsa.

Kuthandiza anthu omwe ali ndi zizindikiro zakuti ali ndi kachilombo ka TB kosagwira ntchito (kungokhala matalala) kungateteze kufalikira kwake. Kuyezetsa kwa PPD ndi mayeso ena a TB atha kuchitika ngati muli ndi matendawa.

Mayiko ena omwe ali ndi chifuwa chachikulu cha TB amapatsa anthu katemera wotchedwa BCG wopewera TB. Koma, mphamvu ya katemerayu ndi yochepa, ndipo samagwiritsidwa ntchito ku United States. Katemera wa BCG atha kuthandizira kupewa mitundu yayikulu ya TB, monga meningitis, mwa ana aang'ono kwambiri omwe amakhala m'malo omwe matendawa amapezeka.

Tubercular oumitsa khosi; Matenda a TB

• Central dongosolo lamanjenje ndi zotumphukira zamanjenje

Anderson NC, Koshy AA, Roos KL. (Adasankhidwa) Bakiteriya, mafangasi ndi matenda a parasitic amanjenje. Mu: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, olemba. Neurology ya Bradley mu Kuchita Zachipatala. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2016: chap 79.

Cruz AT, Starke JR. Matenda a chifuwa chachikulu. Mu: Cherry JD, Harrison GJ, Kaplan SL, Steinbach WJ, Hotez PJ, olemba. Feigin ndi Cherry's Bookbook of Pediatric Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier; 2019: mutu 96.

Fitzgerald DW, Sterling TR, Haas DW. Mycobacterium chifuwa chachikulu. Mu: Bennett JE, Dolin R, Blaser MJ, olemba., Eds. Mandell, Douglas, ndi Mfundo za Bennett ndi Kuchita kwa Matenda Opatsirana, Kusinthidwa. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015: chap 251.