Endocarditis - ana

Mzere wamkati wazipinda zamtima ndi ma valve amtima amatchedwa endocardium. Endocarditis imachitika pomwe minofu iyi yatupa kapena yotupa, nthawi zambiri chifukwa cha matenda amagetsi a mtima.

Endocarditis imachitika pamene majeremusi amalowa m'magazi ndikupita kumtima.

• Matenda a bakiteriya ndi omwe amafala kwambiri
• Matenda a fungal ndi osowa kwambiri
• Nthawi zina, palibe majeremusi omwe angapezeke pambuyo poyesedwa

Endocarditis itha kuphatikizira minofu ya mtima, mavavu amtima, kapena kuyika kwa mtima. Ana omwe ali ndi endocarditis atha kukhala ndi vuto ngati:

• Chibadwa cha kubadwa kwa mtima
• Kuwonongeka kapena kupindika kwa valavu yamtima
• Valavu yatsopano yamtima mutatha opaleshoni

Chiwopsezo chimakhala chachikulu mwa ana omwe ali ndi mbiri yakuchita opaleshoni yamtima, yomwe imatha kusiya malo ovuta m'mbali mwa zipinda zamtima.

Izi zimapangitsa kuti mabakiteriya asavutike kulumikizana.

Majeremusi amatha kulowa m'magazi:

• Pogwiritsa ntchito njira yolowera poyambira yomwe ilipo
• Pa opaleshoni ya mano
• Pakati pa maopareshoni ena kapena njira zazing'ono zopita kuma airways ndi mapapo, thirakiti, khungu lomwe lili ndi kachilombo, kapena mafupa ndi minofu
• Kusuntha kwa mabakiteriya kuchokera m'matumbo kapena m'mero

Zizindikiro za endocarditis zimatha kuyamba pang'onopang'ono kapena mwadzidzidzi.

Malungo, kuzizira, ndi thukuta ndizizindikiro zambiri. Izi nthawi zina zimatha:

• Khalani nawo masiku ambiri zizindikiro zina zisanachitike
• Bwera, pita, kapena uziwonekera kwambiri nthawi yamadzulo

Zizindikiro zina zitha kuphatikiza:

• Kutopa
• Kufooka
• Ululu wophatikizana
• Kupweteka kwa minofu
• Kuvuta kupuma
• Kuchepetsa thupi
• Kutaya njala

Mavuto amitsempha, monga kugwidwa ndi kusokonezeka kwa malingaliro

Zizindikiro za endocarditis zitha kuphatikizaponso:

• Madera ang'onoang'ono otaya magazi pansi pa misomali (kutuluka kwa magazi)
• Mawanga ofiira, opanda ululu padzanja ndi pamiyendo (zotupa za Janeway)
• Zofiira, zopweteka m'miyendo ya zala ndi zala (Osler node)
• Kupuma pang'ono
• Kutupa kwa mapazi, miyendo, pamimba

Wothandizira zaumoyo wa mwana wanu atha kuchita transthoracic echocardiography (TTE) kuti aone ngati ali ndi endocarditis mwa ana azaka 10 kapena kupitilira apo.

Mayesero ena atha kuphatikizira:

• Chikhalidwe chamagazi chothandiza kuzindikira mabakiteriya kapena bowa zomwe zimayambitsa matendawa
• Kuwerengera kwathunthu kwa magazi (CBC)
• C-reactive protein (CRP) kapena erythrocyte sedimentation rate (ESR)

Chithandizo cha endocarditis chimadalira pa:

• Choyambitsa matendawa
• Zaka za mwana
• Kukula kwa zizindikilo

Mwana wanu adzafunika akhale mchipatala kuti alandire maantibayotiki kudzera mumtsempha (IV). Zikhalidwe zamagazi ndi kuyezetsa kumathandizira woperekayo kusankha mankhwala abwino kwambiri.

Mwana wanu adzafunika chithandizo chamankhwala chamtundu wautali.

• Mwana wanu adzafunika mankhwalawa kwa milungu 4 mpaka 8 kuti aphe mabakiteriya onse ochokera muzipinda zamtima ndi mavavu.
• Mankhwala a maantibayotiki omwe amayamba kuchipatala adzafunika kupitilizidwa kunyumba mwana wanu akadzakhazikika.

Kuchita opaleshoni m'malo mwa valavu yamtima yomwe ili ndi kachilombo kungafune ngati:

• Maantibayotiki sagwira ntchito pochiza matendawa
• Matendawa akung'amba tating'onoting'ono, ndikupangitsa sitiroko
• Mwanayo amayamba kulephera pamtima chifukwa cha ma valve amtima owonongeka
• Valavu yamtima yawonongeka kwambiri

Kupeza chithandizo cha endocarditis nthawi yomweyo kumathandiza kuti athetse matendawa ndikupewa zovuta.

Zovuta zotheka za endocarditis mwa ana ndi izi:

• Kuwonongeka kwa mavavu amtima ndi mtima
• Abscess mu mtima waminyewa
• Matenda opatsirana m'mitsempha yamitsempha
• Sitiroko, yomwe imayambitsidwa ndimatenda ang'onoang'ono kapena zidutswa za matendawa zimayamba kupita kuubongo
• Kufalitsa kachilomboka kumadera ena a thupi, monga mapapo

Itanani woyang'anira mwana wanu ngati muwona izi:

• Magazi mkodzo
• Kupweteka pachifuwa
• Kutopa
• Malungo
• Kunjenjemera
• Kufooka
• Kuchepetsa thupi popanda kusintha zakudya

American Heart Association imalimbikitsa maantibayotiki oteteza kwa ana omwe ali pachiwopsezo cha endocarditis, monga omwe ali ndi:

• Zolakwika zina zakubadwa zosasinthidwa zamtima
• Kuika mtima ndi mavuto a valavu
• Mavavu amtima opangidwa ndi anthu (opanga)
• Mbiri yakale ya endocarditis

Ana awa ayenera kulandira maantibayotiki akakhala ndi:

• Njira zamano zomwe zimayambitsa magazi
• Njira zomwe zimakhudza kupuma, kwamikodzo, kapena kagayidwe kazakudya
• Njira zotetezera khungu ndi matenda ofewa

Valavu matenda - ana; Staphylococcus aureus - endocarditis - ana; Enterococcus - endocarditis- ana; Streptococcus viridians - endocarditis - ana; Candida - endocarditis - ana; Bakiteriya endocarditis - ana; Matenda opatsirana endocarditis - ana; Kobadwa nako matenda a mtima - endocarditis - ana

• Mavavu amtima - mawonekedwe apamwamba

Baltimore RS, Gewitz M, Baddour LM, ndi al; American Heart Association Rheumatic Fever, Endocarditis, ndi Kawasaki Disease Committee of the Council on Cardiovascular Disease in the Young ndi Council on Cardiovascular and Stroke Nursing. Infective endocarditis muubwana: 2015 pomwe: mawu asayansi ochokera ku American Heart Association. Kuzungulira. 2015; 132 (15): 1487-1515. PMID: 26373317 www.ncbi.nlm.nih.gov/pubmed/26373317. (Adasankhidwa)

Kaplan SL, Vallejo JG. Matenda opatsirana endocarditis. 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: chaputala 26.

[Adasankhidwa] Marcdante KJ, Kliegman RM. Matenda opatsirana endocarditis. Mu: Marcdante KJ, Kliegman RM, olemba. Nelson Zofunikira pa Matenda a Ana. 8th ed. Philadelphia, PA: Elsevier; 2019: mutu 111.

Mick NW. Malungo a ana. Mu: Makoma RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018: chap 166.