Viral Meningitis kunye Naphezulu
Igama elithi "meningitis" lithetha ukuvuvukala kwama-meninges, ezo zicubu ezinotsholongwane ezijikeleze ingqondo kunye nomgudu womgogodla . Ezi zicubu ziyakucasulwa ngama-bacterium, iintsholongwane, i-fungi, i-cancer, kunye nemithi enjenge- ibuprofen .
I-Meningitis ebangelwa yi-bacteria ibizwa ngokuba yi-septic meningitis. Le yongxamiseko yonyango kwaye ifuna ukuba unyango olukhawulezileyo kunye namayeza omzimba.
Ngethamsanqa, lolu hlobo lwe-meningitis aluqhelekanga kune-aseptic meningitis.
I-meningitis ye-Aseptic imane isho ukuthi i-meningitis ayiyiyo ngenxa yeebhaktheriya, ezishiya ininzi yezizathu ezinobangela. Uninzi lwexesha, i-aseptic meningitis ayiyikusongela ubomi. Ukuba ubuchopho bomzimba buya kutshabalala (i- encephalitis ), imeko ibaluleke kakhulu. Ezinye iintlobo ze-meningitis, njengalezo ezibangelwa yi- herpes simplex , zinomngcipheko ophezulu wokuba yi-encephalitis. Ngenxa yokuba i-meningitis ne-encephalitis zihlobene kakhulu, abanye oogqirha basebenzisa igama elithi "meningoencephalitis" ukuchaza izifo ngokufanayo.
Ziziphi iimpawu ze-Aseptic Meningitis ?
Ukufunyanwa kweklasiki ye-meningitis ngumkhuhlane, intamo enzima (nuchal rigidity), kunye nentloko. Ezinye iimpawu ziquka ukuncwina, ukuhlanza nokunyuka kwesifo sekhanda ngokukhanya (photophobia). Abantwana abaneminyaka eyaneleyo yokuthetha banokukhalaza isifo senyoko okanye isicupunu.
Ukuba i-meningitis isoloko ibangele zonke ezintathu iimpawu, ukuxilongwa kwe-meningitis kuya kuba lula. Ngelishwa, le meko ayinjalo ngokuthe ngqo. Kwiimeko ezibuhlungu, ukufunyanwa kweklasikhi kwentamo eqinile kungabonakali. Ukwenza ukuxilongwa kubaluleke kakhulu kubantwana, abasenokuba bancinci ukuchaza intloko.
Iintsana zinokuba nomkhuhlane kunye nezinye iimpawu zokugula ngokubanzi, ezifana nokugqithisa, ukuhanjiswa, okanye ukungadli kakuhle.
Yintoni eqhelekileyo eyenza i-Aseptic Meningitis?
Isizathu esona siqhelo se-aseptic meningitis yintsholongwane yentsholongwane . Enyanisweni, ngamanye amaxesha i-aseptic meningitis kunye ne-viral meningitis isetyenziswe ngokungafaniyo, nangona ngokuqinisekileyo ezinye izinto ezinjengeempembelelo okanye i-fungus zingabangela ukuba i-aseptic meningitis. Ininzi yethu mhlawumbi ibe ne-aseptic milding meningitis kwixesha elidlulileyo, njengentloko xa sisifo somkhuhlane. Nangona kunjalo, i-aseptic meningitis nayo ifikelele kwiifom ezinzulu, ezinye zazo zingabhubhisa.
Iintsholongwane ezivame ukudala i- meningitis kubantwana ziquka intsapho ebizwa ngokuba yi- enteroviruses . Le ntsapho yintsholongwane ibangela malunga ne-90% yazo zonke iintsholongwane. Le ntsapho yintsholongwane idla ngokubangela ukugqithisa, isicupunu, ukuhlanza, kunye nezinye iimpawu zokuphefumula, kunye neentlungu zomzimba esihlala sizidibanisa nokugula (i-myalgias). Ingxenye engaphezulu kwesigamu sabantwana abaneminyaka engaphezu kweyodwa okanye emibini ine-rigidity nuchal. Ngelixa abaninzi abantu bafumana ngaphandle kobunzima obuninzi, ukuhluka okunye okubizwa ngokuba yi-enterovirus 71 kubaluleke kakhulu kwaye kungabangela i-cranial nerv palsies, ukukhubazeka, kunye ne-edema ye-pulmona.
Olunye usapho lweentsholongwane eziyaziwayo ngokubangela i-meningitis yintsapho ye- herpes simplex (HSV). Uninzi lwethu lucinga ukuba le ntsholongwane iyisifo esithathelwana ngesondo, kodwa ngokwenene, sinokusasazeka ngezinye iindlela. Ngokuqhelekileyo, amasosha omzimba ethu agcina i-HSV ukuba ingabangela inkathazo enkulu, kodwa xa i-HSV iphuma ekulawuleni, yinto engxamisekileyo ye-neurological emergency. I-Encephalitis iyinto eqhelekileyo, enokubangela ukuxhamla kunye nokulahleka kweengqondo njengobuthathaka, ukuphazamiseka, nokudideka. Abantu abaninzi abane-HSV encephalitis bafa nangona bafumana unyango. Ngaphandle kwonyango, izinga lokufa liphezulu.
Ngenhlanhla, i-HSV idla ngokubangela iimpawu ezinjengomkhuhlane, intamo eqinile, kunye nentloko, okwenze kube lula ukuyiqonda kwaye uphathe ngokukhawuleza.
I-Arbovirus yintsholongwane yentsholongwane eqhutywe yizinyoyi kunye namacenge. Ngokuqhelekileyo, ezi ntlobo ze-meningoencephalitis zincinci, kunye nezinye izinto ezingaqhelekanga. Intsholongwane ebangela i-St Louis Louis encephalitis ranges ukusuka kumnyuzi onjenge-meningitis obulalayo. I-Crosse encephalitis ibangele ibangele kwaye ijolise kwiimpawu ze-neurologic. Intsholongwane yaseNtshonalanga nayo ingabangela ezininzi izifo, kuquka ukukhubazeka kunye ne-coma, ngakumbi kubantu abadala. Ngokwahlukileyo, i-encephalitis esentshona ye-equine ibangela izibonakaliso ezinzima kubantwana kunabantu abadala, kubandakanywa nokuxhwala .
Ezinye ezininzi iindiza zingenza i-aseptic meningitis. Iintsana zinokusulelwa yi-perechovirus yabantu (i-HPeV), engabangela i-meningoencephalitis kunye nokukhubazeka. Iimpawu eziqhelekileyo, nangona kunjalo, zivutha nje, i-fever, ne-rash. Iintsana ezisencinane nazo zinokuhlupheka ngenxa yesifo sengqondo se-congenital lymphocytic virus, engabangela iingxaki ezinkulu zeengxaki ze-neurological ngaphezu kwe-meningitis. I-virus ye-rabies igqithise i-encephalitis ngaphandle kwe-meningitis kodwa ingabangela ukuba ne-meningitis. Ukugqithisa i-meningitis ayinqabile ngoku ngenxa yokugonywa, nangona ngezinye izikhathi kusenokubonakala. Ngethamsanqa, i-meningitis emanzini yinto engabonakaliyo kwaye ayiyingozi.
Oogqirha bafumana njani i-Aseptic Meningitis ne-Encephalitis?
Ukuba kukho nayiphi na inkxalabo yokuba umntu unokufumana uhlobo oluthile lwe-meningitis okanye i-encephalitis, oogqirha baya kuqalisa ukulwa namagciwane ngokukhawuleza, nangaphambi kokugqitywa ukuxilongwa kwabo. Ngenxa yokuba ezinye iindidi ze-meningoencephalitis ziyabulala, kwanokuba zilinde iiyure ezimbalwa ezongezelelweyo ukuba iimvavanyo zibuye zibuye zibe yingozi.
Isinyathelo sokuqala kukuqinisekisa ukuba akukho- meningitis ye-bacteria ekhona, efuna ukuba i-antibiotics ethile iqaliswe ngokukhawuleza. Ekugqibeleni, indlela eyona ndlela yokufumana i-meningitis inokugqitywa kwe - lumbar . Kule ndlela, inaliti ishiywe phakathi kwamathambo emqolo kwisangxo se-cerebrospinal fluid (CSF) phantsi ngaphantsi apho intambo yomgudu iyaphela. Oogqirha ke bajonga iimpawu zokuvuvukala, njengezinye iiseli ezimhlophe zegazi kwi-CSF kunokuba kulindeleke. I-gram stain isetyenziswe ukujonga ibhaktheriya. I-glucose kunye neeprotheyini zilinganiswa ngokunjalo. Ukuba i-glucose isezantsi kakhulu, kungenzeka ukuba iiseli ezongezelelweyo ziqhubela ishukela.
Ukuba kukho nayiphi na imiqondiso yokukhathazeka ngokunyanzeliswa kwe- intracranial ephakamileyo , efana nesimo sengqondo esitshintshile kakhulu, i-CT yentloko iya kwenziwa kuqala ukuqinisekisa ukuba ukugqithiswa kwe-lumbar akuyi kubangela ukutshintshwa kwengcinezelo. Ukuba uxinzelelo olungaphantsi kwengqondo lususwe, ukunyuswa kwengcinezelo ngaphakathi kwekhanga kunokutshintsha ingqondo emgodini omncinci apho umthambo womkhuhlane uphuma, ongabangela ukukhubazeka nokufa.
Iimvavanyo zegazi ziya kutsalwa ukukhangela iimpawu zentsholongwane ngaphandle kwenkqubo yesantya. Igazi liya kuhlonyelwa ukuze libone ukuba nayiphi ibhaktheriya ikhula.
Ukuba kukho nayiphi na impawu okanye iimpawu ezibonisa ukutshatyalaliswa kwintsholongwane ethile okanye iibhaktheriya, iimvavanyo zingaqhutyelwa kubasebenzi abangatshatanga. Ngokomzekelo, ngenxa yobuthakathaka bokungenwa kwe-HSV, umzekelo, iimvavanyo zivame ukuqhutyelwa ukuqinisekisa ukuba akukho HSV ikhona kwi-cerebrospinal fluid emva kokugqitywa kwe-lumbar .
Izizathu ezingezantsi ze-Aseptic Meningitis
Ezinye iintlobo zeebhaktheriya aziziphathe ngendlela esinokuyilindela ngayo iintsholongwane ezibangelwa i-meningitis ye-septic. Ngokomzekelo, kwiimeko ezininzi ze-meningitis ye-septic, i-glucose isephantsi. Nangona kunjalo, i-glucose isenokuba isisigxina kwiimeko zeLyme , i-leptospirosis, i-ehrlichiosis kunye ne- syphilis .
Ezinye izifo zinciphisa i-glucose kodwa zingabonakali kwibala eliqhelekileyo le-gram-esetyenziswa ukujonga ibhaktheriya. Kufuneka iimvavanyo ezizodwa ukwenzela ukuphanda nge-meningitis ebangelwa yizinto eziphilayo. Ukusulelwa kwefungal , isifo sofuba kunye ne-listeria yimizekelo yolu hlobo lwesibonakaliso esingekho ngokukhawuleza sobungqina be-meningitis esinokuphepha ukufumana ukuhlalutya kwe-CSF.
Ezinye iziyobisi zingabangela ukuvuvukala kwama-mening. Isilwanyana esona siqhelo ukukwenza oku mhlawumbi siyi -anti-stroidal anti-inflammatory drug (NSAID) efana ne-ibuprofen. I-antibiotics efana ne-trimethoprim-sulfamethoxazole, esetyenziswa ngokubanzi ekuphatheni izifo zogonyamelo lwe-urinary, zingenza ukuba i-aseptic meningitis.
> Imithombo:
> Rotbart HA. Malesitis. Semin Neurol 2000; 20: 277.
> UJohn Attia; Rose Hatala; Deborah J. Cook; kunye na. Ngaba lo Mguli oMdala unayo i-Meningitis enobuchule? JAMA. 1999; 282 (2): 175-181.