Viral Meningitis nokuningi
Igama elithi "meningitis" lisho ukuvuvukala kwama-meninges, okuyizicubu ezithambile ezizungeze ubuchopho nomgogodla . Lezi zicubu zingacasulwa amabhaktheriya, amagciwane, isikhunta, i-cancer, ngisho nemithi ethile efana ne- ibuprofen .
I-Meningitis ebangelwa amabhaktheriya ibizwa ngokuthi i-septic meningitis. Lesi yisimo esiphuthumayo sezokwelapha futhi sidinga ukwelashwa okusheshayo ngama-antibiotic emithi.
Ngenhlanhla, lolu hlobo lwe-meningitis aluvamile kakhulu kune-aseptic meningitis.
I-meningitis ye-aseptic imane isho ukuthi i-meningitis ayikona ngenxa yebhaktheriya, eshiya inqwaba yezinye izimbangela ezikhona. Esikhathini esiningi, i-aseptic meningitis ayisongeli ukuphila. Uma ubuchopho buyi-tissue futhi bukhuni (i- encephalitis ), isimo sinzima nakakhulu. Ezinye izinhlobo ze-meningitis, njengalezo ezibangelwa i- herpes simplex , zinomngcipheko omkhulu wokuba i-encephalitis. Ngenxa yokuthi i-meningitis ne-encephalitis zihlobene kakhulu, abanye odokotela basebenzisa igama elithi "meningoencephalitis" ukuchaza izifo ngesikhathi esisodwa.
Ziyini Izimpawu Ze-Aseptic Meningitis ?
Ukutholwa okuvamile kwe-meningitis kukhona umkhuhlane, intamo elukhuni (nuchal rigidity), kanye nekhanda. Ezinye izibonakaliso zibandakanya ukunxanxathela, ukuhlanza nokwehla kwesifo sekhanda ngokukhanya (photophobia). Izingane ezindala ngokwanele ukukhuluma zingakhononda ikhanda noma isicanucanu.
Uma i-meningitis ihlale ibangele zonke lezi zimpawu, ukuxilongwa kwe-meningitis kungaba lula. Ngeshwa, lesi simo ngokuvamile asiyona eqondile. Ezimweni ezinzima, ukutholwa okuvamile kwentamo eqinile kungase kungabonakali. Ukwenza ukuxilongwa kubaluleke nakakhulu ezinganeni, okungenzeka ukuthi zisencane kakhulu ukuchaza inhloko.
Izinsana zingase zibe nomkhuhlane kanye nezinye izibonakaliso zokugula okujwayelekile, ezifana nokushona, ukuhuda, noma ukungadli kahle.
Yini Evame Ukubangela I-Aseptic Meningitis?
Isizathu esivame kakhulu se-aseptic meningitis yisifo se- viral . Eqinisweni, ngezinye izikhathi amagama aseptic meningitis kanye ne-viral meningitis asetshenziselwa ngokungafani, nakuba empeleni ezinye izinto ezinjenge-reactionergic reaction noma i-fungus nazo zingabangela i-aseptic meningitis. Iningi lethu cishe lalinomdlavuza we-aseptic we-aseptic esikhathini esidlule, njenge-headache uma sine-flu. Kodwa-ke, i-aseptic meningitis nayo ingangena ezifweni ezingathí sina, ezinye zazo ezingabulala.
Amagciwane avame ukubangela i- meningitis ezinganeni zihlanganisa umndeni okuthiwa i- enteroviruses . Lo mndeni wegciwane udala cishe amaphesenti angu-90 kuwo wonke ama-viral meningitis. Lo mndeni wamagciwane nawo uvame ukubangela ukuqhuma, ukucabangela, ukuhlanza, kanye nezinye izimpawu zokuphefumula, kanye nama-acry accle esibajwayele ukuzihlanganisa nokugula (myalgias). Kuphela kwengxenye eyodwa kwengxenye yezingane ezindala kunomunye owodwa noma emibili kunesidingo se-nuchal. Ngenkathi abantu abaningi belulama ngaphandle kobunzima obuningi, okuhlukile okubizwa ngokuthi i-enterovirus 71 kubaluleke kakhulu futhi kungabangela izinhlungu ze-cranial nerve, ukukhubazeka, ne-edema ye-pulmona.
Omunye umndeni wegciwane eyaziwa ngokubangela i-meningitis ngumndeni wegciwane le- herpes simplex (HSV). Abaningi bethu bacabanga ukuthi leli gciwane liyisifo esithathelwana ngocansi, kodwa empeleni, lingasakazeka ngezinye izindlela. Ngokuvamile, amasosha omzimba ethu agcina i-HSV engabangela inkathazo enkulu, kepha lapho i-HSV ingena ekulawuleni, kuyisimo esiphuthumayo esibucayi kakhulu. I-encephalitis iyinto evamile, engabangela ukuhlukunyezwa nokulahleka kwezinzwa njengobuthakathaka, ukuphazamiseka, nokudideka. Abantu abaningi abane-HSV encephalitis bafa ngisho noma bethola ukwelashwa. Ngaphandle kokwelashwa, izinga lokufa liphakeme nakakhulu.
Ngenhlanhla, i-HSV ngokuvamile ibangela izimpawu zakudala ezinjengomkhuhlane, intamo eqinile, nezinsipho, okwenza kube lula ukubona nokuphatha ngokushesha.
I-Arboviruses yimizalwane yegciwane ethwalwe omiyane nemikhaza. Ngokuvamile, lezi zinhlobo ze-meningoencephalitis zinobumnene kakhulu, ngaphandle kokunye okungafani neze. Igciwane elibangela izintambo ze-St Louis Louis encephalitis ezivela e-meningitis efana nobumkhuhlane obulalayo. Ngokuvamile i-La Crosse encephalitis ibangela ukugwinya nokugxila kwezibonakaliso ze-neurologic. I-West Nile igciwane lingabangela nezinhlobonhlobo zezifo, kuhlanganise nokukhubazeka kanye ne-coma, ikakhulukazi kubantu abadala. Ngokuphambene, i-encephalitis entshonalanga ye-encephalitis ibangela izimpawu ezingaphezu kakhudlwana ezinganeni kunabantu abadala, kufaka phakathi ukuhlukunyezwa .
Amanye amaningi amagciwane angabangela i-aseptic meningitis. Izinsana zingenwa yi-parechovirus yabantu (i-HPeV), engabangela i-meningoencephalitis ngisho nokukhubazeka. Izimpawu ezivame kakhulu, noma kunjalo, ziwukucasula nje kuphela, ukuphelelwa ngumkhuhlane, nokuqhwala. Izinsana ezisencane nazo zingase zihlwithwe yi-congenital lymphocytic choriomeningitis virus, engabangela izinkinga ezinkulu ze-neurological ngaphezu kwe-meningitis. I-virus yama-rabies ngokuvamile ibangele i-encephalitis ngaphandle kwe-meningitis kodwa ingabangela i-meningitis. Ukwehla kwamantombazane kunesidingo manje ngenxa yemigomo, nakuba ngezinye izikhathi kungase kubonakale. Ngenhlanhla, i-meningitis emangqamuzaneni kokubili ayingavamile futhi ayinabungozi.
Odokotela Baxosha kanjani i-Aseptic Meningitis ne-Encephalitis?
Uma kukhona ukukhathazeka ukuthi umuntu angase abe nesimo esibi se-meningitis noma i-encephalitis, odokotela bavame ukuqala ama-antibiotics ngokushesha, ngisho nangaphambi kokuba baqede ukuphawula kwabo. Ngenxa yokuthi ezinye izinhlobo ze-meningoencephalitis zibulala kakhulu, ngisho nokulinda amahora ambalwa okuhlolwa ukuze ubuyele kungase kube yingozi.
Isinyathelo sokuqala ukuqinisekisa ukuthi ayikho i- meningitis ye-bacterial ekhona, okuzodinga ukuthi amanye ama-antibiotic aqale ngokushesha. Ekugcineni, indlela engcono kakhulu yokuxilonga i-meningitis inokugqama kwe-lumbar . Kule nqubo, inaliti ishiywe phakathi kwamathambo angemuva emgodleni we-cerebrospinal fluid (CSF) ngaphansi ngezansi lapho intambo yomgogodla iphela khona. Odokotela base befuna izibonakaliso zokuvuvukala, njengamaseli amaningi amhlophe egazi ku-CSF kunalindelekile. I-gram stain isetshenziselwa ukubuka amabhaktheriya. I-glucose namaprotheni nazo zilinganiswa. Uma i-glucose iphansi kakhulu, kungase kube ngoba amangqamuzana angeziwe ayaphazamisa ushukela.
Uma kunezibonakaliso zokukhathazeka ngokucindezela okuphezulu okungahambi kahle , njengesimo sengqondo esishintshile kakhulu, i-CT ikhanda izokwenziwa kuqala ukuze kuqinisekiswe ukuthi ukukhishwa kwe-lumbar akubangele ukushintsha kwengcindezi. Uma ingcindezi engezansi ebuchosheni isusiwe, ukucindezela okwenyuka ngaphakathi kwekhanda kungashintsha ubuchopho emgodini omncane lapho umgogodla uphuma khona, okungabangela ukukhubazeka nokufa.
Ukuhlolwa kwegazi kuyodonseka ukubuka izimpawu zokutheleleka ngaphandle kwesistimu yezinzwa. Igazi lizohlonywa ukuze libone uma kukhona amabhaktheriya akhula.
Uma kukhona izibonakaliso noma izimpawu ezibonisa igciwane elithile noma amabhaktheriya, ukuhlolwa kungasetshenziswa kulawo ma-agent aphethwe yodwa. Isibonelo, ngenxa yobuthakathaka bokutheleleka kwe-HSV, isibonelo, izivivinyo zivame ukugijima ukuze kuqinisekiswe ukuthi akukho HSV okhona ku-cerebrospinal fluid ngemuva kokukhishwa kwe-lumbar .
Izimbangela ezingavumelani ze-Aseptic Meningitis
Izinhlobo ezithile zebhaktheriya aziziphathe ngendlela esingayilindela ngayo amagciwane abangela i-septic meningitis. Ngokwesibonelo, ezimweni eziningi ze-septic meningitis, i-glucose iphansi ngokwejwayelekile. Kodwa-ke, i-glucose ingase ibe yinto evamile ezimweni zesifo seLyme , i-leptospirosis, i-ehrlichiosis, ne- syphilis .
Ezinye izifo zinciphisa i-glucose kodwa aziveli esigabeni esivamile segrimu esetshenziswa ukubuka amabhaktheriya. Ukuhlola okhethekile kuyadingeka ukuze uphenye nge-meningitis ebangelwa lezi zilwane. Izifo ze-fungal , isifo sofuba kanye ne-listeria yizibonelo zalolu hlobo lwezimbangela ezingezansi ngokushesha ze-meningitis ezingagwema ukutholakala ekuhlaziyeni okujwayelekile kwe-CSF.
Ezinye izidakamizwa zingabangela ukuvuvukala kwama-meninges. Isidakamizwa esivame kakhulu ukukwenza lokhu cishe yisidakamizwa esingekho ngaphezu kwe-nonsteroidal anti-inflammatory (NSAID) efana ne-ibuprofen. Ama-antibiotics afana ne-trimethoprim-sulfamethoxazole, evame ukusetshenziswa ukutheleleka kwezifo zamagciwane, angabangela i-aseptic meningitis.
> Imithombo:
> Rotbart HA. I-meningitis eyi-viral. I-Semin Neurol 2000; 20: 277.
> John Attia; Rose Hatala; Deborah J. Cook; futhi al. Ingabe Lo Mguli Okhulile Unenhliziyo Eyingozi Ye-Meningitis? I-JAMA. 1999; 282 (2): 175-181.