Pseudomembranous colitis

Pseudomembranous colitis e bolela ho ruruha kapa ho ruruha ha mala a maholo (colon) ka lebaka la ho tlola ha Clostridioides e fapane (C fapana) libaktheria.

Ts'oaetso ena ke sesosa se tloaelehileng sa letšollo kamora ts'ebeliso ea lithibela-mafu.

The C fapana libaktheria li lula ka maleng. Leha ho le joalo, libaktheria tse ngata haholo li ka hola ha o noa lithibela-mafu. Libaktheria li fana ka chefo e matla e bakang ho ruruha le ho tsoa mali ka lera la kolone.

Lithibela-mafu leha e le life li ka baka boemo bona. Meriana e ikarabellang bakeng sa bothata hangata ke ampicillin, clindamycin, fluoroquinolones le cephalosporins.

Bafani ba tlhokomelo ea bophelo sepetlele ba ka fetisetsa baktheria ena ho tloha ho motho e mong ho ea ho e mong.

Pseudomembranous colitis ha e tloaelehe ho bana, ebile ha e fumanehe hangata ho masea. Hangata e bonoa ho batho ba sepetlele. Leha ho le joalo, e se e tloaelehile haholo ho batho ba noang lithibela-mafu 'me ba se sepetlele.

Mabaka a kotsi a kenyelletsa:

• Botsofali
• Tšebeliso ea lithibela-mafu
• Ts'ebeliso ea meriana e fokolisang sesole sa 'mele (joalo ka meriana ea chemotherapy)
• Ho buuoa haufinyane
• Nalane ea pseudomembranous colitis
• Nalane ea lefu la ulcerative colitis le lefu la Crohn

Matšoao a kenyelletsa:

• Mahlaba a mpeng (a bonolo ho isa ho a matla)
• Litulo tse nang le mali
• Feberu
• Khothaletsa ho ba le mantle
• Letšollo le metsi (hangata makhetlo a 5 ho isa ho a 10 ka letsatsi)

Liteko tse latelang li ka etsoa:

• Colonoscopy kapa sigmoidoscopy e tenyetsehang
• Immunoassay bakeng sa chefo ea C difficile setulong
• Liteko tse ncha tsa setuloana joalo ka PCR

Lithibela-mafu kapa moriana o mong o bakang boemo boo o lokela ho emisoa. Metronidazole, vancomycin, kapa fidaxomicin hangata li sebelisoa ho sebetsana le bothata, empa meriana e meng le eona e ka sebelisoa.

Ho ka hlokahala tharollo ea motlakase kapa maro a tsoang mothapong ho phekola ho felloa ke metsi 'meleng ka lebaka la lets'ollo. Maemong a sa tloaelehang, ho hlokahala opereishene ho phekola tšoaetso e mpefalang kapa e sa arabeleng lithibela-mafu.

Ho ka hlokahala lithibela-mafu tsa nako e telele haeba C fapana tšoaetso ea khutla. Kalafo e ncha e bitsoang fecal microbiota transplant ("stool transplant") le eona e atlehile bakeng sa tšoaetso e khutlang.

Mofani oa hau a ka boela a fana ka tlhahiso ea hore u noe li-probiotic haeba tšoaetso e khutla.

Ponahalo e ntle maemong a mangata, haeba ho se na mathata. Leha ho le joalo, tšoaetso e le 'ngoe ho tse 5 e ka khutla mme e hloka kalafo e eketsehileng.

Mathata a ka kenyelletsa:

• Ho felloa ke metsi 'meleng ka ho se leka-lekane ha electrolyte
• Pherekano ea (lesoba ho pholletsa) le colon
• Megacolon e chefo
• Lefu

Bitsa mofani oa hau haeba u e-na le matšoao a latelang:

• Litulo leha e le life tsa mali (haholo-holo ka mor'a ho noa lithibela-mafu)
• Likarolo tse hlano kapa ho feta tsa letšollo ka letsatsi matsatsi a fetang 1 ho isa ho a 2
• Bohloko bo bohloko ba mpeng
• Matšoao a ho felloa ke metsi 'meleng

Batho ba nang le "pseudomembranous colitis" ba lokela ho joetsa bafani ba bona pele ba noa lithibela-mafu hape. Ho bohlokoa hape ho hlapa matsoho ho thibela ho fetisetsa kokoana-hloko ho batho ba bang. Hase kamehla batho ba hloekisang joala ba sebetsang teng C fapana.

Colitis e amanang le lithibela-mafu; Colitis - pseudomembranous; Lefu la ho ruruha; C difficile - pseudomembranous

• Tsamaiso ea ho sila lijo
• Lisebelisoa tsa tsamaiso ea lijo

Gerding DN, Johnson S. Clostridial tšoaetso. Ka: Goldman L, Schafer AI, li-eds. Phekolo ea Goldman-Cecil. La 26th. Philadelphia, PA: Elsevier; 2020: khaolo ea 280.

Gerding DN, VB e monyane. Donskey CJ. Clostridiode e fapane (pele Clostridium difficle) tšoaetso. Ka: Bennett JE, Dolin R, Blaser MJ, bahlophisi. Mandell, Douglas, le Bennett's Principles and Practice of Infectious Diseases. La 9th. Philadelphia, PA: Elsevier; 2020: khaolo ea 243.

Kelly CP, letšollo le amanang le lithibela-mafu le clostridioides difficile tshwaetso. Ka: Feldman M, Friedman LS, Brandt LJ, bahlophisi. Sleisenger le Fordtran's Mpeng le Mafu a Sebete. 11th ed. Philadelphia, PA: Elsevier; 2021: khaolo ea 112.

McDonald LC, Gerding DN, Johnson S, le al. Litataiso tsa kalafo ea clostridium difficile Ts'oaetso ho batho ba baholo le bana: Tlhatlhobo ea 2017 ea Infectious Diseases Society of America (IDSA) le Society for Healthcare Epidemiology of America (SHEA). Kliniki ea tšoaetso Dis. 2018; 66 (7): 987-994. PMID: 29562266 pubmed.ncbi.nlm.nih.gov/29562266/.