Endocarditis

Endocarditis ke ho ruruha ha lesela le kahare la likamore tsa pelo le li-valve tsa pelo (endocardium). E bakoa ke baktheria kapa, hangata tšoaetso ea fungal.

Endocarditis e ka kenyelletsa mesifa ea pelo, li-valve tsa pelo, kapa lesela la pelo. Batho ba bang ba hlahisang endocarditis ba na le:

• Tsoalo ea tlhaho ea pelo
• Sephahla se senyehileng kapa se sa tloaelehang sa pelo
• Nalane ea endocarditis
• Sephahla se secha sa pelo kamora ho buuoa
• Ho lemalla lithethefatsi tsa Parenteral (intravenous)

Endocarditis e qala ha likokoana-hloko li kena maling ebe li ea pelong.

• Tšoaetso ea baktheria ke sesosa se tloaelehileng sa endocarditis.
• Endocarditis le eona e ka bakoa ke li-fungus, joalo ka Candida.
• Maemong a mang, ha ho lebaka le ka fumanoang.

Likokoana-hloko li na le monyetla oa ho kena maling nakong ea:

• Litsela tse bohareng tsa venous tsa phihlello
• Ts'ebeliso ea ente ea lithethefatsi, ho tloha ts'ebelisong ea linalete tse sa hloekang (tse sa tsitsang)
• Ts'ebetso ea morao-rao ea meno
• Lits'ebetso tse ling tsa ho buoa kapa lits'ebetso tse nyane ho karolo ea phefumoloho, pampitšana ea moroto, letlalo le tšoaelitsoeng, kapa masapo le mesifa

Matšoao a endocarditis a ka hlaha butle kapa ka tšohanyetso.

Feberu, ho hatsela le ho fufuleloa ke matšoao a khafetsa. Ka linako tse ling tsena li ka:

• Eba teng matsatsi a mangata pele matšoao a mang a hlaha
• Tloo 'me u tsamaee, kapa u hlokomele haholo bosiu

U kanna oa ba le mokhathala, bofokoli, le mahlaba le bohloko mesifa kapa manonyeletso.

Lipontšo tse ling li ka kenyelletsa:

• Libaka tse nyane tsa ho tsoa mali ka tlasa lipekere (likhahla tsa mali)
• Matheba a khubelu, a se nang bohloko liatleng le bohatong (Janeway liso)
• Bofubelu, li-node tse bohloko lipakeng tsa menoana le menoana ea maoto (Osler node)
• Phefumoloho e khutšoane le ts'ebetso
• Ho ruruha ha maoto, maoto, mpa

Mofani oa tlhokomelo ea bophelo a ka 'na a lemoha ho korotla ha pelo e ncha, kapa phetoho ea ho korotla ha pelo e fetileng.

Ho hlahlojoa mahlo ho ka bontša ho tsoa mali ka har'a leihlo le sebakeng se bohareng sa ho hloekisa. Tlhaloso ena e tsejoa e le libaka tsa Roth. Ho kanna ha ba le libaka tse nyane, tse supang ho tsoa mali ka leihlo kapa mahlo a mahlo.

Liteko tse ka etsoang li kenyelletsa:

• Tloaelo ea mali ho thusa ho tseba libaktheria kapa fungus e bakang tšoaetso
• Palo e felletseng ea mali (CBC), C-reactive protein (CRP), kapa erythrocyte sedimentation rate (ESR)
• Echocardiogram ho sheba li-valve tsa pelo

U kanna oa hloka ho ba sepetlele ho fumana lithibela-mafu ka methapo (IV kapa ka methapo). Litso le liteko tsa mali li tla thusa mofani oa hau ho khetha lithibela-mafu tse molemohali.

Joale o tla hloka kalafo ea lithibela-mafu ea nako e telele.

• Hangata batho ba hloka kalafo bakeng sa libeke tse 4 ho isa ho tse 6 ho bolaea libaktheria tsohle tse tsoang likamoreng tsa pelo le li-valve.
• Kalafo ea lithibela-mafu e qalileng sepetlele e tla hloka ho ntšetsoa pele hae.

Ho buoa ho nka sebaka sa sephahla sa pelo ho hlokahala hangata ha:

• Tšoaetso e arohana ka likotoana tse nyane, e fella ka lichapo.
• Motho o ba le bofokoli ba pelo ka lebaka la li-valve tsa pelo tse senyehileng.
• Ho na le bopaki ba tšenyo e mpe ea setho.

Ho fumana kalafo ea endocarditis hanghang ho ntlafatsa menyetla ea sephetho se setle.

Mathata a tebileng a ka bang teng a kenyelletsa:

• Boqheku ba boko
• Tšenyo e 'ngoe li-valve tsa pelo, tse bakang ho hloleha ha pelo
• Ho hasana ha tšoaetso likarolong tse ling tsa 'mele
• Leqeba, le bakoang ke maqeba a manyane kapa likotoana tsa tšoaetso tse qalang le ho ea bokong

Bitsa mofani oa hau haeba u hlokomela matšoao a latelang nakong ea kalafo kapa kamora 'ona.

• Madi morotong
• Bohloko ba sefuba
• Mokhathala
• Feberu e sa tloheng
• Feberu
• Boikitlaetso
• Bofokoli
• Ho theola boima ba 'mele ntle le phetoho lijong

American Heart Association e khothaletsa lithibela-mafu bakeng sa batho ba kotsing ea ho fumana tšoaetso ea endocarditis, joalo ka ba nang le:

• Bofokoli bo itseng ba tsoalo ea pelo
• Mathata a ho kenyelletsa pelo le li-valve
• Li-valve tsa pelo tsa maiketsetso (li-valve tsa pelo tse kentsoeng ke ngaka e buoang)
• Nalane e fetileng ea endocarditis

Batho bana ba lokela ho fumana lithibela-mafu ha ba na le:

• Mekhoa ea meno e ka bakang ho tsoa mali
• Mekhoa e amanang le phefumoloho
• Mekhoa e kenyelletsang sistimi ea ho ntša metsi
• Mekhoa e amanang le tšilo ea lijo
• Mekhoa ea ho tšoaetsoa ke letlalo le tšoaetso e bonolo ea lisele

Tšoaetso ea valve; Staphylococcus aureus - endocarditis; Enterococcus - endocarditis; Streptococcus viridans - endocarditis; Candida - endocarditis

• Ho buuoa ka valve ea pelo - ho tsoa

• Pelo - karolo ho ea bohareng
• Pelo - pono e ka pele
• Janeway lesion - haufi-ufi
• Janeway lesion monoaneng
• Li-valve tsa pelo

Baddour LM, Freeman WK, Suri RM, Wilson WR. Ts'oaetso ea pelo. Ka: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Lefu la pelo la Braunwald: Buka ea bongaka ea meriana ea pelo. 11th ed. Philadelphia, PA: Elsevier; 2019: khaolo ea 73.

Baddour LM, Wilson WR, Bayer AS, le al. Matšoao a tšoaetsanoang a endocarditis ho batho ba baholo: ho hlahlojoa, kalafo ea likokoana-hloko, le taolo ea mathata: polelo ea saense bakeng sa litsebi tsa tlhokomelo ea bophelo bo botle ba American Heart Association. Tsamaiso. 2015; 132 (15): 1435-1486. PMID: 26373316 www.ncbi.nlm.nih.gov/pubmed/26373316.

Fowler VG, Bayer AS, Baddour LM. Endocarditis e tšoaetsanoang. Ka: Goldman L, Schafer AI, li-eds. Phekolo ea Goldman-Cecil. La 25th ed. Philadelphia, PA: Elsevier Saunders; 2016: khaolo ea 76.

Fowler VG, Scheld WM, Bayer AS. Endocarditis le tšoaetso ea methapo. Ka: Bennett JE, Dolin R, Blaser MJ, bahlophisi. Mandell, Douglas, le Bennett's Principles and Practice of Infectious Diseases. La 8th. Philadelphia, PA: Elsevier Saunders; 2015: khaolo ea 82.