Endocarditis - bana

Lera la kahare la likamore tsa pelo le li-valve tsa pelo li bitsoa endocardium. Endocarditis e etsahala ha lisele tsena li ruruha kapa li ruruha, hangata ka lebaka la ts'oaetso li-valve tsa pelo.

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

• Tšoaetso ea baktheria ke sesosa se tloaelehileng haholo
• Mafu a fungal a sa tloaelehang haholo
• Maemong a mang, ha ho na likokoana-hloko tse ka fumanoang kamora tlhahlobo

Endocarditis e ka kenyelletsa mesifa ea pelo, li-valve tsa pelo, kapa lesela la pelo. Bana ba nang le endocarditis ba ka ba le bothata bo joalo ka:

• Tsoalo ea tlhaho ea pelo
• Sephahla se senyehileng kapa se sa tloaelehang sa pelo
• Sephahla se secha sa pelo kamora ho buuoa

Kotsi e phahame haholo ho bana ba nang le nalane ea ho buuoa ka pelo, e ka tlohang libakeng tse thata moeling oa likamore tsa pelo.

Sena se nolofalletsa libaktheria ho khomarela lera.

Likokoana-hloko li ka kena maling:

• Ka tsela ea phihlello ea venous e fumanehang
• Nakong ea ho buuoa ka meno
• Nakong ea liopereishene tse ling kapa lits'ebetso tse nyane ho ea moeeng le matšoafong, pampiri ea ho ntša metsi, letlalo le tšoaelitsoeng, kapa masapo le mesifa
• Ho falla ha libaktheria ho tsoa maleng kapa 'metso

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

Matšoao a mang a kenyeletsa:

• Ho kgathala
• Bofokoli
• Bohloko bo kopaneng
• Bohloko ba mesifa
• Ho hema ka thata
• Ho fokotsa boima ba 'mele
• Ho felloa ke takatso ea lijo

Mathata a amanang le methapo ea pelo, joalo ka ho oa le ho tšoenyeha kelellong

Matšoao a endocarditis a 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 khutšoanyane
• Ho ruruha ha maoto, maoto, mpa

Mofani oa tlhokomelo ea bophelo ba ngoana oa hau a ka etsa transthoracic echocardiography (TTE) ho hlahloba endocarditis ho bana ba lilemo li 10 kapa tlase.

Liteko tse ling li ka kenyelletsa:

• Tloaelo ea mali ho thusa ho tseba libaktheria kapa fungus e bakang tšoaetso
• Palo e felletseng ea mali (CBC)
• Protheine ea C-reactive (CRP) kapa erythrocyte sedimentation rate (ESR)

Kalafo ea endocarditis e ipapisitse le:

• Sesosa sa tšoaetso
• Lilemo tsa ngoana
• Boima ba matšoao

Ngoana oa hau o tla hloka ho ba sepetlele ho fumana lithibela-mafu ka mothapo (IV). Litso le liteko tsa mali li tla thusa mofani hore a khethe lithibela-mafu tse molemohali.

Ngoana oa hau o tla hloka kalafo ea lithibela-mafu ea nako e telele.

• Ngoana oa hau o tla hloka kalafo ena ka libeke tse 4 ho isa ho tse 8 ho bolaea libaktheria tsohle tse tsoang likamoreng tsa pelo le li-valve.
• Kalafo ea lithibela-mafu e qalileng sepetlele e tla hloka ho tsoela pele lapeng ha ngoana oa hau a se a tsitsitse.

Ho buoa ho nka sebaka sa sephahla sa pelo se nang le ts'oaetso ho ka hlokahala ha:

• Lithibela-mafu ha li sebetse ho phekola tšoaetso
• Tšoaetso e arohana ka likotoana tse nyane, e fella ka lichapo
• Ngoana o ba le bofokoli ba pelo ka lebaka la li-valve tsa pelo tse senyehileng
• Sefahleho sa pelo se senyehile hampe

Ho fumana kalafo ea endocarditis hanghang ho ntlafatsa menyetla ea ho tlosa tšoaetso le ho thibela mathata.

Mathata a ka bang teng a endocarditis ho bana ke:

• Tšenyo ea li-valve tsa pelo le pelo
• Abscess ka mesifa ea pelo
• Lefu le tšoaetsanoang methapong ea mali
• Leqeba, le bakoang ke maqeba a manyane kapa likotoana tsa tšoaetso tse qalang le ho ea bokong
• Ho hasana ha tšoaetso likarolong tse ling tsa 'mele, tse kang matšoafo

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

• Madi morotong
• Bohloko ba sefuba
• Mokhathala
• Feberu
• Boikitlaetso
• Bofokoli
• Ho theola boima ba 'mele ntle le phetoho ea lijo

American Heart Association e khothaletsa lithibela-mafu tse thibelang bana ba kotsing ea endocarditis, joalo ka ba nang le:

• Bofokoli bo itseng bo lokisitsoeng kapa bo sa nepisoang ba tsoalo ea pelo
• Mathata a ho kenyelletsa pelo le li-valve
• Li-valve tsa pelo tse entsoeng ke motho
• Nalane e fetileng ea endocarditis

Bana 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, leqhubu la ho ntša metsi, kapa tšilo ea lijo
• Mekhoa ea ho tšoaetsoa ke letlalo le tšoaetso e bonolo ea lisele

Tšoaetso ea valve - bana; Staphylococcus aureus - endocarditis - bana; Enterococcus - endocarditis- bana; Streptococcus viridians - endocarditis - bana; Candida - endocarditis - bana; Baktheria endocarditis - bana; Tšoaetso endocarditis - bana; Congenital lefu la pelo - endocarditis - bana

• Li-valve tsa pelo - pono e phahameng

Baltimore RS, Gewitz M, Baddour LM, le al; American Heart Association Rheumatic Fever, Endocarditis, le Komiti ea Maloetse ea Kawasaki ea Lekhotla la Mafu a Pelo le Melemo ho Bacha le Lekhotla la Baoki ba Pelo le Pelo. Infective endocarditis bongoaneng: ntjhafatso ea 2015: polelo ea mahlale e tsoang ho American Heart Association. Tsamaiso. 2015; 132 (15): 1487-1515 (Khatisitsoeng) PMID: 26373317 www.ncbi.nlm.nih.gov/pubmed/26373317.

Kaplan SL, Vallejo JG. Endocarditis e tšoaetsanoang. Ka: Cherry JD, Harrison GJ, Kaplan SL, Steinbach WJ, Hotez PJ, bahlophisi. Buka ea Feigin le Cherry ea Pediatric Infectious Diseases. La 8th. Philadelphia, PA: Elsevier; 2019: khaolo ea 26.

Marcdante KJ, Kliegman RM. Endocarditis e tšoaetsanoang. Ka: Marcdante KJ, Kliegman RM, bahlophisi. Nelson Bohlokoa ba Pediatrics. La 8th. Philadelphia, PA: Elsevier; 2019: khaolo ea 111.

Mick NW. Feberu ea bana. Ka: Marako RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Likhopolo le Tloaelo ea Kliniki. La 9th. Philadelphia, PA: Elsevier; 2018: khaolo ea 166.