Yomumuzongoza - tuberculous

Tuberculous meningitis chirwere chetishu dzinovhara uropi uye musana (meninges).

Tuberculous meningitis inokonzerwa ne Mycobacterium tibhii. Ichi ndicho bhakitiriya chinokonzera tibhii (TB). Iyo bhakitiriya inopararira kuuropi uye musana kubva kune imwe nzvimbo mumuviri, kazhinji mapapu.

Tuberculous meningitis isingawanzoitika muUnited States. Kazhinji kazhinji vanhu vakaenda kuUnited States kubva kune dzimwe nyika uko TB yakajairika.

Vanhu vane zvinotevera vane mukana wepamusoro wekubata tuberculous meningitis:

• HIV / AIDS
• Inwa doro zvakawandisa
• TB yemapapu
• Dziviriro yezvirwere mumuviri

Zviratidzo zvinowanzotanga zvishoma nezvishoma, uye zvinogona kusanganisira:

• Fivha uye kutonhora
• Mamiriro epfungwa anochinja
• Kusvotwa uye kurutsa
• Kunzwisisa kuchiedza (photophobia)
• Musoro wakanyanya
• Mutsipa wakaoma (meningismus)

Zvimwe zviratidzo zvinogona kuitika nechirwere ichi zvinogona kusanganisira:

• Kusagadzikana
• Kubhururuka fontanelles (nyoro nzvimbo) mune vacheche
• Kuderera kwekuziva
• Kudya kwakashata kana kutsamwa muvana
• Kugara kusingajairike, nemusoro nemutsipa zvakatemerwa kumashure (opisthotonos). Izvi zvinowanzo kuwanikwa mune vacheche.

Anokuchengetedza hutano achakuongorora. Izvi zvinowanzo kuratidza kuti une zvinotevera:

• Kukurumidza kurova kwemoyo
• Kupindwa nechando
• Mamiriro epfungwa anochinja
• Mutsipa wakaoma

Lumbar puncture (musana tambo) muyedzo wakakosha mukuongorora chirwere chengono. Izvo zvinoitwa kuunganidza muyenzaniso wepelinha yemvura kuti uongororwe. Zvinopfuura imwechete sampuro zvinogona kudikanwa kuti zvionekwe.

Mimwe bvunzo inogona kuitwa inosanganisira:

• Biopsy yeuropi kana meninges (zvisingawanzoitika)
• Tsika yeropa
• Chest x-ray
• CSF kuongororwa kwesero kuverenga, glucose, uye mapuroteni
• CT scan yemusoro
• Gram stain, mamwe akasviba mavara, uye tsika yeCSF
• Polymerase cheni reaction (PCR) yeCSF
• Ganda bvunzo yeTB (PPD)
• Mimwe miedzo yekutsvaga TB

Unozopihwa mishonga yakati wandei yekurwisa hutachiona hweTB. Dzimwe nguva, kurapwa kunotangwa kunyangwe kana mupi wako achifunga kuti une chirwere, asi kuyedzwa hakuna kuchisimbisa.

Kurapa kunowanzo kutora kwemwedzi gumi nembiri. Mishonga inonzi corticosteroids inogona zvakare kushandiswa.

Tuberculous meningitis kutyisidzira hupenyu kana ikasarapwa. Yenguva refu yekutevera inodiwa kuti uone hutachiona hwakadzokororwa (kudzokazve).

Pasina kurapwa, chirwere ichi chinogona kukonzera chero cheanotevera:

• Kukuvara kwehuropi
• Kuvaka-kumusoro kwemvura pakati pehenya nehuropi (subdural effusion)
• Kunzwa kurasikirwa
• Hydrocephalus (buildup yemvura mukati medehenya inotungamira kukudzwa kwehuropi)
• Kufenda
• Rufu

Fonera iyo yekumusoro emergency emergency (yakadai sa911) kana enda kuimba yekukurumidzira kana iwe uchifungidzira meningitis mumwana mudiki ane zvinotevera zviratidzo:

• Matambudziko ekudyisa
• Kuchema kwepamusoro
• Kushatirwa
• Kuramba kusinganzwisisike fivha

Fonera iyo yemuno emergency emergency kana iwe ukagadzira chero chakakomba zviratidzo zvakanyorwa pamusoro. Meningitis inogona kukurumidza kuve chirwere chinotyisa.

Kurapa vanhu vane zviratidzo zvehutachiona hweTB husiri kushanda (hwakarara) kunogona kudzivirira kupararira. Kuongororwa kwePPD uye kumwe kuongorora kweTB kunogona kuitwa kuti utaure kana uine rudzi urwu rwehutachiona.

Dzimwe nyika dzine huturu hweTB dzinopa vanhu jekiseni rinonzi BCG kudzivirira TB. Asi, kushanda kwemushonga uyu kushoma, uye hakuwanzoshandiswa muUnited States. Mushonga weBCG unogona kubatsira kudzivirira mhando dzakakomba dzeTB, senge meningitis, muvana vadiki kwazvo vanogara munzvimbo dzinowanikwa chirwere ichi.

Tubercular yomumuzongoza; TB yomumuzongoza

• Central nervous system uye yekumusoro tsinga system

Anderson NC, Koshy AA, Roos KL. Hutachiona, fungal uye chisvetasimba chirwere chetsinga system. Mune: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology muClinical Dzidzira. 7th ed. Philadelphia, PA: Elsevier; 2016: chits. 79.

Cruz AT, Starke JR. Tiibhii. Mune: Cherry JD, Harrison GJ, Kaplan SL, Steinbach WJ, Hotez PJ, eds. Feigin naCherry's Bhuku reBhuku rePediatric Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier; 2019: chap 96.

Fitzgerald DW, Sterling TR, Haas DW. Mycobacterium tibhii. Mune: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, uye Bennett's Principles uye Practice yeInfectious Diseases, Yakagadziridzwa Edhisheni. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015: chitsiko 251.