Meningitis - paukū

ʻO ka meningitis tuberculous kahi maʻi o nā aʻa e uhi ana i ka lolo a me ka iwi kuamoʻo (meninges).

Hoʻokumu ʻia ka meningitis ʻōmaka e Mycobacterium tuberculosis. ʻO kēia ka maʻi bacteria e kumu ai ka maʻi kō (TB). Hoʻolahalaha ka bacteria i ka lolo a me ka iwi kuamoʻo mai kahi ʻē aʻe i ke kino, ʻo ka maʻamau ka lung.

Kākaʻikahi loa ka meningitis tuberculous ma United States. ʻO ka hapa nui o nā hihia i hele i ʻAmelika Hui Pū ʻIa mai nā ʻāina ʻē kahi maʻamau ka TB.

ʻO ka poʻe i loaʻa ka mea aʻe aʻe i ka manawa kiʻekiʻe o ka hoʻomohala ʻana i ka maʻi puʻupuʻu puʻupuʻu:

• HIV / AIDS
• Inu ʻalekika i ka nui
• TB o ka māmā
• ʻŌnaehana pale nawaliwali

Hoʻomaka e hoʻomaka mālie nā ʻōuli, a pili pū paha:

• Fiva a me nā anuanu
• Hoʻololi ke kūlana noʻonoʻo
• ʻO Nusea a me ka luaʻi
• ʻIke i ka mālamalama (photophobia)
• ʻEha poʻo poʻo
• ʻĀʻī ʻoʻoleʻa (meningismus)

ʻO nā ʻōuli ʻē aʻe i hiki ke loaʻa me kēia maʻi e komo pū paha me:

• Hoʻoikaika
• ʻO nā fontanelles ʻōhū (nā wahi palupalu) i nā pēpē
• Hoemi i ka ʻike
• Hānai hānai a hoʻonāukiuki paha i nā keiki
• Kūleʻa maʻamau, me ke poʻo a me ka ʻāʻī e hoʻohele i hope (opisthotonos). Loaʻa kēia i nā pēpē.

E nānā ka mea mālama ola iā ʻoe. E hōʻike maʻamau kēia iā ʻoe i kēia mau mea:

• Ka helu puʻuwai wikiwiki
• Fiva
• Hoʻololi ke kūlana noʻonoʻo
• ʻĀʻī ʻoʻoleʻa

ʻO kahi lumbar puncture (spinal tap) kahi hōʻike nui i ka hōʻoia ʻana i ka meningitis. Hana ʻia e hōʻiliʻili i kahi laʻana o ka wai spinal no ka nānā ʻana. Ma mua o hoʻokahi mau laʻana e pono ai e hōʻoia.

Nā hoʻokolohua ʻē aʻe i hana ʻia e hoʻopili ʻia:

• ʻO Biopsy o ka lolo a i ʻole meninges (rare)
• Moʻomeheu Koko
• Pākuʻi x-ray
• Nānā CSF no ka helu pūnaewele, glucose, a me protein
• CT scan o ke poʻo
• Pākuʻi Gram, nā stains kūikawā ʻē aʻe, a me ka moʻomeheu o CSF
• ʻO ka hopena polymerase chain (PCR) o CSF
• ʻIli ʻili no TB (PPD)
• Nā hōʻike ʻē aʻe e nānā no ka TB

Hāʻawi ʻia ʻoe i nā lāʻau e hakakā ai i ka bacteria bacteria. I kekahi manawa, hoʻomaka ka lapaʻau ʻoiai inā manaʻo kāu mea hāʻawi iā ʻoe ka maʻi, akā ʻaʻole i hoʻokūpaʻa ʻia ka hoʻāʻo ʻana.

Lōʻihi ka mālama ʻana ma ka liʻiliʻi he 12 mau mahina. Hiki ke hoʻohana ʻia nā lāʻau i kapa ʻia ʻo Corticosteroids.

ʻO ka meningitis tubercious ke hoʻoweliweli i ke ola inā mālama ʻole ʻia. Pono ka ukali wā lōʻihi e ʻike i nā maʻi hou (recurrences).

ʻAʻole mālama ʻia, hiki i ka maʻi ke hana i kekahi o kēia mau mea:

• Poino lolo
• Kūkulu o ka loli ma waena o ka iwi poʻo a me ka lolo (subdural effusion)
• Lohe hoʻolohe
• Hydrocephalus (kūkulu ʻia o ka wai i loko o ka iwi poʻo e alakaʻi ai i ka lolo e ʻōhū)
• Ka hopu ʻana i nā maʻi
• Make

Kāhea i ka helu kūloko kūloko (e like me 911) a i ʻole hele i kahi keʻena pilikia inā manaʻo ʻoe he meningitis i kahi keiki ʻōpio i loaʻa kēia mau ʻōuli penei:

• Nā pilikia hānai
• Uē kūho kiʻekiʻe
• Huhū
• ʻO ke kuni kuhi ʻole mau

Kāhea i ka helu kūloko kūloko inā hoʻomohala ʻoe i kekahi o nā hōʻailona koʻikoʻi i helu ʻia ma luna. Hiki i ka Meningitis ke lilo koke i maʻi hoʻoweliweli.

ʻO ka mālama ʻana i ka poʻe i loaʻa nā hōʻailona o ka maʻi ʻole (dormant) TB maʻi hiki ke pale aku i kona hoʻolaha ʻana. Hiki i kahi hōʻike PPD a me nā hoʻokolohua TB ʻē aʻe ke haʻi inā loaʻa iā ʻoe kēia ʻano maʻi.

Hāʻawi kekahi mau ʻāina me ka nui o ka maʻi TB i ka poʻe i ka lāʻau lapaʻau i kapa ʻia ʻo BCG e pale aku ai i ka TB. Akā, kaupalena ʻia ka maikaʻi o kēia lāʻau āpau, a hoʻohana pinepine ʻole ʻia ia ma ʻAmelika Hui Pū ʻIa. Hiki paha i ka lāʻau BCG ke pale aku i nā ʻano TB koʻikoʻi, e like me ka meningitis, i loko o nā keiki liʻiliʻi e noho ana ma nā wahi e maʻa mau ai ka maʻi.

Meningitis Tubercular; Meningitis TB

• ʻŌnaehana ʻōnaehana waena a me ka ʻōnaehana ʻōnaehana peripheral

Anderson NC, Koshy AA, Roos KL. ʻO nā maʻi koʻohune, fungal a me nā parasite o ka ʻōnaehana hopohopo. I: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. ʻO Bradley's Neurology i ka hana lapaʻau. ʻEpekema 7 Piladelapia, PA: Elsevier; 2016: chap 79.

Cruz AT, Starke JR. Maʻi puʻu. I: Cherry JD, Harrison GJ, Kaplan SL, Steinbach WJ, Hotez PJ, eds. ʻO Feigin lāua ʻo Cherry's Textbook of Pediatric Infectious Diseases. 8th ed. Piladelapia, PA: Elsevier; 2019: chap 96.

Fitzgerald DW, Sterling TR, Haas DW. Mycobacterium tuberculosis. I: Bennett JE, Dolin R, Blaser MJ, hua pā. ʻO Mandell, Douglas, a me Bennett's Principal a me ka hoʻomaʻamaʻa ʻana i nā maʻi kūpikipiki, Hoʻopuka Hou. 8th ed. Piladelapia, PA: Elsevier Saunders; 2015: chap 251.