Endocarditis - keiki

ʻO ka pale o loko o nā keʻena o ka puʻuwai a me nā kiʻikuhi puʻuwai i kapa ʻia ʻo endocardium. Hana ʻia ka endocarditis ke hele a pehu a wela paha kēia mea, pinepine ma muli o ka maʻi i nā valves naʻau.

Hana ʻia ka endocarditis ke komo nā g germ i ke kahe o ke koko a laila huakaʻi i ka puʻuwai.

• ʻO ka maʻi bacteria ka kumu maʻamau
• ʻOi aku ka nui o nā maʻi fungal
• I kekahi mau hihia, ʻaʻole hiki ke loaʻa i nā grob ma hope o ka hoʻāʻo ʻana

Hiki i ka endocarditis ke hoʻopili i ka puʻuwai puʻuwai, nā puʻuwai puʻuwai, a i ʻole ka pale o ka puʻuwai. Hiki i nā keiki me ka endocarditis ke ʻano i lalo e like me:

• Hema hānau o ka puʻuwai
• Poino puuwai poino a i ʻole maikaʻi ʻole
• Pākuʻi puʻuwai hou ma hope o ke kaha ʻana

ʻOi aku ka kiʻekiʻe o ka makaʻu i nā keiki i loaʻa ka mōʻaukala o ka puʻuwai puʻuwai, i hiki ke waiho i nā wahi ʻoʻoleʻa i ka uhi o nā keʻena puʻuwai.

Māmā kēia i ka hoʻopili ʻana o nā bacteria i ka pale.

Komo paha nā Kelemona i ke kahe o ke koko.

• Ma ke ala o kahi laina komo komo waena i loko o kahi
• I ka wā o ke kīpoki niho
• I nā ʻoki ʻana ʻē aʻe a i ʻole nā ​​kaʻina hana liʻiliʻi i nā ala ea a me nā akemāmā, ka maʻi mimi, ka ʻili i pā ʻia, a i ʻole nā ​​iwi a me nā mākala
• Ka neʻe ʻana o ka maʻi bacteria mai ka ʻōpū a i ʻole ka puʻu

Hiki ke ulu lohi a i ʻole hikiwawe paha nā ʻōuli o ka endocarditis.

ʻO ka fiva, ke anuanu, a me ka hou ka pinepine. Hiki i kēia mau manawa ke:

• E noho no nā lā ma mua o ka hōʻike ʻana o kekahi hōʻailona
• Hele a hele, a ʻike ʻia paha i ka pō

Hiki i nā ʻōuli ʻē aʻe ke:

• Ka luhi
• Nawaliwali
• ʻEha hui
• ʻEha ʻeha
• Hī pilikia
• Kaumaha emi
• Loaʻa ka ʻai ʻole

Nā pilikia Neurological, e like me ka hopu ʻana a me ke kūlana noʻonoʻo i hoʻopilikia ʻia

Hiki pū i nā hōʻailona o endocarditis ke:

• Nā wahi kahe liʻiliʻi ma lalo o nā kui (splinter hemorrhages)
• ʻO nā ʻili ʻulaʻula, ʻeha ʻole ma nā lima a me nā kapuwaʻi (lesion Janeway)
• ʻUlaʻula, ʻeha nā pona i nā pale o nā manamana lima a me nā manamana wāwae (Osler node)
• Pokole o ka hanu
• ʻO ka pehu ʻana o nā wāwae, nā wāwae, a me nā ʻōpū

Hiki i ka mea mālama ola olakino kāu keiki ke hana i ka echocardiography transthoracic (TTE) e nānā no ka endocarditis i nā keiki he 10 mau makahiki a ʻoi paha.

Hiki i nā hoʻokolohua ʻē aʻe ke:

• ʻO ka moʻomeheu koko e kōkua e ʻike i ke koʻohune a i ʻole ka fungus e hoʻomaka nei i ka maʻi
• Helu piha koko (CBC)
• C-reactive protein (CRP) a i ʻole ka erythrocyte sedimentation rate (ESR)

Mālama ʻia ka endocarditis ma luna o ka:

• ʻO ke kumu o ka maʻi
• Ka makahiki o ke keiki
• Ka nui o nā ʻōuli

Pono kāu keiki i ka haukapila e loaʻa nā lāʻau ʻalopika ma o ke aa (IV). E kōkua nā moʻomeheu koko a me nā hoʻāʻo i ka mea hāʻawi e koho i ka antibiotic ʻoi loa.

Pono kāu keiki i kahi lāʻau antibiotic lōʻihi lōʻihi.

• Pono kāu keiki i kēia lāʻau no 4 a 8 mau pule e hoʻomake loa i nā maʻi āpau mai nā keʻena puʻuwai a me nā kiʻiona.
• Pono e hoʻomau ʻia nā lāʻau Antibiotic i ka haukapila ma ka home ke kūpaʻa kāu keiki.

Pono paha kahi ʻoki e hoʻololi i kahi kiwikā puʻuwai i loaʻa i ka wā:

• ʻAʻole hana nā Antibiotics e mālama i ka maʻi
• Ke haki nei ka maʻi i nā ʻāpana liʻiliʻi, a laila loaʻa nā hahau
• Hoʻoulu ke keiki i ka maikaʻi ʻole o ka puʻuwai ma ke ʻano he hopena o nā kiʻo puʻuwai i hōʻino ʻia
• Ua hōʻinoʻino ʻia ka pāpū puʻuwai

ʻO ka loaʻa ʻana o ka lāʻau no ka endocarditis i kēia manawa e hoʻomaikaʻi i nā manawa o ka hoʻomaʻemaʻe ʻana i ka maʻi a me ka pale ʻana i nā pilikia.

ʻO nā pilikia kūpono o ka endocarditis i nā keiki:

• Poino i nā puʻuwai a me nā puʻuwai puʻuwai
• Loaʻa ʻole i ka puʻuwai puʻuwai
• Pākuʻi infective i nā aʻa coronary
• ʻO ka hahau, i hoʻokumu ʻia e nā clots liʻiliʻi a i ʻole nā ​​ʻāpana o ka maʻi i haki a hele i ka lolo
• Hoʻolahalaha ʻia ka maʻi i nā ʻāpana ʻē aʻe o ke kino, e like me nā akemāmā

Kāhea i ka mea hāʻawi i kāu keiki inā ʻoe e ʻike i nā ʻōuli penei i ka wā a ma hope paha o ka mālama ʻana.

• Koko i ka mimi
• ʻEha ʻeha
• Ka luhi
• Fiva
• Pōpō
• Nawaliwali
• ʻO ka hōʻemi kaumaha me ka loli ʻole o ka papaʻai

Paipai ka American Heart Association i nā antibiotic pale no nā keiki i ka makaʻu no ka endocarditis, e like me kēlā me:

• Ua hoʻoponopono ʻia a hoʻoponopono ʻole ʻia paha nā hānau hānau o ka puʻuwai
• Hoʻopilikia i ka hoʻoliʻiliʻi naʻau a me nā pilikia
• Nā nohona puʻuwai na ke kāne i hana (prosthetic)
• He moʻolelo i hala o endocarditis

Pono e loaʻa i kēia mau keiki nā lāʻau antibiotic ke loaʻa iā lākou:

• Kahua niho nā kaʻina hana e paha e kumu kahe ana ke koko
• ʻO nā kaʻina hana e pili ana i ka hanu hanu, ke ala urinary, a i ʻole ka tract digestive
• Nā hana e pili ai i nā maʻi ʻili a me nā maʻi palupalu

Pākuʻi Valve - keiki; Staphylococcus aureus - endocarditis - keiki; Enterococcus - endocarditis- keiki; Streptococcus viridians - endocarditis - keiki; Candida - endocarditis - keiki; Endocarditis koʻohune - keiki; Infocarditis infective - keiki; ʻO ka maʻi puʻuwai Congenital - endocarditis - keiki

• Nā valves puʻuwai - ʻike kiʻekiʻe

ʻO Baltimore RS, Gewitz M, Baddour LM, et al; ʻO ka American Heart Association Rheumatic Fever, Endocarditis, a me ke Komite maʻi ʻo Kawasaki o ka ʻaha kūkā no ka maʻi Cardiovascular i ka ʻōpio a me ka ʻaha kūkā no ka hanai maʻi Cardiovascular a me ka maʻi hahau. Endocarditis infective i ka wā kamaliʻi: hōʻano hou 2015: kahi ʻōlelo ʻepekema mai ka American Heart Association. Kaapuni. 2015; 132 (15): 1487-1515. PMID: 26373317 www.ncbi.nlm.nih.gov/pubmed/26373317.

Kaplan SL, Vallejo JG. Endocarditis infective. I: Cherry JD, Harrison GJ, Kaplan SL, Steinbach WJ, Hotez PJ, eds. ʻO Feigin a me Cherry's Textbook of Pediatric Infectious Diseases. 8th ed. Piladelapia, PA: Elsevier; 2019: chap 26.

Marcdante KJ, Kliegman RM. Endocarditis infective. I: Marcdante KJ, Kliegman RM, hua. Nā Pono Nui o Pediatrics. 8th ed. Piladelapia, PA: Elsevier; 2019: chap 111.

Mick NW. Kahuna Pediatric. I: Nā paia RM, Hockberger RS, Gausche-Hill M, nā ʻaoʻao. ʻO Rosen's Emergency Medicine: Nā Manaʻo Manaʻo a me ka hana lapaʻau. 9th ed. Piladelapia, PA: Elsevier; 2018: chap 166.