I-Rheumatic Fever

I-Rheumatic fever, isifo sokuvuvukala esiyinkimbinkimbi, ingabangela ukulimala okungapheli enhliziyweni uma ingelashwa. Lesi simo ngokuvamile siqala nge-strep throat infection futhi singathuthuka sithinte izingxenye ezihlukahlukene zomzimba. Ukuqonda isifo se-rheumatic fever kubalulekile ekutholakaleni kusenesikhathi nokunakekelwa okufanele.

Lesi sihloko sizama ukunikeza ukuqonda okujulile kwezimbangela, izimpawu, nokwelashwa kwesifo se-rheumatic fever. Sizohlola izimpawu okufanele uziqaphele, izici ezandisa ubungozi bokungenwa yilesi sifo, kanye nezinkinga ezingaba khona. Ukwengeza, sizoxoxa ngokuthi odokotela baxilonga kanjani i-rheumatic fever, izinketho zokwelashwa ezitholakalayo, kanye nezinyathelo zokuvimbela ukwenzeka kwayo. 

Iyini I-Rheumatic Fever?

Kuyisifo esibi kakhulu sokuvuvukala esingaba khona lapho i-strep throat noma i-scarlet fever ingelashwa. Kwenzeka lapho amasosha omzimba esabela ngokweqile ekuthelelekeni ngamabhaktheriya e-streptococcus eqembu A. Lokhu kusabela ngokweqile kwenza umzimba uhlasele izicubu zawo ezinempilo, okuholela ekuvuvukeni ezingxenyeni ezihlukahlukene zomzimba, kuhlanganise nenhliziyo, amalunga, isikhumba, nobuchopho. I-Rheumatic fever ihlasela ngokuyinhloko izingane ezineminyaka engu-5 kuya kwengu-15, ngokuvamile ezikhula ezinsukwini ezingu-14 kuya kwezingu-28 ngemva kokutheleleka nge-strep. Nakuba kuyivelakancane emazweni athuthukile, kusewukukhathazeka kwezinye izindawo. Lesi simo singaba nemiphumela ehlala isikhathi eside, ikakhulukazi enhliziyweni, engase ibangele umonakalo kuma-valve enhliziyo ngisho nokuhluleka kwenhliziyo uma kungelashwa.

Izimpawu Ze-Rheumatic Fever

Izimpawu ze-Rheumatic fever ngokuvamile zivela emasontweni angu-2 kuya kwangu-4 ngemva kokutheleleka nge-strep throat. Lesi simo sibangela ukuvuvukala ezingxenyeni ezihlukahlukene zomzimba, okuholela ezimpawu ezihlukahlukene. Lokhu kungafaka: 

• Fever
• ubuhlungu Joint 
• Ukuvuvukala kwamalunga, ikakhulukazi emadolweni, emaqakaleni, ezindololwaneni nasezihlakaleni 
• ubuhlungu besifuba kanye nokushaya kwenhliziyo okungajwayelekile
• Ukukhathala
• Amaqhubu amancane angenabuhlungu ngaphansi kwesikhumba
• Umqubuko oyisicaba noma ophakanyiswe kancane onamachopho amadlaka
• Abanye abantu baba ne-Sydenham chorea, ebonakala ngokunyakazisa umzimba okungalawuleki, ikakhulukazi ezandleni, ezinyaweni nasebusweni. 

Izimpawu nezimpawu ze-rheumatic fever zingahluka kakhulu, zize zihambe, noma zishintshe ngesikhathi sokugula. Kubalulekile ukuqaphela ukuthi i-rheumatic fever ingathinta abantu ngokuhlukile, futhi abanye bangase babe nezifo ezinjalo ezincane kangangokuthi abaqapheli ukuthi banazo kuze kube yilapho i-rheumatic fever iqala kamuva.

Izimbangela Ze-Rheumatic Fever

I-Rheumatic fever iqala njengendlela yokusabela okungavamile komzimba ekuthelelekeni kweqembu A Streptococcus, ikakhulukazi i-strep throat noma i-scarlet fever. Lesi simo senzeka lapho izindlela zokuzivikela zomzimba zihlasela ngephutha izicubu ezinempilo esikhundleni samagciwane. Lokhu kusabela okweqile ngokuvamile kwenzeka emasontweni amabili kuya kwamane ngemva kokutheleleka nge-streptococcal okungalashwanga.

Izingozi Zezingozi

Ziningana izici ezandisa amathuba okuthuthukisa i-rheumatic fever, okuhlanganisa: 

• Ukuhlala ezimeni eziminyene, ikakhulukazi emazweni anemali engenayo ephansi kanye nemaphakathi anokufinyelela okulinganiselwe ekunakekelweni kwezempilo
• Ukuba namasosha omzimba abuthakathaka
• Iminyaka yobudala nayo idlala indima, izingane kanye nentsha ephakathi kweminyaka engu-5 nengu-15 ubudala yibona abasengozini enkulu. 
• Umlando womndeni we-rheumatic fever
• Ukutheleleka kwe-strep njalo kungaba nomthelela engcupheni ephezulu ye-rheumatic fever.
• Izimo zezindlu ezingezinhle, njengendawo ebandayo, enomswakama, nesikhunta
• Izithiyo zokufinyelela ekunakekelweni kwezempilo okuyisisekelo, okuhlanganisa ukungakwazi ukubhukha ama-aphoyintimenti ngesikhathi noma ukukhokhela imiyalelo, kungabambezela ukwelashwa kwezifo ze-strep, ezingase ziholele kumkhuhlane wamathambo.

Izinkinga

I-Rheumatic fever ingaholela ezinkingeni ezinzima:

• Umphumela obaluleke kakhulu wesikhathi eside yisifo senhliziyo esibuhlungu, esidala ukulimala okungapheli kuma-valve enhliziyo. Lo monakalo ungaholela kokuthi:
• I-Valve stenosis noma ukuguqulwa kabusha, okungase kuholele ekuhlulekeni kwenhliziyo, i-arrhythmias, kanye nengozi eyengeziwe yokushaywa unhlangothi. 
  • I-fibrillation ye-Atrial
  • I-Endocarditis
  • Umfutho wegazi ophezulu wamaphaphu 
• Ezimweni ezingavamile, i-rheumatic fever ingathinta isimiso sezinzwa, ibangele i-Sydenham chorea, isimo esibonakala ngokunyakaza okungahleliwe. 
• Izinkinga ezihlangene, njenge-Jaccoud arthropathy, zingase zenzeke, ikakhulukazi iminwe, izinzwane, nezihlakala. 
• abesifazane abakhulelwe abane-rheumatic heart disease babhekana nezingozi eziphakeme zemiphumela emibi ngenxa yokwanda kokucindezeleka kwenhliziyo. 

Ukuxilongwa Kwe-Rheumatic Fever

Ukuxilongwa kusalokhu kuyinselele ngenxa yokuntuleka kokutholwe okuthile komtholampilo noma kwaselabhorethri, okudinga ukucatshangelwa ngokucophelela kwezimpawu nemiphumela yokuhlolwa. Odokotela bathembele kunqubo kaJones ebuyekeziwe, ehlanganisa ukubonakaliswa okukhulu nokuncane. Ukuze kuhlolwe i-rheumatic fever, iziguli kumelwe zibe nemibandela emibili emikhulu noma eyodwa enkulu nezimbili ezincane, kanye nobufakazi bokutheleleka kwamuva nje kwe-streptococcal. 

Imibandela emikhulu ihlanganisa:

• I-Carditis
• Isifo Sokuqaqamba Kwamalunga
• I-Chorea
• I-Erythema marginatum
• Amaqhuqhuva angaphansi kwesikhumba

Imibandela encane ihlanganisa: 

• Fever
• Izimpawu zokuvuvukala eziphakanyisiwe
• ubuhlungu Joint
• I-ECG iyashintsha
• Ukuhlolwa kwegazi kuhlola ukuvuvukala kanye namasosha omzimba e-streptococcal. 
• Ukuhlolwa kwenhliziyo, okufana ne-echocardiogram kanye ne-electrocardiograms, kuhlola ukusebenza kwenhliziyo. 
• I-Echocardiography nge-Doppler manje isinconyiwe kuzo zonke izigameko ezisolwayo ukuze kutholwe i-subclinical carditis. 

Ukwelashwa Kwe-Rheumatic Fever

Ukwelashwa kwe-rheumatic fever kugxile ekuqedeni ukutheleleka kwamagciwane kanye nokubhekana nokuvuvukala. 

• Imithi:
  • Odokotela banikeza ama-antibiotics, ngokuvamile i-penicillin, ukuze kuqedwe ukutheleleka kwe-streptococcal. 
  • Imithi elwa nokuvuvukala yokunciphisa ukuvuvukala futhi idambise izimpawu ezinjengobuhlungu bamalunga. 
  • Ezimweni ezimbi kakhulu, odokotela bangase banikeze i-corticosteroids. 
  • Ukuvimbela okwesibili kuhilela i-antibiotic prophylaxis yesikhathi eside ukuvimbela ukuhlasela okuphindaphindiwe, ne-penicillin ye-intramuscular ibe indlela ekhethwayo ngenxa yokusebenza kwayo kanye nokuthobela okungcono.
  • Amasu okwelapha ahlanganisa nokulawula ukuhlasela okunamandla kanye nokuvimbela izifo ezengeziwe. Odokotela banikeza imithi efana ne-digoxin, i-vasodilator, ne-diuretics ezigulini ezinezinkinga zenhliziyo. 
• Ukuhlinzwa: Ezimweni ezimbi kakhulu, kungase kudingeke ukuhlinzwa kwenhliziyo ukuze kwelashwe izilonda ezinzima zama-valve. 

Uzoyibona Nini Udokotela

• Kubalulekile ukubonana nodokotela wakho ngokushesha uma wena noma ingane yakho iba nezimpawu ze-strep throat noma i-scarlet fever. Ukwelashwa kusenesikhathi kwe-strep throat kungavimbela i-rheumatic fever. 
• Xhumana nodokotela uma ubona izimpawu ze-strep throat, njengobuhlungu bomphimbo kungazelelwe, ubuhlungu bokugwinya, umkhuhlane, ikhanda elibuhlungu, noma ukungakhululeki kwesisu. Lezi zimpawu zidinga ukuhlolwa ngokucophelela kwezokwelapha, njengoba izimo eziningana zihlanganyela izimpawu ezifanayo. 
• Ezinganeni ezinomphimbo obuhlungu othatha izinsuku ezingaphezu kwezimbalwa, kuhle ukuthintana nodokotela. 

Khumbula, ukungenelela kwezokwelapha okufika ngesikhathi kuyisihluthulelo sokunciphisa ingozi yokuba ne-rheumatic fever kanye nezinkinga zayo ezingaba khona.

Prevention

Ukuvimbela i-rheumatic fever kuhilela ukuhlonza ngendlela efanele kanye nokwelapha ngokwanele izifo ze-strep throat. Isinyathelo esisheshayo sibalulekile lapho kuvela izimpawu. 

• Uma ingane yakho inomphimbo obuhlungu othatha izinsuku ezintathu, thintana nodokotela ngokushesha. Qinisekisa ukuthi ingane yakho iqeda inkambo yemithi elwa namagciwane, noma ngabe izizwa ingcono, ukuze kuqedwe ukutheleleka. 
• Imikhuba emihle yenhlanzeko ibalulekile ekugwemeni. Khuthaza ukugeza izandla njalo ngensipho, futhi ufundise izingane ukukhwehlela noma ukuthimula kusicubu noma indololwane (uma ingekho indwangu noma izicubu). 
• Gwema ukwabelana ngezinto zomuntu siqu nabantu abagulayo. 

I-antibiotic prophylaxis yesikhathi eside ingase inconywe kulabo ababetholwe ngaphambilini bene-rheumatic fever ukuvimbela ukuphindaphinda kanye nokutheleleka kwe-strep esizayo.

Isiphetho

I-Rheumatic fever inomthelela omkhulu kubantu, ikakhulukazi izingane kanye nentsha, enemiphumela engaba nzima empilweni yenhliziyo. Ukuba yinkimbinkimbi kwalesi simo, kusukela emsukeni waso ezifweni ze-strep ezingalashwa kuya ezimpawu zaso ezibanzi, kugcizelela ukubaluleka kokutholwa kusenesikhathi nokunakekelwa okufanele. Ukuqonda izici zobungozi kanye nokubona izimpawu kungabaluleka ekuvimbeleni izinkinga zesikhathi eside. Ngokuqwashisa ngalesi simo nokukhuthaza imikhuba emihle yenhlanzeko, singasebenzela ukwehlisa ukuvela kwaso. Khumbula, umphimbo obuhlungu akufanele neze unganakwa, njengoba ukungenelela okufika ngesikhathi kungenza umehluko ekuvimbeleni lesi sifo esibi kakhulu kanye nemiphumela yaso ehlala njalo empilweni.

FAQ sika

1. Ivame kangakanani i-rheumatic fever?

I-Rheumatic fever inomthelela omkhulu empilweni yomhlaba wonke, cishe nezigameko ezintsha ezingama-470,000 ezenzeka minyaka yonke. Kuyivelakancane emazweni asethuthukile kodwa kusejwayelekile ezindaweni ezinobubha kanye nezinhlelo zezempilo ezingezinhle. Umthwalo wezifo uphezulu emazweni asathuthuka ngenxa yezifo ze-strep ezingalashwanga noma ezingalashwa ngokwanele. 

2. Ingabe i-rheumatic fever iyelapheka?

Nakuba i-rheumatic fever ngokwayo ingelashwa, ingase ibangele ukulimala kwenhliziyo okuhlala isikhathi eside. Ukwelashwa kuhilela ama-antibiotics ukuze kuqedwe amagciwane e-strep nokuvimbela ukuphindeka.

Imithi elwa nokuvuvukala isiza ukuphatha izimpawu. Abantu abaningi bayalulama, kodwa iphesenti elincane lingase libe nokulimala kwenhliziyo unomphela. I-antibiotic prophylaxis yesikhathi eside ingavimbela iziqephu zesikhathi esizayo.

3. Iyini i-rheumatic fever enganeni?

I-Rheumatic fever ihlasela ngokuyinhloko izingane ezineminyaka engu-5 kuya ku-15, ngokuvamile ivela emavikini angu-2 kuya kwangu-4 ngemva kokutheleleka nge-strep throat. Ukusabela kwe-autoimmune okubangela ukuvuvukala ezingxenyeni ezihlukahlukene zomzimba, okuhlanganisa amalunga, inhliziyo, isikhumba, nobuchopho. Izimpawu zingase zihlanganise ubuhlungu bamalunga, imfiva, ubuhlungu besifuba, nokunyakaza ngokuzenzakalelayo.

4. Ingabe isifo samathambo siyelapheka?

I-Rheumatic fever, isifo sokuvuvukala, singelashwa kodwa singaholela ezinkingeni zesikhathi eside, ikakhulukazi isifo senhliziyo esibuhlungu. Nakuba isigaba esibucayi singaphathwa ngama-antibiotics kanye nemithi elwa nokuvuvukala, ezinye iziguli zingase zithole imiphumela ehlala njalo kuma-valve enhliziyo yazo. Ukuhlolwa njalo kubalulekile, njengoba ukulimala kwenhliziyo kungase kungabonakali iminyaka noma ngisho namashumi eminyaka ngemva kokutheleleka kokuqala.

5. Yikuphi ukudla okungalungile ku-rheumatoid arthritis?

Nakuba isifo sokuqaqamba kwamalunga e-rheumatoid singafani nemfiva ye-rheumatic, ukudla okuthile kungase kubhebhethekise ukuvuvukala kuzo zombili izimo. Lokhu kubandakanya:

• Inyama eyosiwe, eyosiwe noma ethosiwe
• Ukudla okunamafutha amaningi
• Ushukela kanye nama-carbohydrate acwengekile
• Ukudla okunama-preservatives kanye nezithuthukisi ukunambitheka
• Utshwala ngokweqile

6. Ingabe i-rheumatic fever ibuhlungu?

I-Rheumatic fever ingabangela ubuhlungu obukhulu, ikakhulukazi emalungeni. I-arthritis noma i-arthralgias ivame ukubonakaliswa kokuqala ku-60% kuya ku-80% weziguli ze-rheumatic fever. Ubuhlungu ngokuvamile buthinta amalunga amakhulu njengamadolo, amaqakala, noma izihlakala futhi bungafuduka. Ukwengeza, ezinye iziguli zingase zizwe ubuhlungu besifuba ngenxa yokuvuvukala kwenhliziyo. Ubukhulu bobuhlungu bungahluka phakathi kwabantu.

7. Iqala nini i-rheumatic fever?

I-Rheumatic fever ngokuvamile iqala emavikini angu-2 kuya kwangu-4 ngemva kokutheleleka nge-strep throat. Kodwa-ke, ezinye izimo zingase zikhule ngokushesha ngemva kwesonto elilodwa noma ngemva kwamasonto amahlanu ngemva kokutheleleka kokuqala. Ukuqala kwezimpawu kungaba kancane kancane noma kungazelelwe.

UDkt. Gandham Sneha

I-MBBS, DNB (Imithi Yangaphakathi)
CARE Hospitals Outpatient Centre, Banjara Hills, Hyderabad

Ukuze Ubhukhe Isikhathi, shayela:

+ 91 40-68106529

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