Waliwo ekizibu ekinene munda mu mubiri gwo? Ka tuyige ku bulwadde bwa Waterhouse-Friderichsen Syndrome!

Wali owuliddeko nti obusimu obutono bubiri mu mubiri bulekera awo okukola, era buyinza okukosa ennyo obulamu bwo? Leero tugenda kwogera ku mbeera ey’akabi ennyo bwetyo, era singa tejjanjabibwa mangu, eyinza okutta omuntu. Kino kiyitibwa obulwadde bwa Waterhouse-Friderichsen Syndrome. Wadde ng’erinnya lino liyinza okulabika ng’ery’ewala katono, ka twogere mu ngeri ennyangu ku kiki kye liri, lwaki libaawo, n’engeri y’okuwangaala.

Obulwadde buno obwa Waterhouse-Friderichsen kye ki?

Mu ngeri ennyangu, obulwadde bwa Waterhouse-Friderichsen Syndrome (WFS) mbeera ya maanyi nnyo. Ekibaawo endwadde zo ez’omu lubuto (adrenal glands) , nga zino nnywanyi bbiri entonotono ezisangibwa waggulu w’ensigo zo, zivaamu omusaayi (kino tukiyita `adrenal hemorrhage`) era endwadde emu oba zombi ku zino zikoma okukola. Ebiseera ebisinga, kino kiva ku yinfekisoni ey’amaanyi. Singa tezijjanjabwa, endwadde zino ez’omu kibumba kumpi zikoma ddala okukola obusimu obuyitibwa cortisol, obwetaagisa ennyo mu mubiri gwaffe. Kino kye tuyita obuzibu bw'ekibumba . Okubeera omutuufu, mbeera ya mangu!

Waliwo erinnya eddala eriyitibwa kino, nga lino lye ``hemorrhagic adrenalitis.'' Ekyo kitegeeza nti endwadde z'ekibumba zivaamu omusaayi ne zizimba.

Embeera eno ya bulijjo etya?

Mu butuufu, obulwadde bwa Waterhouse-Friderickson tebutera kubaawo nnyo . Mu budde obutuufu, okwekebejja omulambo kuzuula nti embeera eno y’evunaanyizibwa ku bantu nga 1% bokka abafa. Kino kitegeeza nti si bulwadde obukwata buli muntu, naye bwe bubaawo, bwa bulabe nnyo.

Bubonero ki obulaga obulwadde buno?

Teebereza, ofuna akawuka oba obuwuka mu bwangu n’ofuna embeera eno eya WFS. Olwo oyinza okutandika okulaga obubonero bw’obulwadde buno mu bwangu. Omanyi ekyo kye ki?

• Nfuna omusujja ogw’amaanyi.
• Omubiri guwulira nga gunnyogoga era nga gukankana (Chills).
• Omutwe gunnuma nnyo.
• Ngenda kusesema, ngenda kusesema.
• Ebinywa mu mubiri binnuma naddala mu bifo ng’omugongo ogwa wansi, olubuto n’amagulu.
• Ennyondo zange zinnuma.
• Oluusi wayinza okubaawo okubulwa okutegeera (syncope).

Okuvaamu omusaayi guno bwe gutandika okukosa endwadde z’ekibumba zokka wabula n’ebitundu by’omubiri ebirala, obubonero obulala buyinza okulabika. Mu bino mulimu:

• Disseminated intravascular coagulation (DIC): Kino kiwulikika nga kizibu katono, si bwe kiri? Mu ngeri ennyangu, buzibu nga enkola y’okuzimba omusaayi mu mubiri gwonna egenda mu maaso. Omusaayi bwe gukola mu kifo ekimu, tegusobola kulekera awo kuvaamu musaayi mu kifo kirala.
• Okusiiyibwa ku lususu:Oluusi ziyinza okulabika ku lususu ng’obutundutundu obutonotono oba obutundutundu obunene.
• Septic shock: Eno mbeera nga puleesa ekka wansi mu ngeri ey’akabi olw’obuwuka, ekivaako ebitundu by’omubiri obutafuna musaayi gumala. Kino nakyo kya bulabe nnyo.

Bubonero ki obulaga nti omuntu avaamu omusaayi mu nseke z’omubiri (adrenal gland)?

WFS ekwatagana n’okuvaamu omusaayi mu kibumba, ekiyinza okuwerekerwako obubonero obulala:

• Okulumwa olubuto.
• Obulumi mu kitundu waggulu w’ekiwato, wansi w’embavu (ekiwato).
• Malaise, okuwulira nga tolina mirembe.
• Obugayaavu.
• Okuziyira n’okusiiyibwa.
• Embiro.

Kiki ekivaako kino?

Emirundi egisinga, ekisinga okuvaako obulwadde bwa Waterhouse-Friderickson bwe bulwadde bwa bakitiriya n’akawuka (sepsis) . Okubeera omutuufu, obuwuka buyingira mu mubiri ne busaasaana mu mubiri gwonna nga tebufugibwa.

Ebika bya bakitiriya ebimu bisobola okukwatibwa kino naddala. Wano waliwo ebyokulabirako ebitonotono:

• `Obulwadde bwa Pseudomonas aeruginosa`
• Obuwuuka bwa Meningococcus: Buno bwe businga okuba obw’obulabe obuyinza okuleeta WFS.
• `Obulwadde bwa Streptococcus pneumoniae`
• `Obulwadde bwa ssennyiga obuyitibwa Haemophilus influenzae`
• `Ekiwuka ekiyitibwa Escherichia coli (E. coli)`
• `Obulwadde bwa Staphylococcus aureus`

Ebika bya bakitiriya ebirala bingi bisobola okuleeta kino.

Ate era, ebika bya akawuka ebimu bisobola okuleeta kino:

• Akawuka ka Cytomegalovirus (CMV) .
• Akawuka ka Parvovirus `(Kawuka ka Parvovirus)`
• Akawuka ka Epstein-Barr
• Akawuka ka Ebola `(Obulwadde bw'akawuka ka Ebola)`
• Akawuka ka Varicella-zoster (kano ke kaleeta endwadde nga ekifuba ne herpes) .

Ng’oggyeeko yinfekisoni zino, waliwo ebintu ebirala ebiyinza okuvaako okulwala WFS:

• Okukozesa eddagala eriziyiza okuzimba omusaayi. Bino byongera obulabe bw’okuvaamu omusaayi.
• Thrombocytopenia: Kino kitegeeza nti omuwendo gwa platelets (obutoffaali obuyamba omusaayi okuzimba) mu musaayi gukendeera.
• Endwadde z’ekibumba (adrenal glands) zoonoonese mu ngeri emu oba endala.

Ani asinga okukosebwa embeera eno?

Obulwadde bwa Waterhouse-Friderickson butera okubeera mu baana abato okusinga mu bantu abakulu . N’olwekyo omwana omuto bw’afuna obubonero ng’omusujja n’okulumwa omubiri, olina okwegendereza ennyo.

Kino kiyinza okuleeta bizibu ki?

Kino kye kintu ekisinga obukulu. Singa tebujjanjabwa mangu era mu ngeri entuufu, obulwadde bwa Waterhouse-Friderickson butta. Ekyo kitegeeza nti kiyinza okutta omuntu. Kale kino kisaana okutwalibwa ng’eky’amangu.

Obulwadde buno buzuulibwa butya?

Okuzuula obulwadde buno, mazima ddala weetaaga obuyambi bw’omusawo. Omusawo ajja kukubuuza ku bubonero bwo, akubuuze ku bulwadde bwo obw’emabega, n’oluvannyuma akebere omubiri gwo.

Naye okuzuula WFS kiyinza okuba ekizibu katono, kubanga obubonero bwayo bufaanagana nnyo n’obw’obulwadde bwa septic shock . N’olwekyo, okukakasa oba WFS, omusawo ajja kulagira okukeberebwa okw’enjawulo.

Bikebere ki ebikozesebwa okuzuula obulwadde buno?

Okukakasa oba waliwo yinfekisoni, omusawo ayinza okukola ebigezo bino wammanga:

Ebigezo by’okukuba ebifaananyi

• Okukebera amaloboozi agayitibwa ultrasound scan oba CT (computed tomography) scan esobola okukolebwa okukebera oba omusaayi gukuŋŋaanyiziddwa munda mu nseke z’ekibumba. Sikaani zino zikuba ebifaananyi by’omubiri munda, bwe zityo zisobola okulaba obulungi ebitundu ebivaamu omusaayi.

Okukebera omusaayi

• Okukebera omusaayi kuyinza okumanya oba olina obulwadde bwa bakitiriya. Kino kizingiramu okuggya empiso entono mu musuwa oguli mu mukono gwo, n’oggyayo omusaayi omutono, n’ogutunuulira ng’okozesa microscope. Kino kijja kunoonya obubonero obulaga nti omuntu alina obulwadde.

Okukebera obuwuka bwa Meningococcus

Singa omusawo alowooza nti ekivaako buwuka bwa meningococcus, olwo bayinza okukola okukebera nga kuno:

• Spinal tap / lumbar puncture: Kino kizingiramu okuyingiza empiso ennyimpi mu mugongo gwo ogwa wansi, wakati w’omugongo abiri, n’onywa amazzi amatono mu mugongo. Kino kiyinza okuwulikika ng’ekitiisa naye abasawo bakikola n’obwegendereza.
• Skin biopsy: Bw’oba ​​olina ekiwundu ku lususu lwo, akatundu akatono ak’olususu kajja kuggyibwa mu kiwundu ne keekebejjebwa.
• Gram stain test: Sampuli eggyibwa mu kifo ekiteeberezebwa (nga ekiwundu) okunoonya obuwuka.
• Okwekenenya omusulo: Ojja kusabibwa okufulumya omusulo mu kibya eky’enjawulo. Olwo sampuli y’omusulo ejja kukeberebwa okulaba oba waliwo obubonero obulaga nti alina obulwadde.

Okukebera obuzibu bw’ekibumba (acute adrenal crisis).

Ebigezo bino biyamba okuzuula oba olina ekizibu ky’ekibumba , embeera ng’endwadde z’ekibumba tezikola bulungi:

• Adrenocorticotropic hormone (ACTH) stimulation test: Mu kukebera kuno, omusawo akuwa empiso entono ey’obusimu obuyitibwa ACTH. Oluvannyuma, oluvannyuma lw’eddakiika 30 ku 60, bakwata omusaayi okulaba engeri endwadde zo ez’omu kibumba gye zikwatamu ACTH. Kino kigezo ekipima engeri endwadde zo ez’omu kibumba gye zikolamu.
• Okukebera ssukaali mu musaayi:Omusaayi guggyibwako katono ne bapimibwa ssukaali (glucose) alimu. Ssukaali ayinza okuba omutono mu kiseera ky’obuzibu bw’ekibumba.
• Okukebera cortisol: Sampuli y’omusaayi gwo, omusulo, amalusu oba bino ebibiri oba bisatu nga bigattiddwa wamu bikwatibwa okukebera obungi bwa cortisol endwadde zo ez’omu kibumba ze zikola.
• Okukebera omusaayi gwa pH: Sampuli y’omusaayi eggyibwa ne kipimibwa acid-base level yaayo (pH). Kino kiyinza okukolebwa n’okukebera omukka gw’omusaayi mu misuwa (ABG) oba ekipande ky’amasannyalaze. Mu budde obwabulijjo, pH y’omusaayi gwaffe erina okuba wakati wa 7.35 ne 7.45.
• Okukebera omusaayi gwa potassium: Okukebera omusaayi okupima obungi bwa potassium mu musaayi gwo. Potassium kiriisa ekiyamba obusimu n’ebinywa byaffe okukola obulungi. Emitendera gino giyinza okukyuka mu kiseera ky’obuzibu bw’ekibumba.
• Okukebera omusaayi gwa sodium: Okukebera omusaayi kupima obungi bwa sodium mu musaayi gwo. Sodium era mukulu nnyo okusobola okukola obulungi obusimu n’ebinywa byo. Emitendera gino nagyo giyinza okwawukana.

Kino kikwatibwa kitya?

Bw’oba ​​olina WFS, oyinza n’okuba n’obulwadde bwa sepsis . Kale, abasawo kye banaasooka okukola kwe kukutandika ku ddagala eritta obuwuka amangu ago nga bwe bakola okukebera okuzuula kiki ddala ekyavaako WFS. Era bajja kulondoola amasannyalaze go (omunnyo) n’amazzi.

Obubonero bw’obulwadde bwa sepsis bwe bumala okufugibwa, abasawo bajja kutandika okukuwa eddagala eriyitibwa glucocorticoids ne mineralocorticoids . Zino ze busimu obuyitibwa steroid hormones. Glucocorticoids zikola okukendeeza ku buzimba mu mubiri. Mineralocorticoids zikola okutereeza omunnyo n’amazzi mu mubiri gwo. Mu ngeri ennyangu, ziringa okukuwa obusimu endwadde zo ez’omu kibumba ze zirina okuba nga zikola, naye nga tezikola.

Oyinza okwetaaga okuteekebwamu omusaayi oba enkola eyitibwa angioembolization . Kino kizingiramu okukozesa angiogram ne blood clot (embolization) okuzuula n’okuziyiza emisuwa egigabira omusaayi mu nseke z’ekibumba. Kino kikolebwa okukomya okuvaamu omusaayi.

Ekisinga obukulu, oluvannyuma lwa WFS, abantu bangi bajja kwetaaga okumira eddagala eddala ery’obusimu obulamu bwabwe bwonna , kubanga endwadde z’ekibumba bwe zimala okwonooneka, ziyinza obutakyasobola kukola busimu bulungi.

Nja kuwulira mangu ntya oluvannyuma lw’okujjanjabibwa?

Abantu abasinga batandika okuwulira obulungi mu wiiki emu oba bbiri nga batandise obujjanjabi. Kyokka ne bw’oba ​​oteredde mu bujjuvu, oyinza okuba ng’okyalina ebizibu ebimu mu mubiri oba mu birowoozo okumala emyezi, oba n’emyaka. Okugeza nga:

• Emmere tewooma.
• Akooye nnyo.
• Okukaluubirirwa okwebaka (obuteebaka).
• Omuze gw’okulwala amangu.
• Okweraliikirira.
• Ennaku.

N’olwekyo, kikulu okukijjukira nti kiyinza okutwala ekiseera okutereera mu bujjuvu.

Kiki ky’osuubira singa ofuna obulwadde buno?

Nga bwe twagambye emabegako, singa erekebwa nga tejjanjabiddwa, WFS mbeera ya kufa. Tewali kubuusabuusa ku nsonga eyo.

Naye, singa bafuna obujjanjabi nga bukyali, obutuufu n‟okuddaabiriza, abantu abasinga obungi abalina WFS bawona. Kyokka, oyinza okwetaaga obujjanjabi obw’amaanyi, era ebiva mu WFS bisobola okumala emyezi, wadde emyaka. N’olwekyo, si kintu kya kutwalibwa ng’ekitono.

Embeera eno esobola okuziyizibwa?

Waliwo ebintu ebiwerako by’oyinza okukola okukendeeza ku bulabe bw’okulwala obulwadde bwa Waterhouse-Friderickson syndrome:

• Okunaaba mu ngalo buli kiseera era obulungi kiyinza okuyamba okuziyiza yinfekisoni. Kino kintu kyangu nnyo, naye kisobola okukuwonya endwadde nnyingi.
• Okugema obuwuka obuyitibwa meningococcal bacteria kikulu nnyo naddala eri abaana.
• Bw’oba ​​oteebereza nti olina yinfekisoni, noonya obujjanjabi mu bwangu. Tobuusa maaso omusujja omutono oba okusesema.

Weerabirira otya ng’owona?

Nga bw’odda engulu, ggwe n’omusawo wo mulina okukolera awamu okukola enteekateeka y’okuddaabiriza esaanira, etali ya bulabe, era esinga obulungi gy’oli. Enteekateeka eyo eyinza okuzingiramu ebintu nga:

• Funa ekiwummulo ekiwera. Omubiri n’ebirowoozo byombi byetaaga okuwummula.
• Okugoberera endya ennungi ejja okukuyamba okuddamu okufuna amaanyi kirungi. Kyandibadde kirungi nnyo singa osobola okufuna amagezi okuva eri omukugu mu by’endya ku kino.
• Teekawo ebiruubirirwa ebitonotono. Okugeza okutuula ku kitanda, okuyimirira, okwambala wekka, okunaaba, okutambula olugendo olutono, okulinnya amadaala.
• Okwogera ku nneewulira zo n’ab’omu maka go, mikwano gyo, oba omusawo ajjanjaba kikulu mu biseera bino ebizibu.
• Dduyiro ng’olina amaanyi n’amaanyi. Tandika mpola era okole dduyiro okusinziira ku biragiro by’omusawo.

Ddi lwe nnina okulaba omusawo? / Ddi lwe nnina okugenda mu kisenge ky’abalwadde ab’amangu?

Bw’oba ​​okyawulira bulungi oluvannyuma lw’okujjanjabwa, oba ng’olina obuzibu okutuuka ku biruubirirwa byo eby’okuddaabiriza, kakasa nti oyogera n’omusawo wo.

WFS mbeera ya maanyi era eyinza okutta omuntu singa tegijjanjabwa. Bw’oba ​​olina obubonero bwonna obwa WFS, okugeza, yinfekisoni eyeeyongera okusajjuka nga tegenda, olwo olina okugenda mu kisenge eky’amangu (ETU) amangu ddala.Si kirungi kino okukiteeka ku bbali.

Bibuuzo ki by’osaanidde okubuuza omusawo wo?

Bw’okizuula nti olina WFS, oyinza okuba n’ebibuuzo bingi. Totya, buuza omusawo wo ebibuuzo nga bino okumalawo okubuusabuusa kwo:

• Omanya otya nti nnina obulwadde bwa Waterhouse-Friderickson?
• Bwemba sirina bulwadde bwa Waterhouse-Friderickson syndrome, mbeera ki endala gye nnyinza okuba nayo?
• Kiki ekivaako obulwadde bwange obwa Waterhouse-Friderickson?
• Nnaaba nnina okulongoosebwa okuddaabiriza endwadde zange ez’omu kibumba?
• Olowooza nja kuwona mu bujjuvu?
• Nnaanneetaaga okumira obusimu obw’enjawulo?
• Nja kuba nnina okumala bbanga ki nga nnywa obusimu obulala?

Kale, bintu ki ebikulu bye tulina okujjukira okuva mu kino?

Obulwadde bwa Waterhouse-Friderichsen syndrome (WFS) mbeera ya maanyi nnyo eyeetaaga okujjanjabibwa amangu. Bw’oba ​​olina obubonero buno bwonna, oba bw’oba ​​olina yinfekisoni etatereera, kikulu okugenda mu kisenge eky’amangu amangu ddala nga bwe kisoboka.

Goberera ddala ebiragiro byonna eby’obujjanjabi ebikuweereddwa omusawo wo. Olwo lwokka lw’osobola okufuga embeera eno eya WFS n’odda engulu amangu nga bwe kisoboka. Jjukira nti okujjanjabibwa amangu kiyinza okutaasa obulamu! Ekirala, kikulu nnyo okwerabirira obulungi mu kiseera ky’okuwona.

` Obulwadde bwa Waterhouse-Friderichsen, endwadde z’ekibumba, cortisol, sepsis, yinfekisoni, okulabirira mu bwangu, obusimu