Antibiotics course khat i ei hnuah i pum na emaw, pum na emaw i nei tawh em? Ni khat emaw ni hnih emaw hnuah a bo tlangpui. Mahse, a chang chuan he dinhmun hi a na deuh thei bawk. Vawiin hian chutiang natna khirh tak pakhat, antibiotics hmanna nena inzawm theih chungchang kan sawi dawn a ni. Hei hi Pseudomembranous Colitis kan ti a. A hming hi a mak deuhin a lang thei a, mahse a chanchin hriat a pawimawh hle.
A awlsam zawngin, Pseudomembranous Colitis chu eng nge ni?
Hei hi kan intestine lian (colon)-a inflammation na tak (severe colitis) a ni a, chu chu a hring leh hliam tihna a ni. Kan intestine lian tak chhunga lining (mucosa) nalh tak chu thil pakhatin a tichhia ang tih han ngaihtuah teh. He chhiatna hi bacteria emaw, chu bacteria atanga toxin siam emaw, natna dang emaw avanga lo awm thei a ni.
Hetiang chhiatna a thlen hian hliamna hmun chungah hian plaque thuk tak tak, hnah hring (crusty plaques) a lo awm thin. Hliam kan neih hian kan vunah crust a lo awm ang bawkin. Mahse hengte hi crust tak tak an ni lo. Cell thi leh thisen var atanga siam an ni. Heng yellow-white membrane te hi doctor-te'n "pseudomembrane" an tih chu an ni. "Pseudo" tih awmzia chu "dik lo" tihna a ni. Chu chu false membrane an ni tihna a ni. Hetiang dinhmun hi pseudomembranous colitis kan tih hi a ni.
Hetiang natna lan chhuah dan hi engte nge ni?
Hetiang natna vei hian natna lan chhuahna chi hrang hrang a nei thei a, mahse thil langsar tlemte hmuh tur a awm.
| Symptom a ni | Hrilhfiahna |
|---|---|
| Diarrhea na tak a awm | Hei hi a symptom ber a ni. Ni khatah vawi 10-15 vel i ril a tam thei. A châng chuan thisen emaw, hnim emaw chu bawlhhlawh nen a chhuak tih i hmu thei bawk. |
| Pum Natna | Pum natna nasa tak leh hrualna a awm thei bawk. Pum pawh khawih a na thei bawk. |
| Khawsik | Taksaah khawsik a lo awm thei. Chumi awmzia chu taksaah natna hrik a darh zel tihna a ni. |
| Luhai | I luak chhuak dawn niin i hria mai thei. Mi thenkhat phei chuan an luak chhuak thei bawk. |
Engvangin nge hetiang natna hi a lo awm? A chhan ber chu eng nge ni?
Hei hi a chhan ber leh a tam ber chu bacteria Clostridium difficile , a tawi zawngin C. diff kan tih hi a ni. Hei hi hri kai 90% aia tam awm chhan a ni.
Tunah chuan he C. diff bacteria hian engtin nge hetiang natna hi a thlen theih tih i ngaihtuah mai thei. Thuziak chu hetiang hian a kal a ni:
Bacteria maktaduai tam tak, a tha leh tha lo pawh kan intestin-ah hian an cheng a. Heng bacteria tha tak takte hian kan taksa tan thil tam tak an ti a ni. Tunah chuan doctor pakhatin natna dang (entir nan, rilru natna) atan antibiotics a pe che ang tih han ngaihtuah teh. Heng antibiotics te hian kan taksaa bacteria awmte chu a that thin. Mahse chutianga an tih chuan natna thlentu bacteria tha lo chauh ni lovin, kan intestines-a bacteria tha tak tak tam tak chu a chhe vek a ni.
Mahse mak tak mai chu C. diff hian antibiotics tam tak lakah a do thei a ni. Chuvangin bacteria dang an thih chuan C. diff hian a duh angin a pung chak thei a, inelna engmah a nei lo.
Hetianga C. diff bacteria lo pung lutuk hian toxin a siam tan a, chu chuan kan intestine lian lining a tichhia a ni. Heng toxins te hian intestinal cell te chu a thi a, a hliam a, a hmaa kan sawi tawh pseudomembrane te chu a siam ta a ni.
C. diff natna thlentu tam ber antibiotics
Antibiotic eng pawhin he hlauhawmna hi a thlen thei a, chi thenkhat erawh chuan he hlauhawmna hi a thlen tam zawk thung. Chung zinga ṭhenkhat chu:
- Clindamycin hman a ni
- Cephalosporins chi hrang hrang
- Penicillin chi hrang hrang
- Fluoroquinolones chi hrang hrang
C. diff tih loh chu chhan dang a awm em?
Awle. C. diff infection hi a chhan ber ni mahse, he natna hi chhan dang vang pawh a ni thei a, a tlem hle.
- Bacteria natna dang (e.g. *Staphylococcus aureus*, *E. coli*) te hi a ni.
- Cytomegalovirus hrik kai a ni
- Colon chhunga thisen kal tlem (Ischemic colitis) .
- Cancer natna atana chemotherapy damdawi thenkhat
- Autoimmune natna thenkhat
He natna vei theihna hlauhawm ber chu tute nge ni?
Tu pawhin he natna hi vei thei mahse, mi thenkhat chu an hlauhawm zawk.
- Damdawi ina enkawl mekte: Damdawi in hi C. diff ang chi hrik awlsam taka darh theihna hmun a ni.
- Tun hnaia antibiotics ei tawhte: Kan sawi tawh ang khan hei hi a hlauhawm ber a ni.
- Kum 65 chunglam mite: A chhan chu kum upat deuh deuh hian taksa invenna a tlahniam a.
- Nursing home-a awmte chu:
- Mite taksa chak lohna nei te: (e.g. HIV kai, cancer vei) .
- Autoimmune natna vei te: (e.g. Inflammatory Bowel Disease - IBD) .
- Tun hmaa C. diff natna vei tawhte:
Hei hi a pawi hle a nih chuan eng harsatna nge a awm theih ang?
Hei hi i tan chuan hlauhawm deuhin a ri mai thei. Mahse hre reng ang che, heng harsatnate hi natna a nasat a, enkawlna mumal pek a nih loh hunah chauh a thleng fo thin. Chuvang chuan doctor pan hmasak kan rawt a ni.
- Dehydration leh electrolyte imbalance: Ni khatah vawi 10-15 vel i ril a chhuah chuan tui leh electrolyte tam tak i hloh thin. Hei hi a nasat chuan thisen sang hniam leh kal (kidney failure) ang chi dinhmun hlauhawm tak tak a thlen thei a ni.
- Toxic Megacolon: Hei hi natna hlauhawm tak a ni. Thil thleng chu colon inflammation a nasat em avangin colon chu a thawk tha lo a, gas leh stool a inkhung a, colon chu a lian em em a, a puak thei bawk.
- Gastrointestinal perforation: Hliam na tak chuan intestinal wall-ah khur a siam thei. Chutiang a nih chuan intestine atanga bacteria te chu pum chhungah lutin nunna atana hlauhawm infection (peritonitis, sepsis) a thlen thei a ni.
- Sepsis: Nunna atana hlauhawm, natna hrik chu taksa pum puiah a darh a, taksa peng hrang hrangte a chhe tan thin.
Heng thilte hi hlau suh. Heng thilte hi a thleng tlem hle. A pawimawh ber chu symptoms a lan veleh damdawi lam thurawn lak hi a ni.
Engtin nge doctor hian he natna hi dik taka a hriat theih ang?
Doctor i pan hunah i natna lan chhuah dan te, tun hnaia damdawi i ei tawh zawng zawng (a bik takin antibiotics) te a zawt ang che a, chutah chuan i natna hriat chian nan test thenkhat a kalpui thei ang.
1. Stool test: Hei hi test pawimawh ber a ni. I bawlhhlawh sample lak a ni a, C. diff bacteria emaw, bacteria siam toxins emaw a awm leh awm loh test a ni.
2. 2. A rilru a hah lutuk chuan a rilru a buai em em a.Thisen test: Hengte hian infection leh white blood cell count sang zawk enfiah nan a pui thin.
3. Colonoscopy: Hei hian hnute kaltlangin camera hmanga tube te tak te dahin intestine lian chhung lam enfiah a ni. Hei hian kan sawi tawh pseudomembrane a awm leh awm loh mit pahnih hmangin kan hmu thei a ni. A tul chuan tissue te tak te (biopsy) te chu enfiah nan lak theih a ni.
Hei hi eng enkawlna nge ni?
Enkawlna chu natna chhan leh a nasat danah a innghat a ni.
- A chhan enkawl dan: C. diff infection vang a nih chuan i doctor chuan bacteria that thei antibiotic bik a pe ang. Heng damdawi thenkhat hi Metronidazole, Vancomycin, leh Fidaxomicin te an ni.
- Supportive Care: Hei hian tui tlakchhamna tur IV fluid pek leh intestines chawlh hahdamna tur intravenous nutrition pek te a huam thei.
- Surgery: A nasat em em, toxic megacolon ang chi complication ang chi ah chuan colon chhia chu surgery hmanga lakchhuah (colectomy) a ngai thei. Mahse, hei hi a tlem hle.
He natna hi tihdam theih vek a ni. Enkawlna mumal a awm chuan mi tam zawk chu an dam thuai thin.
Hetiang dinhmun hi dam khawchhuak turin eng nge kan tih ang?
Hei hi ven hi a pawimawh hle a, a bik takin damdawi in leh nursing home ang chi hmunah te hian a pawimawh hle.
- Kut sil fo tur: C. diff hi zu hmanga siam hand sanitizer lakah a do thei a, chuvangin sahbawn leh tui hmanga kut silfai hi invenna tha ber a ni.
- Isolation: Damdawi inah chuan C. diff natna vei damlote chu pindan hranah enkawl an ni.
- Surface tihfai: C. diff hi surface-ah rei tak a awm thei. Chlorine-based disinfectant hmanga lei chungte tihfai fo a pawimawh.
Engtikah nge doctor kan hmuh vat ang?
A hnuaia symptoms te hi i neih chuan doctor pan nghal la, damdawi in Emergency Department (ETU) ah kal nghal bawk ang che.
| Vaukhânna chhinchhiahna fimkhur tûr | |
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Antibiotics ei hnua pum na hi thil awm fo mahse, chutiang chuan a awlsam lo. A châng chuan Pseudomembranous Colitis ang chi natna khirh tak bul ṭanna a ni thei bawk. Chuvang chuan i taksa thu ngaihthlak a pawimawh hle. I natna lan chhuah danah rinhlelhna i neih chuan doctor nen inbiakna neih hreh suh. Enkawlna dik tak i neih chuan he natna atang hian i dam chhuak vek thei a ni.
Take-Home Thuchah a ni
- Antibiotics ei hnua riltam leh pum na hi ngaihthah ngai suh.
- Pseudomembranous Colitis hi bacteria pakhat C. diff an tih atanga lo chhuak a ni. Antibiotics avanga intestine-a bacteria tha tak takte tihchhiat avanga lo awm a ni.
- I natna lan chhuah dan, luak chhuak na tak, khawsik, pum na tak tak i neih chuan tihkhawtlai lohvin doctor pan nghal tur a ni.
- He natna hi enkawlna tha tak tak a awm a. Chuvangin hlauhthawn a ngai lo. A pawimawh ber chu natna hi hriat hmasak a, enkawl tan a ni.
- Sahbawn hmanga kut silfai hi C. diff ang natna hrik laka invenna tha ber a ni.
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