Meninjitis bakteriiji, septisemiya meningokok, e ɓuuɓri jarribo gilaas¶

Meninjitis bakteriiji (ɓuuɓri bakteriiji baawndi warde nguurndam e nder ndiyam reentorɗam e membraneeji taariiɗi ngaandi e ɓalndu) e septisemiya meningokok (tooke bakteriiji fulminant gonɗi e ƴiiƴam, baɗɗi Neisseria meningitidis) ina njeyaa e safaaraaji ɓurɗi yaawde feeñde e neɗɗo. Cukalel, suka jahroowo e duuɓi 18, janngoowo duɗal jaaɓi haaɗtirde, walla mawɗo ina waawi feeñde e cellal timmungal e nder ñaamde, heɓa ko nanndi e grippe ɓutte walla ɓuuɓri ƴiiƴam haa ñalnde heen, e yahrude yeeso haa wonta septic shock, hernia ngaandi, ŋakkeende terɗe keewɗe, nekrosis terɗe, walla maayde e nder waktuuji 12 haa 24.

Kuule maa ko yaawi so tawii meninjaasi bakteriiji walla septisemi meningokok ina tuumaa ko anndude fuɗɗoode "juuɗe e koyɗe cooyɗe, ɓuuɓri koyɗe tiiɗndi, e ɓalndu ɓuuɓndu/ɓuuɓndu" septisemi prodrome waktuuji ko adii jarribo wutte tiiɗɗo walla ɓuuɓri per**ar hay app thelassr pinpoint boɗeeji walla ɓaleeji ɓaleeji ngam anndude non-blanching petechial walla purpuric rash, noddude sarwisaaji safaara urgence ɗoon e ɗoon ko ɓuri faddaade yeewtere safrirde, reenaade ñawɗo oo e annoore jaaynde e aspiration ɓuuɓɗo tawa ina fadi safrooɓe, e jeertinde gollotooɓe safrirde triage intravenous ɗiɗaɓo oo ina waawi arde e30 Hojomaaji 60.

Waɗde ɗum jooni¶

1. Noddu sarwisaaji safaara caɗtuɗi ɗoon e ɗoon so tawii won banngeeji boɗeeji meninjitis walla septicemia ina ngoodi: Noddu limoore cafrirɗe caɗtuɗe nokku maa (911 to Amerik e Kanadaa, 112 e nder Dental Orop, 999 to Dental Dowlaaji Amerik, 000 to Ostarali) walla ƴeewto regginorde amen of limooje caɗtuɗe so tawii neɗɗo mo ɓuuɓri walla rafi ɓooyɗo heɓi ɓuuɓri ndi ɓuuɓnataa les gilaas laaɓɗo, wuddu tiiɗndu, ɓuuɓri hoore tiiɗndi e ɓuuɓri ɓuuɓndi e annoore jalbunde, jiiɓru kesu walla ɗanngal mawngal, ɓuuɓri c.apitfonne walla so) ɓuuɓndi cukalel, walla juuɗe e koyɗe ɓuuɓɗe no ice nii, ina wondi e ɓuuɓri koyɗe tiiɗndi e ɓalndu ɓuuɓndu.
2. Waɗde "Glass Tumbler Test" e kala nokku gonɗo e ɓalndu jooni jooni: Toɓɓu bannge gilaas njaram laaɓɗo no feewi e kala nokku keso boɗeejo, roosa, walla boɗeejo walla ɓuuɓri e ɓalndu. So tawii toɓɓe ɗee heddiima boɗeeje walla boɗeeje, aɗa waawi yiyde ɗe haa jooni e laaɓal e nder gilaas oo e nder ɓuuɓri tiiɗndi (non-blanching), ƴettu ɗum no septicemia meningococcal walla... sepsis emergency e noddude safrirde ɗoon e ɗoon. E dow mbaydiiji ɓalli ɓurɗi ɓallaade, ƴeewto paɗe juuɗe, koyɗe, reedu, nder gite (conjonctivae), e dow hunduko (palate).
3. Woto meeɗ ɗaɓɓude ɓuuɓri hade maa noddude ballal ɓuuɓngal: Haa e feccere e ñawɓe meninjitis bakteriiji laaɓtuɗi meeɗaa heɓde ɓuuɓri, e nder septisemiya meningokok, ɓuuɓri purpur ndi ɓuuɓnataa ina heewi wonde maande ɓooynde feeñnde caggal nde bakteriiji ɗii puɗɗii ɓuuɓde ƴiiƴam. So neɗɗo ina ndaara ko yaawi ko ɓuri mboros viral no woorunoo, waɗtu ɗoon e ɗoon.
4. Joɗɗin ñawɗo oo e kisal, ɓuuɓna fitirlaaji jalbooji ɗii fof: So aɗa fadi ambulance, ɓuuɓna fitirlaaji dow ɗii, ƴettu ridooji ngam ustude fotofobi mettuɗo. So tawii neɗɗo oo ina ummoo, ina jeertina tawa alaa ko ɓuuɓnata, yo o foofto, hoore makko e koyɗe makko ina toowa seeɗa e 30 degere ngam ustude ɓuuɓri nder reedu. So tawii neɗɗo oo ina ɗaanii, ina jiiɓii, walla ina ɓuuɓtoo, ɓuuɓna ɗum e bannge mum e nder position recovery mbele ɓuuɓri ina waasa naatde e ɓuuɓri mum.
5. Hoto hokku hay huunde e hunuko (strictly NPO): Woto hokku ñaamdu, ndiyam, walla tablette ɓuuɓɗe e hunuko. Ñawɓe meninjitis ɓuuɓɗo ina keewi ɓuuɓde no feewi walla waasde faamde, tee ɓuuɓde ndiyam ina addana ɗum en ɓuuɓde e ɓuuɓde no feewi.
6. Bayyina "Meninjitis bakteriiji tuumaaɗo / Rash mo ɓuuɓnataa" e fuɗɗoode noddaango urgence e nder triage opitaal: Huutoro e laaɓndal konnguɗi "meninjitis bakteriiji tuumaaɗo" walla "fever e rash purple mo ɓuuɓnataa" nde kaaldata e ñawɗo oo e triage urgency the dispatur suudu daɗndo ngam heɓde antibiotik e nder ƴiiƴam ko yaawi e wuurtinde ndiyam.

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Famde warooɓe ɓiɗɓe ɗiɗo ɓee : Meninjaasi bakteriiji e septisemiya meningokok¶

Hay so tawii yimɓe ɓee ina keewi innirde ɗeeɗoo geɗe ɗiɗi tan ko « meninjitis », laabi safaara ummoriiɗi e Fedde Adunaare Cellal (OMS), e Duɗal Ngenndiwal Cellal e Toppitagol (NICE NG240), e Fedde wiɗtooji Meninjitis ina teeŋtina wonde bakteriiji ko wayi no Neisseria (meningoco pneumoniae (pneumococcus) ina addana tigi rigi caɗeele ɗiɗi ceertuɗe, keewɗe jokkondirde. Anndude no ɗe ceertiri ina hollita ko waɗi won e ñawɓe ina njogii ɓuuɓri hoore e daande tiiɗnde tawa alaa ko woni e mum so wonaa ɓuuɓri, won heen kadi ina njogii ɓuuɓri ɓaleeri yaawndi saabaade ɗum en e ƴiye toowɗe ɗe ngalaa daande tiiɗnde hay dara.

Waktuuji waktuuji : Hol ko waɗi waktuuji 4 haa 8 gadani ɗii ko windo teskinngo¶

E nder wiɗtooji kilinik maantinɗi bayyinaaɗi e wiɗtooɓe Oxford (Thompson et al., The Lancet) ƴeewndotooɗi sukaaɓe e mawɓe wonduɓe e rafi meningokok, safrooɓe ɓee njiyti ko huunde mettunde : ko ɓuri heewde e ñawɓe ɓee ina njiyee, ina neldaa galleeji mum en ko doktoor walla jibinannde mum en e nder dumunna first net, ɓe ngalaa diff 4, 8 . fotofobi, walla ɓuuɓri ɓaleeri. E nder ɗuum, e nder ɗeen waktuuji 4 haa 8 gadani, ɓe kollitii maandeeji keertiiɗi jeertinaango septisemiya gadano, nannduɗi seeɗa e ɓuuɓri walla grippe viral no woorunoo :

Faandaare 1 : Fuɗɗoode nanndunde e mboros mo alaa ko woni e mum (Waktuuji 0 haa 4)¶

• Fuɗɗoode nguleeki ɗoon e ɗoon (walla ɓuuɓde no feewi e ɓuuɓde e rigor).
• Naamne, ŋakkere ñaamde, ɓuuɓri, walla ɓuuɓri (tesko: Serogroupe W Neisseria meningitidis ina anndaa fuɗɗoraade e ɓuuɓri reedu tiiɗndi, ɓuuɓri, e ɓuuɓri ƴiiƴam nanndundi tooke nguura walla ɓuuɓri ɓalndu ɓuuɓndi hade mum yahrude yeeso e yaawre haa wonta septik shock fatal).
• Hoore huuɓtodinnde, ɓuuɓri daande, e ɓuuɓri.

Faandaare 2 : Tatire septisemiya meningokok arandeere (Waktuuji 4 haa 8)¶

Ko ɓooyaani ko adii nde maale meninjitis kiiɗɗe ɗee peeñata (ɗe keewi feeñde ko hedde waktuuji 12 haa 15), maale tati keertiiɗe gonɗe e ɓuuɓri ƴiiƴam e iskemiiji ƴiiƴam ina peeña hakkunde waktuuji 4 e 8 :

1. Naamne koyɗe tiiɗɗe, ɗe nganndaaka (myalgie) e salaade yahde: Ko ɓuri 70 e nder teemedere sukaaɓe e mawɓe wonduɓe e septisemi meningokok fuɗɗotooɗo ina keɓa naamne tiiɗɗe, ɓuuɓɗe, ɓuuɓɗe e nder calɗi mum en, e nder koyɗe mum en, walla e nder ɓalndu mum en, tawi ko bakteriiji mikroskopiiji e lar ejurfu (hypoxiper) e kapillaaji mum en ƴiye koyɗe. E sukaaɓe tokosɓe e sukaaɓe tokosɓe, ɗum feeñata ko jaɓde daraade, jogaade teddeendi, walla yahde.
2. Juuɗe e koyɗe ɓuuɓɗe e sahaa juutɗo : Hay so tiinde neɗɗo oo walla ɓalndu mum ina nanndi e nguleeki 39,5 degere Celsius (103,1 degere Fahrenheit), juuɗe mum en e koyɗe mum en ina njiya ɓuuɓri caard to the touch boundary up, e a So a toɓɓiima no feewi e leeso maɓɓe, e dow junngo maɓɓe, walla e dow ŋoral maɓɓe fotde leƴƴanɗe 5, aɗa yaltina, ɓalndu nduu ina ƴetta ko ɓuri leƴƴanɗe 2 haa 3 ngam waylude mbaydi roosaaji kadi (delayed capillary refill).
3. Nokkuure ɓalndu nde wonaa no woorunoo (pallor, mottling, walla dusky blue lips): Sabu ɓanndu nduu ina ɓuuɓna ƴiiƴam periferik ngam hisnude ƴiiƴam ngam ɓernde e ngaandi, ɓalndu nduu ina nanndi e ɓaleejo, ɓaleejo, ɓaleejo, walla ina ƴellitoo no feewi, no mbaydi ɓaleeri-e-boɗeeri (**ti) koppi, e ɓanndu.

Faandaare 3 : Ɓooygol meningeal e ɓuuɓri ƴiiƴam (Waktuuji 8 haa 15)¶

• Tiɗɗugol wutte (tiɗɗugol wuddu), fotofobi, ɓurtugol hoore ɓuuɓngol, e fontanelle ɓuuɓɗo (e nder sukaaɓe) ina peeña.
• Ɓoornugol petekiyal e purpurik ina ɓuuɓtoo: E fuɗɗoode, ɓuuɓri boɗeeri walla pinndi (petechiae) tokosiri milimeeteeruuji 1 haa 2 walla hay ɓuuɓri boɗeeri ɓuuɓndi nanndundi e viral ina feeña e ɓalndu, e koyɗe, walla e ƴiye. E nder hojomaaji 30 haa 90, ɗeeɗoo toɓɓe tokoose ina keewi, ina kawra e ɓuuɓri ƴiiƴam ɓaleeri-ɓaleeri ɓurndi mawnude, ɓuuɓndi (purpura e ecchymoses) ndi ɓuuɓnataa les gilaas laaɓɗo.

Daawe 4 : Dekompensaasiyoŋ ɓooyɗo e nanngugol ko yaawi (Waktuuji 15 haa 24)¶

• Jiiɓru, delirium, ɓuuɓri hare (gila e ŋakkere oksijen ngaandi e ɓuuɓri ngaandi), ɓuuɓri, komaa, ɓuuɓri fokaal, puɗi dillaaji fiɓnde, foofaango leelngo ngo aldaa e laawol, e ɓuuɓri ƴiiƴam (purpura fulminans).

Ɗatal-e-Ɗatal: No mbaɗata jarribo Tumbler Glass Clear e denndaangal mbaydiiji ɓalli¶

Ɓuuɓri petekiyal walla purpur wonaa ɓuuɓri ɓalndu wootere; ko ƴiiƴam mikroskoop goonga e les ɓalndu mo endotoksin bakteriiji e mikroo-klots (koagulation intravasculaire diffuse) ɓuuɓnata koɗorɗe kapilaaruuji ɓalndu tokoosi. Sabu ƴiiƴam ɗam yaltii yaasi ƴiiƴam ɗam e nder ƴiiƴam ɓalndu nduu, toɓɓude les e ɓalndu nduu waawaa ruttaade ƴiiƴam ɗam e nder ƴiiƴam ɗam. Ko ɗum waɗi ɓuuɓri meningokok blanche (fade) e nder ɓuuɓri.

Ɗatal 1: Waɗde jarribo gilaas e kala nokku yiyaaɗo¶

1. Ƴettu gilaas njaram laaɓɗo, laaɓɗo, laaɓɗo (walla koppi palastik tiiɗɗo laaɓɗo walla lens magnifying laaɓɗo).
2. Toɓɓu bannge gilaas oo tiɗɗude e tiiɗde to bannge ɓuuɓri ɓalndu walla ɓuuɓri mbele ɓalndu taariindi ndii ina ɓuuɓtoo e ɓuuɓri ndii.
3. Ƴeewee no feewi e nder gilaas oo e nokkuuji ɗii tawa aɗa jogii tiiɗnaare tiiɗnde:
4. Blanching rash (Fades under pressure): So tawii toɓɓe boɗeeje walla roose ɗee majjii haa laaɓi, mbaɗti daneede/ɓuuɓde tawa aɗa toɓɓa les gilaas oo, kadi tan ɗe mbaɗti boɗeeje kadi caggal nde ƴeftu-ɗaa gilaas oo, ɓuuɓri ndii ina ɓuuɓi hannde. Jeertinaango: Ɓoornugol meningokook gadano ina waawi fuɗɗoraade no ɓuuɓri makulopapular ɓuuɓndi e nder waktuuji seeɗa gadani hade mum waylude ko ɓuuɓnataa ; sahaa kala ƴeewto-ɗee nokkuuji kesi kala hojomaaji 30 so tawii neɗɗo oo ina heddii ina selli.
5. Ɓuuɓri ndi ɓuuɓnataa (Ɓuuɓnataa e ɓuuɓri): So tawii ɓuuɓri boɗeeri, ɓaleeri, ɓaleeri, walla ɓaleeri-ɓuuɓri walla ɓuuɓri heddii ina laaɓi e nder gilaas hay so ɓuuɓri tiiɗndi, ɓuuɓri ndii ko ɓuuɓri ndi ɓuuɓnataa (petechiae walla purpura). Noddu 911 / 112 / 999 ɗoon e ɗoon.

Ɗatal 2: No ƴeewtorto-ɗaa ɓuuɓri ndi ɓuuɓnataa e ɓalndu ɓaleeru, ɓaleeru, e ɓaleeru¶

E dow mbaydiiji ɓalli ɓurɗi ɓallaade (Fitzpatrick skin types IV, V, e VI), petekiiji tokoosi boɗeeji walla ɓaleeji e juuɗe, e ɓalndu, walla e ɓalndu ina mbaawi ɓurde saɗtude yiyeede e ɓalli ɗi mbaydiiji keewɗi, ɗum noon ina addana ɗum en leeltude e ƴeewndo. So aɗa ƴeewtoo neɗɗo mo ɓalndu ɓaleeru walla ɓaleeru, huutoroo sahaa kala annoore daneere jaaynde (hono lampa telefoŋ, meeɗaa ɓuuɓnude annoore suudu oole) e ƴeewtaade teeŋti noon ɗeeɗoo zone anatomique jeegom ɓurɗe laaɓtude :

1. Palɗe juuɗe ɗiɗi ɗee e koyɗe ɗiɗi ɗee fof: Toɓɓu gilaas laaɓɗo oo no feewi e kala ɓuuɓri tokosiri boɗeeri, ɓaleeri, walla boɗeeri e dow palɗe e koyɗe.
2. Nder gite les ɗee (conjunctivae palpebrale) : Ƴettu gite les ɗee no feewi, ƴeewaa ƴiiƴam tokosam boɗejam walla ɓalejam ɓuuɓɗam e dow ɓalndu nduu e nder ɓalndu nduu.
3. Danewol gite (sclerae) : Ƴeewto-ɗee so tawii ko toɓɓe boɗeeje pinpoint kese walla ƴiiƴam tokosam e nder gite.
4. Toownde hunduko (palate tiiɗnde e softunde) e nder gite (mucosa buccal): Waɗde neɗɗo oo uddita hunduko mum haa yaaji, jalba lampa e palate e leppi nder ngam yiytude petekiiji tokoosi boɗeeji ɓaleeji walla ɓaleeji.
5. Reedu, nder koyɗe, e ɓuuɓri gonndi e ɓalndu: Laral ina heewi ɓuuɓde e ɓuuɓde seeɗa e nokkuuji ɓuuɓɗi e ɓuuɓɗi, ɗo ɓuuɓri ummoraade e elastik ɓalndu heewi addude petekiiji ina puɗɗoo ɓuuɓde.
6. Palpation tactile de la purpura avancée: Ina wayi no ɓuuɓri viral ɓuuɓndi, purpura meningokok coalescent ina heewi nan’de seeɗa ummiima walla palpable les ɓuuɓri koppi maa no ɓuuɓri ƴiiƴam nder laabi ɓalndu nekrotik.

Maandeeji ɓalli ɓuuɓri meningeal : ɓuuɓri wutte, maande Kernig, maande Brudzinski, e jarribo teskinngo jolt¶

So bakteriiji e ƴiiƴam ɓalejam ina ɓuuɓna ƴiiƴam ɗam ina sudda ngaandi e ɓalndu, kala dille ɓalndu ɓuuɓnooje ɗaɗi ƴiiƴam walla ɓalndu dural ina addana ɓalndu ɓuuɓde e mette. So tawii lay first aiders ngalaa haaju e waɗde ƴeewndorɗe neurologique caɗtuɗe, faamde no tiiɗnaare wuddu e ɓuuɓri hoore mbaɗirta e nder meninjaasi ina wallita seerndude ɗum e ɓuuɓri wuddu ɓuuɓndi walla ɓuuɓri hoore tension :

1. Goonga tiiɗnaare wutte meningeal (rigidité nuchal) e wutte ɓuuɓɗo¶

• E nder ɓuuɓri ɓalndu walla ɓuuɓri reedu, wirnude hoore bannge-e-bannge ("wirnude hoore No") ina metta no feewi no ɓuuɓnude hunuko les nii.
• E nder meningitis acute, yirlaade hoore ndee no feewi bannge-e-bannge ina waawi waɗeede haa jooni, kono ɓurtinde wuddu nduu yeeso ("nodding Yes" ngam addude wuttulo ngoo feewde e ɓalndu) ina fooɗta ƴiiƴam ɗam ɓuuɓɗam ɗam e nder njuuteendi, ina addana ɗum ɓuuɓde no feewi, ina addana wuddu ndu ɓuuɓde no feewi.
• No ƴeewtorto-ɗaa no feewi tawa aɗa doola wuddu: Ñaago-ɗaa neɗɗo oo (so tawii ko o ummii, o gaañaani e dogdu) yo eto memmude wuttulo mum to bannge ɓanndu mum tawa ina uddita hunduko mum. So tawii ɓe mbaawaa addude ƴiye maɓɓe e nder njuuteendi koppi ɗiɗi haa tati e nder reedu maɓɓe tawa ɓe ngalaa ɓuuɓri wuddu tiiɗndi e mette, ɓe mbaɗta ɗum en no rigidité nuchal positive nii. Woto meeɗ doole ƴattaade hoore ñawɗo yeeso.

2. Test "Jolt Accentuation de la Douleur de Chef".¶

E nder sukaaɓe e mawɓe ɓe ɓuuɓri e ɓuuɓri puɗɗii, safrooɓe emergency ina kuutoroo Jolt Accentuation Test : naamnaade ñawɗo oo yo wirnu hoore mum e dow nano e ñaamo e njaaweeki 2 haa 3 yirlaade e nder leƴƴannde kala (hono no wirnude hoore mum "Alaa"). So tawii ɓuuɓnude hoore ndee e dow ŋorol ina addana ɓe ɓuuɓde no feewi, ina hollita ɓuuɓri meningeal.

3. Maandeeji leeso ɓooyɗi (maandeeji Brudzinski e Kernig) .¶

So tawii ina anndaa e defte janngirɗe, maande Brudzinski e maande Kernig ina njogii sensitiviteeji tokoosi (5 haa 30 e nder teemedere), ɗum firti ko ŋakkeende majji meeɗaa haɗde meninjitis, hay so tawii noon woodde majji ina tabitina ɓuuɓri meninjaasi :

• Maande wutte Brudzinski: So ñawɗo oo lelnii e dow koyɗe mum, ina ƴetta hoore mum yeeso feewde e ɓalndu mum, koppi mum e koppi mum fof ina ɓuuɓtoo dow tawa yiɗaa ngam ustude ɓuuɓri e dow ƴiye ɓuuɓɗe.
• Maande Kernig: So ñawɗo oo leliima e dow ŋoral gootal e koppi mum ina njuuti e 90 degere, fooɗtude koyngal les ngal dow ina addana ɗum ɓuuɓde no feewi e ɓuuɓri ɓalndu walla wuddu.

Anndude meninjaasi e nder sukaaɓe jibnaaɓe, sukaaɓe tokosɓe, e sukaaɓe tokosɓe (Mo waawaa haalde ɓuuɓri hoore walla wutte tiiɗɗo)¶

Jibinaaɓe keso (ɓe keɓaani balɗe 28) e sukaaɓe tokosɓe (ɓe keɓaani duuɓi 1) ina njogii ɓurɗo heewde ñawu nguu e nder kala duuɓi (ko ɓuri heewde e mum en ko mboros korona B Streptococcus, Escherichia.coli, Listeria monocytogenes, Stremonitidisnenjas cukalel ngel fotde meeɗaa ƴellitde tiiɗnaare wutte classique. E nder ɗuum, toppitiiɓe ina poti ƴeewtaade ɗeeɗoo balle boɗeeje keertiiɗe e cukalel :

Pelle ɓurɗe heewde mborosaaji ina keewi seertude : janngooɓe duɗe jaaɓi haaɗtirde, mawɓe, e ñawɓe ɓe ngalaa ƴiiƴam¶

1. Jaŋngooɓe duɗe jaaɓi haaɗtirde, duɗe internat, e kaɓirɗe konu ("Freshers' Flu" vs. Meninjitis)¶

Sukaaɓe e sukaaɓe mawɓe yahrooɓe e duuɓi 16 haa 24 hoɗɓe e cuuɗi renndaaɗi, e nder cuuɗi hoɗɓe, walla e nder cuuɗi konu ina njogii tolno ɗiɗaɓo ɓurɗo toowde e rafi meningokok (sibu fotde **20 haa 25 e nder teemedere sukaaɓe ina njogii *Neisseria meningitidis carriage)**, saaktude toɓɓe e nder ɓuuɓri, e muñal, e nokkuuji renndo keewɗi yimɓe.

• Fooyre "Hangover" e "Freshers' Flu": Kala nde ndunngu ari, almuɓɓe duɗe jaaɓi haaɗtirde ina maaya e leɗɗe janngirɗe sabu wondiiɓe mum en ina cikka almuudo mo ɓuuɓri hoore, ɓuuɓri, fotofobi, e ɗanngal tan ɗaaniima e ɓuuɓri alkol (mboros alkol) walla ina jogii ɓuuɓri kammu rutti.
• Kuulal kisal Dormitory: Woto meeɗ accude ñawɗo walla ɓuuɓɗo tan caggal damal suudu ɓuuɓndu ngam "ɗaanaade ɗum." Ƴeewto-ɗee ɓe e yeeso kala waktuuji 1 haa 2, huɓɓu-ɗee fitirla kaa seeɗa ngam ƴeewde so tawii ɓe ngoni ko e ɓuuɓde e ƴeewde so tawii ɓe mbaawii haalde ko laaɓti e ɓuuɓnude daande maɓɓe, noddaa ɗoon e ɗoon sarwisaaji toppitiiɗi ko fayti e cellal so tawii ɓe ngoni ko e jiiɓde, ɓe njogii juuɗe/koyɗe cooyɗe, walla ɓe mbaawaa daraade.

2. Mawɓe (Ko ɓuri duuɓi 60) e ñawɓe ɓe ngalaa ƴiiƴam¶

E mawɓe ɓurɓe duuɓi 60 e yimɓe wonduɓe e safaara ɓuuɓɗo, tiɗɗugol daande e nguleeki toowki ina keewi wonde ko ɓuuɓɗi walla ko ŋakki. E nder ɗuum, meninjitis bakteriiji (haa teeŋti noon e Streptococcus pneumoniae walla Listeria monocytogenes, bakteriiji gonɗi e nguura, ɗi ndartaaki antibiyotikaaji sefalosporiin kuutorteeɗi, ina ɗaɓɓi ampisilin e nder ƴiiƴam) ina keewi feeñde e **delirium ɓuuɓɗo, jiiɓru ɓuuɓndu walla ɓuuɓndu ɓuuɓndu mboros.

Kala mo waɗi splenectomie chirurgicale walla mo asplenie fonctionnelle (ina heen kala mo... ñawu nguu ina wiyee sickle cell) alaa filtirde adannde ngam halkude bakteriiji gonɗi e nder ɓalndu (Streptokokkus pneumoniae, Neisseria meningitidis, e Hemophilus influenzae). Ɓeen yimɓe ina mbaawi heɓde Infection post-splenectomie overwhelming (OPSI), yahrude yeeso gila e nguleeki seeɗa haa e septik shock fatal e nder ko famɗi fof waktuuji 6 haa 12, tawa ina foti yahde to departemaa urgency so tawii ko maande adannde nguleeki walla ɓuuɓri.

Ballal gadanal hade safrirde e ko foti wonde e nder departemaa urgence¶

Toppitagol ko adii opitaal, tawi ina fadi ambulance¶

1. Reentaade laawol henndu e darnde fawaade e hakkille:
2. So tawii ko e ŋoŋɗi, e jeertinaango, e ƴiiƴam ina tiiɗi: Waɗde neɗɗo oo ina fooftoo e nder suudu niɓɓiɗndu, deeƴndu, hoore mum e ɓanndu mum toowndu ina toowa 30 degere. Toownude hoore seeɗa ina hirjina ƴiiƴam ƴiiƴam ummoraade e ngaandi rewrude e ƴiiƴam juɓɓule, ina wallita e ustude ɓeydagol nguleeki ɓalndu (ICP). Waɗde wutte maɓɓe e position moyenne droite (woto ɓuuɓnu hoore ndee no feewi e bannge, ko ɗum kinndinta ƴiiƴam jugular nder).
3. So tawii ko ɗanngal, ɓuuɓri, ɓuuɓri tiiɗndi, walla caggal ɓuuɓri: Roŋkude ɗum en e bannge mum en e nder recovery position ɗoon e ɗoon ngam ɓuuɓri e ɓuuɓri yalta e hunuko.
4. So e nder ɓuuɓri septik (pulse radial pale, clammy, faible pulse radiale, dizzy lorsqu’il seit) kono ina foofa e hoore mum: Lelnude ɗum en e dow ŋoral (woto jooɗoɗee e dow ŋoral, ko ɗum ustata ƴiiƴam e ngaandi) tawa hoore ndee ina wirnii no feewi ngam laaɓtinde ɓuuɓri so ina haani.
5. Reende e sahaa ɓuuɓri: Haa e 20 haa 30 e nder teemedere ñawɓe meninjitis bakteriiji ina keɓa tonik-klonik kuuɓtodinɗo nanngugol sabu ɓuuɓri kortikol e ɓuuɓri ngaandi. Kuuɓal hoore maɓɓe e jacket walla pillow follaa, laaɓtina mobelaaji, waktuuji seppooji ɗii e waktu, meeɗaa waɗde hay huunde e hunuko maɓɓe, e ruttaade e bannge maɓɓe nde convulsive jerking stops.
6. Reento torla cooyngal ɓanndu (alaa lootgol coofngol walla ɓuuɓri ice): Woto ɓuuɓnu ñawɗo meninjitis ɓuuɓɗo e ndiyam ngulɗam walla paccu ɗum e ice ngam ustude nguleeki mum. Dimmbagol tiiɗngol asamaan-rockets njaru oksijen ngaandi e ɓuuɓri nder hoore. Ittu tan duvette teeŋtuɗe walla sweateruuji ɓeydaaɗi mbele nguleeki ina waawa yaltude e nafoore, tawa aɗa jogii lefol lewlewndu e dow mum en so tawii ina njogii ɓuuɓri.
7. Moftu daartol tiiɗngol wonande safrooɓe e safrooɓe emergency: Winndu walla peewnu ngam haalande ekipaaji safrooɓe:
8. Wakkati tigi-rigi neɗɗo oo sakkitii sellude haa timmi e waktu tigi-rigi rafi walla jiiɓru fuɗɗii.
9. Mbele ɓe keɓii kala antibiotik e hunuko e nder yontere ɓennunde ndee (ina waawi maskude feccere e pine ƴiiƴam cerebrospinal).
10. Kala daartol ɓooyngol ɓuuɓri noppi (otitis media), sinusitis, mastoiditis, ɓuuɓri hoore / ɓuuɓri ɓalndu (ndiyam laaɓɗam ɓuuɓɗam ummoraade e hunuko walla noppi ina hollita ɓuuɓri ƴiiƴam ɓalndu rokkata Streptococcus pneumoniae laawol mawngol e nder ɓalndu, si ñawu, walla alerji penisilin/sefalosporin.

Ko waɗi opitaaluuji ina ndokka antibiotik e deksametason e nder waktu gadano¶

E nder departemaa urgence, meninjitis bakteriiji e septisemiya meningokok ina addana "Damal-to-Antibiotik" waktuuji limtaaɗi ko ina tolnoo e hojomaaji 60 (kala waktu mo neɗɗo leeltini fuɗɗoraade antibiotik bakteriiji e nder ƴiiƴam ina ɓeyda no feewi maayde e ŋakkeende neɗɗaagal duumiinde):

• Pine ƴiiƴam e antibiyotikuuji gonɗi e nder ƴiiƴam ɗoon e ɗoon: Ko adii hay waɗde tappirde ƴiiƴam (puncture lumbaire) so tawii CT scan ina haani ko adii walla so tawii ñawɗo oo ina wondi e ɓuuɓri septik, safrooɓe ɓee ina ƴetta pinal ƴiiƴam, ina mbaɗa ɗoon e ɗoon antibiyotikuuji keewɗi, ɗi naatnata e nder ƴiiƴam, ɗi naatnata e nder ƴiiƴam (seftriakson walla sefotaksim) e vankomisin (ngam suɗaade Streptococcus pneumoniae gonɗo e ɓuuɓri) e ampisilin/amoksisilin (so tawii ñawɗo oo ina yahra e lewru 1, ina yahra e duuɓi 50, ina reedu, walla ina jogii monogeneto*s).
• Deksametason (kortikosteroid) gonɗo e nder ƴiiƴam ko adii walla e dose antibiotik gadano oo: So antibiotik gonɗo e nder ƴiiƴam yanii e bakteriiji nder ƴiiƴam ɓalndu, bakteriiji maayɗi ɗii ina ɓuuɓtoo, ina njaltina ɓuuɓri ƴiiƴam ɓuuɓndi, ndi waawi saabaade ɓuuɓri kulɓiniindi e nder ɓalndu (ɓurtugol nanɗe sensorineural, ko caɗeele duumotooɗe ɓurɗe heewde e meninjitis bakteriiji). Hokkude deksametason e nder ƴiiƴam hojomaaji 10 haa 20 ko adii walla e sahaa gooto e doseeji gadani ɗii, ina usta ndeeɗoo ɓuuɓri, ina usta no feewi maayde e meninjitis pneumococcal, ina haɗa muusde duumiinde.

Reende jokkondiral ɓadtingal : Hol potɗo haajuuji ngam haɓaade antibiotik caggal nde neɗɗo heɓi ɗum ?¶

So tawii ñawu nguu ina wondi e ñawu nguu (Neisseria meningitidis)** walla haemophilus influenzae mo sifaa b (Hib) (teskuya: Streptococcus pneumoniae ñawu nguu waɗaani ñawbuuli ngam haɓaade ñawu nguu ngam jokkondirde), laamuuji cellal renndo ina ndokkira ñawbuuli **postexpooksi siprofloksasin, seftriakson, walla rifampin) ngam ittude mboros oo e dartinde ñawuuji ɗiɗaɓi.

Jokkondir e ardiiɓe cellal renndo walla cafroowo ngam heɓde antibiotik ngam haɗde ñawu nguu e nder waktuuji 24 caggal nde ñawu nguu heɓi so tawii ko a jokkondirɗo e ɓadiiɗo, ko CDC, OMS, e UK Health Security Agency cifotoo ko wayi no:

• Terɗe galle: Kala jooɗiiɗo e ɗaaniiɗo e nder galle gooto, suudu janngirdu, walla suudu renndundu e ñawɗo oo e nder balɗe 7 ko adii fuɗɗoode maale ñawu nguu.
• Jokkondiral hakkunde ƴiiƴam e ƴiiƴam : Kala jokkondirɗo e ƴiiƴam ñawɗo oo (ko wayi no muñde ƴiiƴam, renndinde ƴiiƴam walla yarde, walla jokkondiral e duɗal sukaaɓe) e nder balɗe 7 hade ñawu nguu.
• Jaabiiɓe adanɓe wonduɓe e ɓuuɓri gonndi e ƴiiƴam ndi reenaaka: Ko jaabtiiɓe tan mbaɗi resuscitation directe mouth-à-mouth, suukara gonɗo e ƴiiƴam mo reenaaka, walla intubation tawa ɓe ngalaa mask yeeso ko adii waktuuji 24 e safaara antibiotik. Jokkondiral gonngal e nder suudu janngirdu, biro, walla ambulance tawa alaa ko woni e mum so wonaa ɓuuɓri gonndi e hunuko, waɗaani antibiotik ngam haɗde ɗum.

Naamne keewɗe naamneede¶

Fuɗɗoode ƴeewtaama¶

• Duɗal ngenndiwal toppitiingal cellal e toppitagol (NICE, Royaume-Uni): Meninjitis (bakteri) e ñawu meningokok: Anndinde, ƴeewtaade e ƴellitde (Kuulal NICE NG240, kesɗitinaangal 2024).
• Fedde Adunaare Cellal (OMS): Foolde Meninjitis haa 2030 Kartal winnderewal e Deftere Pocket toppitagol sukaaɓe e opitaal: Triage e njuɓɓudi Meninjitis bakteriiji e septisemiya meningokok.
• Fedde ñawuuji mborosaaji Amerik (IDSA) e nokkuuji toppitiiɗi ko fayti e ñawuuji (CDC, Amerik): Kuule kuutoragol ngam haɓaade ñawuuji bakteriiji e Deftere ngam ƴeewtaade ñawuuji baawɗi haɓeede e faggudu: Ñawu Meningococcal.
• Fedde Oropnaare toppitiinde ko faati e mikroo-biyoloji e ñawuuji mborosaaji (ESCMID): Kuulal ESCMID ko faati e ƴeewndo e safrude ñawu nguu e nder bakteriiji ɓuuɓɗi.
• Tompson MJ, Ninis N, Perera R, e woɗɓe. (The Lancet): Anndinde ñawu meningokook e nder sukaaɓe e mawɓe (tabitingol sepsis gadano waktuuji 4 haa 8, ko wayi no ɓuuɓri koyɗe, juuɗe e koyɗe coofɗe, e mbaydi ɓalndu ndi aldaa e sago).
• Foyre wiɗtooji meninjitis (MRF) e meninjitis jooni (Leydi Angalteer): Banndirɗe boɗeeje kilinik e jarribo gilaas e denndaangal tonngooɗe ɓalli.

Ardiiɓe jokkondirɓe¶

• Sepsis e septik shock anndinde e ballal gadanal e nder sahaa
• Seernaaɓe e ballal gadanal e nder sahaa ɓuuɓɗo
• Shock ballal gadanal e cirkulaasiyoŋ collapse positionnement
• Kiriis sickle cell e caɗeele nguleeki asplenia gollorɗo
• Limooje emergency e leydi