Disama dia tshipupu tshia toxique (TSS) Dimanya ne dilama dia lukasa¶

Disama dia tshipupu tshia toxique (TSS) i disama dia tshimpitshimpi didi difumina ku superantigènes ya bactérie mikole idi ipatuka mu mashi kudi mishindu kampanda ya Staphylococcus aureus anyi Group A Streptococcus (Streptococcus pyosgene). Bishilangane na misongo ya bactérie idi ne tshia kuvulangana mu mashi onso bua kuenza tshipupu, mu disama dia staphylococcal toxic shock syndrome tshisumbu tshia bactérie tshidi tshitamba kuikala munda mua **tampon wa mu tshifu, dikopo dia ku ngondo, tshiponji tshia dikuba dia difu, tshilamba tshia ku mishiku panyima pa dipatuka dia mashi anyi sinus, mputa wa panyima pa dilela, anyi mputa mikese udi upatula bintu bidi kabiyi bimueneka patoke (bu mudi Toxic Shock Syndrome Toxin-1, anyi TSST-1) bidi bibuela buludiludi mu mashi, bienza bua tshiluilu tshia mubidi wa muntu tshikale tshipi, ne bifikisha ku tshipupu tshikole tshia cytokine storm, capillary leak, tshipupu tshia hypotension, ne dipanga dia bitupa bia mubidi bia bungi mu mêba 12 too ne ku 48.

Mudimu webe wa lukasa padibu bela meji ne: udi ne disama dia toxic shock syndrome udi wa kumanya tshimanyinu tshia kapia kakole ka tshimpitshimpi ka pa mutu pa 38,9 degrés Celsius (102,0 degrés Fahrenheit), disama dia dikoba dikunze didi ditangalake bikole (erythrodermie), disama dia nsukadi anyi disama dia mâyi, disama dia mashi, disama dia mêsu ne disama dia tshiadi anyi dijimija dia lungenyi paudi wimana, umbusha diakamue tshintu tshionso tshia mu tshifu, dikopo dia ngondo, tshiamu tshia dikuba natshi difu, anyi tshiamu tshia mputa tshidi katshiyi tshienza mudimu wa dipanda bua kuimanyika dienza dia toxin, bikila diakamue bena mudimu ba luondapu lua lukasa, balala mubedi panshi ne maulu makuatshike padiye umvua tshiji anyi mutshioke, ne umutuadile lukasa mu lupitadi bua kupeta mâyi a mu tshifu antibiotiques mu mushipa, ne dikonkonona dia mputa ya dipanda.

Enza nunku mpindieu¶

1. Bikila bena mudimu ba lupitadi lua lukasa lukasa: Bikila nimero ya lukasa lukasa ya muaba unudi (911 mu États-Unis ne Canada, 112 mu Union européenne mujima, 999 mu Royaume-Uni, 000 mu Australie) anyi tangila mukanda wetu wa nomba ya tshimpitshimpi muntu yeye mupeta kapia kakole ka tshimpitshimpi (38.9 degrés Celsius / 102.0 degrés Fahrenheit anyi kupita apu) dienda pamue ne disama dia mutu anyi dijimija dia lungenyi padiye muimane, tshitupa tshikunze tshidi tshimueneka bu tshia kuosha kudi dîba, difuka ne disama dia munda dia mâyi, disama dikole dia mifuba, nangananga padibu bafua udi mu tshikondo tshia kumona ngondo, mulela matuku mashale aa, udi ne tshiamu tshia kuela mu mishiku, anyi udi ne mputa wa dikoba, muoshe, anyi dipanda dia mubidi.
2. Umbusha diakamue tampon yonso, dikopo dia ku ngondo, tshiponji tshia dikuba natshi difu, anyi diaphragme ("Source Control"): Bikala muntu wenza mudimu ne tampon wa mu tshifu, dikopo dia ku ngondo, diske dia ku ngondo, tshiponji tshia dikuba dia difu, anyi tshilamba tshia ku tshifu, umbusha diakamue (anyi muambuluishe bua kutshiumusha ne bianza bisukula). Kumbusha tshintu tshikuabu kudi kupangisha bactérie bua kuela TSST-1 superantigen mu mashi.
3. Lama tampon anyi tshintu tshikuabu tshidibu bumbushe mu tshibombi tshia plastique tshikezuke bua lupitadi: Kuela tampon mu tshina tshia mâyi to. Uteke munda mua tshibombi tshia plastique tshikanga anyi mu tshintu tshikezuke ne utshipeshe baminganga anyi bena mudimu ba mu tshibambalu tshia malu a mpukapuka bua laboratware ya microbiologie ikale mua kuenza mudimu ne mishindu ya bactérie ne ya toxine.
4. KUPATUDI tshilamba tshia munda tshia mu mishiku tshia panyima pa dipanda anyi tshiamu tshia munda tshia mputa to: Bikala muntu ne tshiamu tshia gaze anyi tshia ballon munda mua diulu diende bua disama dikole mashi a mu mishiku anyi dipanda dia mu tshiadi dia matuku mashale aa, lekela diumusha kudi munganga wa mu tshibambalu tshia malu a mpukapuka (kukoka tshiamu tshia mu mishiku kumbelu mu tshikondo tshia tshipupu kudi mua kufikisha ku dipatuka dia mashi adi kaayi mua kukokeshibua), pa kumbusha padibi anu tshintu tshia pa mutu tshia ku nzubu tshidi tshipatuka kakuyi lutatu kakuyi dipatuka dia mashi.
5. Lala muntu pa mukolo bua kuepuka disama dia orthostatic syncope ne dijika dia muoyo: Disama dia toxic shock syndrome didi difikisha ku dipatuka dia mâyi a bungi mu mijilu ya mashi, dipuekesha mashi panshi bikole. Lekela muntu au alale panshi (kumulekedi nansha kakese bua kuimana anyi kuya mu tshina tshia mâyi, mudi babedi ba bungi ba TSS bajimija lungenyi ne bapeta mputa ku mutu). Shi badi na lupusa anyi balala tulu, ubateke ku luseke luabu mu muaba wa kuondopibua.
6. Tangila mputa yonso ya kikoba, miaba idibu bapasule, misuma ya bishi, ne miaba idibu bashipe bua kumona ni udi ne bimanyinu bikunze: Tangila ne tangila mputa yonso idibu bapasule matuku mashale aa, udi ukosa, wosha, mputa ya tshipupu, anyi miaba ya panyima pa dilela. Umanye ne: mputa udi ukebesha TSS wa staphylococcal utu misangu ya bungi umueneka muimpe ne kayi ne disama (kayi ne pus anyi dikala dikunze) bualu toxine udi ukebesha tshipupu tshia mubidi kakuyi difuka dia pus muaba kampanda, kadi streptococcal TSS utu misangu ya bungi uleja kanyinganyinga ka ditangalaka dia lukasa, bipumbishi bia violet, anyi necrotizing fasciitis.

flowchart TD
    Start["Kapia kakole ka tshimpitshimpi (>= 38.9 C / 102.0 F) NE Disama dia munda, Disama dikole dia mu mifuba, Disama dia mutu/Dipanga dia luya, anyi Disama dia munya"] --> CallEMS["1. Bikila bena mudimu ba tshimpitshimpi (911 / 112 / 999) diakamue: Umanyishe ne: udi ne disama dia toxique"]
    CallEMS --> CheckDevice{"2. Tampon wa mu tshifu, dikopo dia ngondo, tshiponji tshia dikuba dia difu anyi diaphragme bidiku anyi?"}
    CheckDevice -->|Yes| RemoveDevice["Umbusha tshibombi/dikopo diakamue ne bianza bikezuke ne ulame mu tshibombi tshia plastike tshikanga bua kulama mu lupitadi"]
    CheckDevice -->|No / Nasal or Wound Source| CheckWound{"3. Kudiku dibuikila dia mu mishiku, dipanda dia matuku mashale aa, diosha, disama dia panyima pa dilela anyi disama dikole dia dikoba anyi?"}
    RemoveDevice --> Position["."]
    CheckWound -->|Nasal Packing| LeaveNasal["Lekela tshintu tshia munda tshia mu mishiku bua kutshipatula kudi munganga wa ED bua kuepuka dipatuka dia mashi"]
    CheckWound -->|Wound, Burn, or Postpartum| ExposeWound["Sunguluja bilamba bikola bua kumona ni bidi ne bipupu anyi bipupu bia violet (Streptococcal TSS)"]
    LeaveNasal --> Position
    ExposeWound --> Position
    Position --> Transport["5. Kufila tshintu nansha tshimue ku mishiku (NPO) ne kuya natshi lukasa bua kupeta mayi a mu tshifu, Vasopresseurs, Clindamycin + Beta-Lactam/Vancomycin"]

Staphylococcal TSS ne Streptococcal TSS: Bilumbu bibidi bishilangane bia tshimpitshimpi¶

Pabuipi ne tshitupa tshia bantu bonso badi ne disama dia toxic shock syndrome lelu kadiyi dia ku ngondo, didi dikuata balume, bakaji ne bana ba bidimu bionso. Mikenji ya luondapu ya kudi tshibambalu tshia diluisha ne dikuba dia masama (CDC, États-Unis) ne tshia Société des maladies infectieuses de l’Amérique (IDSA) idi ileja dishilangana pankatshi pa Staphylococcal TSS (udi ufumina ku Staphylococcus aureus) ne Streptococcal TSS (udi ufumina ku Staphylococcus aureus, Streptococcus pyogenes):

Pathophysiology: Mushindu udi "Superantigen" wa bactérie ukuata 20 pa lukama ya tshiluilu tshieba tshia mubidi musangu umue¶

Bua kumvua bua tshinyi muena manaya wa bidimu 19 udi ne makanda a mubidi mimpe anyi muana udi ne disama dikese dia mubidi udi mua kumbuka ku diumvua bimpe menemene too ne ku dijinga dia diambuluisha dia mu nsombelu mu mêba makese menemene a 18, bidi biambuluisha bua kufuanyikija disama dia pa tshibidilu ne superantigène toxin reaction:

1. Diandamuna dia mubidi diakane (0.001 too ne ku 0.01 pa lukama dia T-cell activation): Mu disama dia bactérie anyi dia virus, globules blanc badibu babikila ne: antigène-presenting cells badi badia tshintu tshidi tshienza bua nsongo ne baleja tshitupa tshikese tshia pa buatshi munda mua **Major Histocompatibility Complex class II (MHC-II)**groove. Anu 0.001 too ne ku 0.01 pa lukama ya selile ya T idi yambuluisha idi ne tshiamu tshiayi tshidi tshipetangana menemene ne tshitupa tshikese atshi ke idi yenza mudimu, ipatula diandamuna dia mubidi didi dilombola ne diambuluisha.
2. Superantigen short-circuit (20 to 30 percent T-cell activation): Staphylococcal TSST-1 ne Streptococcal pyrogenic exotoxins i superantigens. Pamutu pa kubuela munda mua tshitupa tshia antigène, toxin udi wenza mudimu bu tshiamu tshia pambelu tshidi tshilamakaja pambelu pa molecule wa MHC-II buludiludi ku tshijengu tshia beta (V-beta) tshia T-cell receptors, tshienza mudimu ku bukole too ne ku 20 anyi 30 pa lukama ya T-lymphocytes yonso mu mubidi wa muntu musangu umue.
3. Tshipepele tshikole tshia cytokine ne dipatuka dia mishipa: Dienza dia T-cell dinene edi didi kadiyi ne kansungansunga didi dipatula tshipepele tshia proteyine idi ileja disama, bu mudi Interleukin-1 (IL-1), Interleukin-2 (IL-2), **Tumor Necrosis Factor-alpha-alpha (T) ne Infermater (IFN-gamma).
4. IL-1 ne TNF-alpha bidi bipingaja hypothalamus wa buongo bua kuenza tshimpitshimpi tshia **39 too ne ku 40,5 degre Celsius (102,2 too ne 105,0 degre Fahrenheit) ne bidi biunzulula buludiludi mishipa ya mubidi eku biunzulula njila mikole idi pankatshi pa selile ya endothélium idi mu tshitupa tshionso tshia mubidi.
5. Massive Capillary Leak Syndrome: Litre ya plasma ya mashi idi ipatuka mu mashi mu mikolo, mu tshimanu tshia munda, ne mu bitupa bia mubidi (too ne ku litre 8 too ne ku 12 ya dipanga dia mâyi mu mêba 24), bienza bua hypovolemic ne distributive dikema, disama dia tshiadi tshia mupuya (ARDS), disama dia tshiadi, ne disama dia tshiadi.

Mukanda wa dikonkonona dia masama: Bimanyinu 6 bia disama dia Staphylococcal Toxic Shock Syndrome¶

Bu mudi TSS wa kumpala misangu ya bungi umueneka bibi bu disama dia mu tshifu tshikole ("grippe estomaque"), grippe, fièvre rouge, anyi allergie a manga, tshibambalu tshia diluisha ne dikuba dia masama tshia mu États-Unis (CDC) tshiakateka mikenji mikole ya malu a luondapu. Ela meji bua TSS diakamue dîba dionso didi mubedi uleja Kapia ka tshimpitshimpi + Dipuekesha dia mashi/Disama dia mutu + Disama dia mputa + Dibuela dia bitupa bisatu anyi kupita apu:

1. Kapia kakole ka tshimpitshimpi¶

• Luya lua munda ludi lubandila lukasa too ne ku 38.9 degre Celsius (102.0 degre Fahrenheit) anyi kupita apu, pamue ne dikankamika dikole ne dibungama. (Dimanya: Mu babedi badi ne Streptococcal TSS badi kale mu dinyanguka dia mashi, luya lua munda ludi mua kupueka muinshi mua 36.0 degre Celsius / 96.8 degre Fahrenheit).

2. Disama dia macula ditangalake (tshipupu tshia "Sunburn-like") ne hyperemia wa mu mucosal¶

• Tshitupa tshia dikoba: Mu meba 24 a kumpala, tshitupa tshikunze tshidi tshitangalake, tshibalakane, tshitoka tshidi tshimueneka anu bu tshitupa tshibi tshia munya (anyi tshipupu tshimpe tshidi tshimueneka bu tshia dibeji dia nsenga) tshidi tshitangalaka mu mubidi, mu nshingu, mu difu ne mu bitupa bia mubidi, misangu ya bungi mu tshitupa tshia mubidi anyi pabuipi ne tshilonda. Bishilangane na tshipupu tshia violet tshidi katshiyi tshitoka tshia disama dia meningococcal septicemia, TSS erythroderma udi ulua mutoke (udi ulua mutoke) padibu bamufina ne kawena usama anyi usama to. Pa dikoba difiike, disama dia erythroderma didi mua kumueneka bu difiika dia patupu, dikala dia bronze-plum, anyi luya lua dikoba, bienza bua dikonkonona dia mucose dikale dikengedibua.
• Beefy-Red Mucous Membranes (Conjunctival and Pharyngeal Hyperemia): Bualu toxin udi ulengeja mishipa ya mu mucose yonso, mubedi udi upeta:
• Mashi, mêsu makunze bikole (hyperemie conjonctivale) kakuyi tshintu tshikole tshia jaune tshidi tshipatuka.
• "Ludimi lua fraise" mutoke (papillae ya ludimi lutoke) ne mishiku ya munda ne mu nshingu mikunze (hyperemie oropharyngéale).
• Mucosa vaginal rouge mutoke (mu TSS wa ngondo anyi wa panyima pa dilela).
• Dipatuka dia dikoba dia panyima pa matuku (Dinyanguka dia matuku 7 too ne ku 14): Dikoba dia dikoba dia pa mutu pa maboko, makasa, minu, ne minu ntshimanyinu tshimanyike tshia CDC, kadi tshidi tshienzeka mbingu 1 anyi 2 kunyima kua dibanga mu tshikondo tshia diondopangana. Kuindidi nansha kakese bua dikoba dipatuke ku bianza anyi ku makasa bua kumanya disama dia TSS dikole.

3. Dipuekesha dia mashi ne disama dia orthostatic syncope (Dipuekesha dia mashi)¶

• Tension systolique udi upueka muinshi mua 90 mmHg kudi bantu bakole (anyi muinshi mua 5^th percentile bilondeshile bidimu kudi bana), NANSHA mubedi udi upeta tension wa orthostatique, disama dia mutu dikole, dimona dia mu tshina, anyi dijimija lungenyi (dipanga dia lungenyi) mu masekonde makese a kusomba anyi kuimana.

4. Dibuela dia bitupa bia mubidi bia bungi (3 anyi kupita apu pa bitupa 7 bidi bilonda ebi)¶

1. Mu tshifu (Mu >90 pa lukama ya bilumbu, misangu ya bungi tshimanyishilu tshia KUMPALA): Disama dia tshimpitshimpi disama dia mayi ne difu dia misangu ne misangu dituadija mêba makese kumpala kua tshipupu kumueneka. Ke bualu kayi TSS batu misangu ya bungi bafuanyikija ne dinyanguka dia biakudia anyi disama dia mu tshifu didi difumina ku bipupu.
2. Mishipa (Idi mu >90 pa lukama ya bilumbu): Disama dikole, dia pa tshibidilu mifuba ne dibungama dikole (myalgie) mu nyima, mu bitupa bia mubidi, mu bitupa bia ngombe, ne mu difu, misangu ya bungi ne creatine kinase (CK) mu mashi ne rhabdomyolysis.
3. Mucous membranes: Mêsu makunze (conjonctivae), nshingu mikunze/ludimi lua fraise, anyi tshilamba tshikunze tshia mu tshifu.
4. Mifuba (Mifuba): Dikepela dia bungi dia mashi adi apatuka (oliguria), divula dia azote wa mu mashi (BUN) ne creatinine wa mu mashi (misangu ibidi ya pa tshibidilu), anyi selile ya pus idi kayiyi ne disama (pyuria) mu mashi.
5. Mu tshifu (mu tshifu): Enzyme ya mu tshifu (AST/ALT anyi bilirubine misangu ibidi) idi ifikisha ku disama dia jaunisse dikese.
6. Hematologic (Blood clotting): Dipueka dia bungi bua plakete (thrombocytopenia muinshi mua 100,000/mm3) ne ditangalaka dia mashi mu mashi (DIC) didi difikisha ku dipatuka dia mashi mu mishiku anyi mu miaba ya IV.
7. Système nerveux central (Bongo): Dipanga dia lungenyi, dipanga dia lungenyi, dibungama, dipanga dia lungenyi, anyi dipanga dia lungenyi dikole kakuyi disama dia tshiadi, difumina ku disama dia buongo didi difumina ku toxin ne ku dipueka dia mashi.

Malu adi mua kuikala ne njiwu mikole kupita tampons: TSS udi kayi wa ku ngondo udi muntu yonso ne bua kumanya¶

Nansha muvua midimu ya dimanyisha bantu mu bidimu bia 1980 mimbushe tampons ya polyacrylate rayon idi ne bukole bua bungi ne mipuekeshe bungi bua TSS ya ku ngondo, TSS idi kayiyi ya ku ngondo idi mpindieu ne 50 pa lukama ya bantu bonso badi ne TSS ya Staphylococcal ne pabuipi ne 100 pa lukama ya bantu badi ne TSS ya Streptococcal:

Diambuluisha dia kumpala dia kuya ku lupitadi ku kakese ku kakese patudi bindile mashinyi a tshimpitshimpi¶

Tshitupa 1: Diumusha dia lukasa dia tshintu tshikuabu ("Dikonkonona dia kumpala kua lupitadi")¶

Mu tshinyongopelu tshia toxin, mu minite yonso padi tampon, dikopo dia ngondo, anyi tshintu tshia kupangisha natshi difu tshishala munda mua mubidi, Staphylococcus aureus udi utungunuka ne kuenza ne kupatula TSST-1 superantigène mupiamupia mu mashi.

1. Kuowesha bianza anyi kuvuala bifulu bia mudimu bia musangu umua.
2. Lekela mubedi alale pa bulalu anyi pa dididishi ne binu bikuate (kulekedi mubedi udi ne tshiji, udi ne disama dia hypotension wimana pa mutu pa tshina tshia mâyi bua kumbusha tshiamu tshia nzembu, bualu kuimana kudi kufikisha ku dijimija lungenyi lua tshimpitshimpi).
3. Umbusha tampon yonso, dikopo dia ngondo, diske dia ngondo, tshiponji tshia dikuba dia difu, anyi diaphragme bitekete bitekete pa kukoka tshingoma anyi kutshibula kuinshi kua dikopo bua kutshibula tshimanyishilu.
4. Bikala mubedi kayi mujadike ni tampon utshidi munda (anyi shi tshingoma tshikoseke): Shi mubedi udi mudimuke ne umvua bimpe bua kuenza nunku, udi mua kukomba munu wa tshianza tshikezuke munda mua tshina tshia mu tshifu bua kutangila ni tampon mulame muteka ku luseke ku mutu kua tshiibi; Shi ki mmuomu, shiya tshikebelu tshia munda kudi munganga wa tshibambalu tshia malu a mpukapuka (udi mua kutshiumusha mu masekonde makese ku diambuluisha dia tshiamu tshia nzembu ne tshiamu tshia nzembu).
5. Lama tshintu tshiudi mumbushe: Teka tshintu tshia kuela mu tshibombi anyi dikopo munda mua tshibombi tshia plastique tshikezuke tshidi ne dîna dia mubedi ne dîba dia kumumbusha, ne ulue natshi mu mashinyi a lupitadi.

Tshitupa 2: Diteka dia mashi ne dikuba dia njila wa luya¶

• Muaba wa tshimpitshimpi: Lama mubedi mulale panshi pa mukolo bua kupingaja mashi a mu mishipa mu mutshima ne mu buongo. Shi badi bumvua mutu mupepele anyi bafue ne kabayi ne disama dia ku makasa anyi dipanga dia mupuya, kuikisha maulu abu pa tshilamba tshia kulala kudi mua kuambuluisha bua kukolesha bungi bua mashi (dikema).
• Dilama dia nsukadi ne disama dia tshiadi: Bu mudi disama dia nsukadi dia bungi ne disama dia nsukadi dia mâyi bidi pabuipi ne kuikala bia pa buloba bujima mu TSS wa ku ntuadijilu, ikala ne tshibombi ne bilamba bia kuowa nabi mâyi bimpe ku luseke lua bulalu. Kulekedi mubedi uya ku tshina tshia mâyi; ubambuluishe bua kuenza mudimu ne tshilamba tshia bulalu anyi bilamba bia kuowa nabi mâyi padibu balale panshi, ne ubakuate ku luseke luabu mu muaba wa kuondopibua dîba dionso didibu batuta bua aside wa mu tshifu kawuyi mua kubuela mu mikolo to.
• Kakuyi bualu nansha bumue ku mishiku (NPO): Nansha mudi mubedi umvua nyota mikole bua dipatuka dia mashi mu mashi ne disama dia tshiadi, kupeshi muntu mâyi, maluvu a manaya anyi manga a disama dia mukana to. Tshimanu tshia munda mu TSS tshidi tshiuwule ne tshidi ne mashi (mesenteric hypoperfusion), nunku mayi adibu bamina adi anu apingana, ne mubedi udi mua kuikala dijinga ne dipanda dia lukasa anyi dikonkonona dia mputa dia lukasa padiye ufika ku lupitadi.

Tshitupa 3: Dilombola dia luya kakuyi NSAIDs¶

• Umbusha bilamba bikola ne bilamba bikola bua kapia kakole kadi mua kupatuka ku dikoba, pa kumbusha padi mubedi wenda uteketa ne mashika (mu nsombelu eu, enza mudimu ne tshilamba tshimue tshia butoke).
• Kuelayi mayi a mashika anyi bilamba bia mashika, bidi mua kuenza bua mijilu ikale mikole ne dikankamika.
• Kuena ne bua kufila ibuprofen, naproxen, anyi aspirine nansha kakese: NSAIDs idi ikolesha disama dia tshiadi mu babedi ba TSS badi ne disama dia hypotension, idi inyanga dibuela dia mashi mu mashi padi thrombocytopenia mikale mimane kukola, ne idi ivuija dinyanguka dia mifuba ya Streptococcal ya mu tshisumbu tshia A.

Tshidi tshienzeka mu tshibambalu tshia malu a mpukapuka: Bua tshinyi Clindamycin udi ne mushinga wa bungi mu TSS¶

Kujingulula mishindu isatu ya dilengeja dia lupitadi bua disama dia toxic shock syndrome kudi kuambuluisha babedi ne bafidi ba mêku bua kuyukila bimpe ne bisumbu bia diambuluisha dia lukasa lukasa:

Dikunji 1: Dikolesha dia mayi a mu mishipa ne vasopresseurs¶

Bu mudi TSS ukebesha disama dia dipatuka dia mashi mu mashi, mishipa ya mashi ya mubedi mukulumpe idi mua kupatula 6 to ne 12 litres (1.5 to 3 gallons) ya mayi mu bitupa bia mubidi bidi bimunyunguluke mu mêba 24 a kumpala. Baminganga ba mu lupitadi lua lukasa badi bateka diakamue milonda ibidi minene ya mu mishipa ne bateka **mayi a kristaloide adi ne bulongame (bu mudi: lactated Ringer solution anyi 0.9% normal saline, kutuadijila ku 30 millilitres ku kilograme mu mêba 1 anyi 3 a kumpala) **, pashishe kulonda ne mayi a mu mishipa adi atungunuka (noradrenaline) dibueja dia vasopressor pikala tension mushale muinshi nansha mudibu ne mayi.

Dikunji 2: Biamu bibidi bia mu mishipa bidi ne tshintu tshidi tshipangisha bua kuenza proteyine (Clindamycin anyi Linezolid)¶

Bua kuondopa disama dia toxic shock syndrome bidi bikengela kuenza mudimu ne manga mashilangane bikole ne bua kuondopa disama dia patupu:

• Bua tshinyi manga a antibiotique a mu tshimanu tshia selile (penicillins, cephalosporins, vancomycin) nkayawu kaena akumbana to: Ma antibiotique adi ashipa bactérie bu mudi cefazolin, nafcillin, anyi vancomycin adi ashipa bactérie pa kutshibula bimanu bia selile ya pambelu, idi mua kupatula mu tshimpitshimpi tshipupu tshia toxin tshidi tshilongolola kumpala kua dîba, ne mu tshimpitshimpi tshia bactérie mu tshisumbu tshia A" Streptococcus), penicillin udi ulekela mudimu padi bactérie balekela kuditapulula lukasa.
• Kusakidila Clindamycin (anyi Linezolid) mu mishipa kudi kukanga diakamue tshiapu tshia buanga: Clindamycin (ne linezolid) udi ulamakaja buludiludi ku 50S ribosomal subunit munda mua Staphylococcus aureus ne Streptococcus pyogenes, sylthesis wa bactérie ne ST-1 streptococcal pyrogenic exotoxins mu minite mikese nansha mudi bactérie idi yenza mudimu.
• Nunku, mikenji ya matunga masanga idi ilomba bua kusangisha Clindamycin mu mishipa (bua kuimanyika dienza dia buanga) NE Vancomycin anyi Daptomycin mu mushipa (bua kubuikila MRSA) ne Beta-Lactam bu mudi Piperacillin-Tazobactam, Meropenem, anyi Nafcillin/Peniclin G too ne padibi bipingana.

Dikunji 3: Dilombola dia tshishimikidi tshia dipanda ne Intravenous Immunoglobuline (IVIG)¶

• Kukonkonona tshibuelelu tshionso ne tshitupa tshionso: Ba munganga badi benza mudimu wa tshimpitshimpi batu benza tshikebelu tshijima tshia mu tshiadi (bua kumbusha tshintu tshisokoka tshia mu mishiku tshidibu bapue muoyo), bumbusha tshintu tshionso tshidi tshibuikila mu mishiku, ne babikila bamanyi ba malu a dipanda bua kunzulula, kumbusha ne kusukula mputa yonso ya panyima pa dipanda, tshilonda anyi miaba idibu bela meji ne: idiku necrotizing fasciitis.
• Intravenous Immunoglobuline (IVIG): Mu babedi badi ne Streptococcal TSS mikole anyi Staphylococcal TSS udi kayi unyanguka badi bashala mu tshinyongopelu nansha mudibu banua mâyi ne clindamycine, baminganga badi ne disama dikole batu bafila Imunoglobuline Intravenous (IVIG) wa bantu, udi ne bungi bua anticorps udi ushipa buludiludi udi wendakana ne bintu bidi bishipa bantu mu mashi ne ubipangisha kumpala kua bobu kuenza mudimu ne tuselile tua T tua bungi.

Dikuba: Mushindu kayi wa kukepesha njiwu ya TSS ya ku ngondo ne ya mputa¶

Nansha mudibi kabiyi mua kupangisha disama dionso dia TSS, kulonda mikenji ya bukezuke idi mimanyine pa bijadiki kudi kukepesha bikole njiwu ya TSS ya staphylococcal idi ifumina ku ngondo ne ku biamu:

• Wenza mudimu ne tshipiminu tshia tampon tshia muinshi menemene tshidi tshikengela bua dienda diebe dia mpindieu: Dikuata dia tampon ndimanyike pa buloba bujima (Bupepele, bua pa tshibidilu, bua dikema, bua bungi, bua bungi). Kuenza mudimu ne tampon udi ne bukole bua bungi mu dituku dia butoke kudi kuuma ne kufikisha ku bilonda bikese mu mucosa wa mu tshifu eku kukolesha dikola dia bactérie.
• Shintulula tampon kunyima kua meba 4 to ne ku 6 (ne kulekedi nansha umue mu meba mapite pa 8): Shintulula pankatshi pa tampon ne bilamba bia pambelu (nangananga butuku paudi ulala mêba mapite pa 6 to ne 8).
• Kusukula bianza ne mayi ne nsabanga kumpala ne panyima pa kubueja anyi kumbusha tshiamu tshia kuela nabi difu, dikopo dia kumona ngondo, anyi tshintu tshia kupangisha bua kulela: Bualu bantu 30 pa lukama badi ne Staphylococcus aureus ku bianza ne ku mishiku, kuowa bianza kumpala kua kubulula tshilamba anyi kuenza mudimu ne dikopo dia kumona ngondo kudi kupangisha dishintulula Staphylococcus aureus. aureus ku minu yebe pa tshiamu.
• Lamba ne ulengeja makopo a ku ngondo adibu mua kuenza nawu mudimu misangu ya bungi pankatshi pa bikondo ne uapuekeshe mâyi kunyima kua mêba 4 anyi 8: Malonga a mu lupitadi adi ajadika ne: Staphylococcus aureus udi mua kuenza biofilme ne kupatula TSST-1 munda mua makopo a ku ngondo adibu mua kuenza nawu mudimu misangu ya bungi padibu baashiya muaba wabu mutantshi mule anyi bobu basukule anu ne mâyi a mu pompi kakuyi dilamba pankatshi pa bikondo bia ngondo.
• Kuena ne bua kuenza mudimu ne tampon anyi makopo a ku ngondo kabidi wewe muikale ne disama dia Staphylococcal TSS: Bantu batue ku 30 pa lukama badi bapanduka ku TSS wa ku ngondo nebapete disama dia tshiakabidi** mu tshikondo tshia ngondo tshidi tshilonda bobu benza mudimu kabidi ne tampon, bualu superantigène wa TSST-1 udi unyanga makanda a mubidi a B-cell ne udi ukandika bantu ba bungi bua kubenga kukola anti-TSST-1 anticorps. Muntu yense udi ne disama dia TSS udi ne tshia kuenza mudimu ne bilamba bia pambelu anu bua matuku ende onso a muoyo.

Nkonko itubu bela misangu ya bungi¶

Miaba mifumina¶

• Bibambalu bia diluisha ne dikuba dia masama (CDC, États-Unis): Disama dia tshinyangu (pa kumbusha Streptococcal) 2011 Diumvuija dia tshilumbu ne Disama dia Streptococcal Toxic Shock Syndrome (STSS) 2010 Diumvuija dia tshilumbu ne buludiki bua luondapu.
• Infectious Diseases Society of America (IDSA, United States): Mibelu ya kuenza bua kumanya ne kulama masama a kikoba ne a mubidi: Staphylococcal ne Streptococcal Toxic Shock Syndrome.
• Tshilongelu tshia ditunga tshia malu a bukola bua mubidi ne a dilama dia bantu (NICE) ne tshibambalu tshia malu a bukola bua mubidi tshia mu UK (UKHSA, Royaume-Uni): Disama dia sepsis ne disama dia Streptococcal (iGAS) didibu bela meji ne: Dimanya, Dimanya ne Diondapangana kumpala kua dîba.
• National Burn Care Review ne British Burn Association (Royaume-Uni): Mibelu ya kulombola disama dia Pediatric Burn Toxic Shock Syndrome.
• Nonfoux L, Chiaraviglio L, ne bakuabu. (Applied and Environmental Microbiology): Impact of Currently Marketed Tampons and Menstrual Cups on Staphylococcus aureus Growth and Toxic Shock Syndrome Toxin 1 Production In Vitro.
• Lappin E, Ferguson AJ (The Lancet Infectious Diseases): Gram-positive toxic shock syndromes.

Malu adi apetangana¶

• Dimanya dia sepsis ne dia septic shock ne diambuluisha dia lukasa dia lukasa
• Necrotisant fasciitis (disama dia munyinyi) ne cellulite bidi bileja
• Diambuluisha dia kumpala dia tshimpitshimpi ne dikuluka dia mashi
• Dilama dia mashi a mu mishiku (epistaxis) ne dikuba dia mishiku
• Kuosha ne kuosha kuosha ne kuvuala diambuluisha dia kumpala
• Nomba ya njiwu bilondeshile ditunga