Viral vs Bacterial Meningitis
Meningitis yog mob ntawm cov kab mob uas tshwm sim los ntawm cov kab mob, kab mob, fungi lossis kab mob cab. Ob leeg kab mob thiab kab mob viral meningitis muaj tib yam. Cov keeb kwm kev kho mob, kev tshawb nrhiav, kev tshawb nrhiav thiab kev kho mob yog tib yam. Txawm li cas los xij, kev tshawb nrhiav pom, kev kho mob tshwj xeeb thiab kev kwv yees sib txawv. Nws yog ib qho tseem ceeb uas yuav tsum tau kuaj xyuas kom raug raws li seb nws puas yog kab mob kab mob los yog kab mob meningitis vim kab mob meningitis yog tus kheej txwv thiab tsis muaj lub sij hawm ntev sequelae thaum cov kab mob meningitis hnyav dua thiab yog tias xav tias mob meningitis, kev kho yuav tsum tau pib yam tsis muaj kev ncua. Kab lus no yuav tham txog kab mob meningitis kom ntxaws, qhia txog lawv qhov chaw kho mob, cov tsos mob, ua rau, kev tshawb nrhiav thiab kev kuaj mob, kev kuaj mob, kev kho mob, thiab qhov sib txawv ntawm cov kab mob kab mob thiab kab mob viral meningitis.
Meningitis yog ib tug tua neeg, thiab nws tua sai heev. Cov kab mob xws li E coli, beta hemolytic streptococci, Listeria moncytogenes, Heamophilus, Nisseria meningitidis, pneumococcus ua rau mob meningitis. Meningitis tshwm sim nrog mob taub hau uas hnyav zuj zus thaum raug lub teeb, txhav caj dab, Kernig lub cim (mob thiab ua haujlwm ntawm lub hauv caug txuas ntxiv nrog lub duav siab siab), Brudzinski kos npe (lub duav flex ntawm khoov lub taub hau rau pem hauv ntej) thiab opisthotonus. Cov no yog hu ua meningeal nta. Meningitis nce siab hauv pob txha taub hau. Qhov no yog tshwm sim los ntawm kev mob taub hau, chim siab, tsaug zog, ntuav, haum, papilledema, txo qis ntawm kev nco qab, ua tsis taus pa, tsis muaj mem tes, thiab ntshav siab (Nyeem qhov txawv ntawm Pulse Rate thiab ntshav siab). Thaum cov kab mob nkag mus rau hauv cov hlab ntsha septic cov tsos mob xws li mob, pob qij txha o, mob pob qij txha, kev coj cwj pwm txawv, ua pob liab liab, diffuse intravascular coagulation, ua pa nrawm, mem tes ceev, thiab ntshav siab tshwm sim.
Kev kho mob meningitis yuav tsum tsis txhob ncua kom txog thaum kuaj tau tiav. Yog tias xav tias tus mob meningitis, tsis muaj dab tsi yuav tsum ncua cov tshuaj tua kab mob hauv cov hlab ntsha. Txoj kev ua pa, ua pa, thiab kev ncig yuav tsum tau khaws cia. Kev kho cov pa oxygen siab ntawm lub ntsej muag lub ntsej muag yog qhov zoo. Txoj kev kho mob txawv raws li qhov kev nthuav qhia. Yog tias cov tsos mob tshwm sim muaj feem ntau, lumbar puncture yuav tsum tsis txhob sim. Yog tias tus neeg mob poob siab, qhov ntim resuscitation tau qhia. Yog hais tias meningitic nta predominate ntawm kev nthuav qhia, lumbar puncture yuav tsum tau sim yog tias tsis muaj cov yam ntxwv ntawm kev nce intracranial siab. Cov tshuaj tua kab mob hauv cov hlab ntsha yuav tsum tau muab. Yog hais tias muaj ib qho kev qhia txog kev ua pa tsis ua hauj lwm, intubation yuav tsum tsis txhob ncua.
Cov teeb meem ntawm meningitis yog cerebral edema, cranial paj tawg, lag ntseg, thiab cerebral venous sinus thrombosis. Lumbar puncture yog qhov tseem ceeb rau kev kuaj mob. Yog tias tsis muaj cov yam ntxwv ntawm kev nce siab hauv lub cev, lub lumbar puncture yuav tsum tau ua. Yog tias muaj cov yam ntxwv ntawm kev nce siab hauv pob txha taub hau, CT yuav tsum ua ntej lumbar puncture. 3 lub raj mis ntawm cerebrospinal kua yuav tsum raug xa mus rau gram stain, Zheil neilson stain, cytology, virology, qabzib, protein thiab kab lis kev cai. Kev tsom xam kua cerbrospinal tej zaum yuav zoo li qub thaum ntxov. Yog hais tias qhia lumbar puncture yuav tsum tau rov ua dua. Lwm yam kev kuaj xws li ntshav kab lis kev cai, ntshav qabzib, suav ntshav suav tag nrho, urea, electrolytes, hauv siab x-ray, tso zis kab lis kev cai, qhov ntswg qhov ntswg thiab cov quav rau cov kab mob virology.
Cov xwm txheej pheej hmoo rau tus mob meningitis yog ntau dhau, mob taub hau, mob ua kom pom tseeb, hluas heev, laus heev, ua kom tsis muaj zog, tiv thaiv lub cev tsis muaj zog, mob qog noj ntshav, mob qog noj ntshav, thiab CSF shunts. Kab mob kab mob meningitis muaj kev tuag ntawm 70 mus rau 100% tsis kho; Neisseria meningitides muaj kev tuag tag nrho ntawm 15% nyob rau sab hnub poob. Cov neeg muaj txoj sia nyob yuav muaj kev pheej hmoo ntawm kev puas hlwb mus tas li, kev puas hlwb, kev lag ntseg tsis hnov lus thiab cranial paj hlwb palsies.
Dab tsi yog qhov txawv ntawm Kab Mob thiab Kab Mob Meningitis?
• Kab mob meningitis muaj qhov tsis zoo tshwm sim thaum tus kab mob kis kab mob ua rau nws tus kheej txwv, muaj qhov pom zoo thiab tsis muaj qhov tshwm sim ntev.
• Thaum lumbar puncture, CSF zoo li turbid nyob rau hauv cov kab mob meningitis thaum nws zoo nkaus li pom tseeb hauv kab mob meningitis.
• Mononuclear hlwb predominate nyob rau hauv viral meningitis thaum polymorphs predominate nyob rau hauv kab mob meningitis.
• Dawb cell suav hauv CSF tsawg dua 1000 hauv kab mob khaub thuas thaum nws muaj ntau dua 1000 hauv kab mob meningitis.
• CSF qabzib concentration tsawg dua ib nrab ntawm cov ntshav ntshav hauv cov kab mob meningitis thaum, hauv cov kab mob kis kab mob, CSF qab zib concentration ntau dua li ib nrab ntawm cov ntshav.
• CSF protein concentration ntau dua 1.5g/L hauv kab mob meningitis thaum nws tsawg dua 1g/L hauv kab mob khaub thuas.
• Muaj cov kab mob pom nyob hauv smear lossis kab lis kev cai, hauv kab mob meningitis thaum tsis muaj kab mob pom muaj kab mob kis kab mob.
Nyeem qhov txawv ntawm Meningitis thiab Meningococcal
