Aisan Waterhouse-Friderichsen

Aisan Waterhouse-Friderichsen (WFS) jẹ ẹgbẹ awọn aami aiṣan ti o jẹ abajade ikuna ti awọn keekeke ti o wa lati ṣiṣẹ ni deede bi abajade ti ẹjẹ sinu ẹṣẹ.

Awọn keekeke adrenal jẹ awọn keekeke onigun mẹta. Ẹṣẹ kan wa lori oke kidirin kọọkan. Awọn iṣan keekeke ti n ṣe agbejade ati tu silẹ awọn homonu oriṣiriṣi ti ara nilo lati ṣiṣẹ ni deede. Awọn keekeke adrenal le ni ipa nipasẹ ọpọlọpọ awọn aisan, gẹgẹbi awọn akoran bi WFS.

WFS ṣẹlẹ nipasẹ ikolu ti o lagbara pẹlu meningococcus kokoro arun tabi awọn kokoro arun miiran, gẹgẹbi:

• Ẹgbẹ B streptococcus
• Pseudomonas aeruginosa
• Àrùn pneumoniae Streptococcus
• Staphylococcus aureus

Awọn aami aisan waye lojiji. Wọn jẹ nitori awọn kokoro arun ti ndagba (isodipupo) inu ara. Awọn aami aisan pẹlu:

• Iba ati otutu
• Apapọ ati irora iṣan
• Orififo
• Ogbe

Ikolu pẹlu kokoro arun fa ẹjẹ ni gbogbo ara, eyiti o fa:

• Ara sisu
• Ṣiṣọn ẹjẹ intravascular ti a tan kaakiri ninu eyiti awọn didi ẹjẹ kekere ti ge ipese ẹjẹ si awọn ara
• Septic mọnamọna

Ẹjẹ sinu awọn keekeke ti o nfa fa idaamu adrenal, ninu eyiti a ko ṣe agbejade awọn homonu adrenal to. Eyi nyorisi awọn aami aisan bii:

• Dizziness, ailera
• Iwọn ẹjẹ kekere pupọ
• Iyara pupọ pupọ
• Iporuru tabi koma

Olupese ilera yoo ṣe idanwo ti ara ati beere nipa awọn aami aisan eniyan.

Awọn idanwo ẹjẹ yoo ṣee ṣe lati jẹrisi ikolu kokoro. Awọn idanwo le pẹlu:

• Aṣa ẹjẹ
• Pipe ẹjẹ ka pẹlu iyatọ
• Awọn ẹkọ didi ẹjẹ

Ti olupese ba fura pe ikolu naa jẹ nipasẹ awọn kokoro arun meningococcus, awọn idanwo miiran ti o le ṣe pẹlu:

• Lumbar puncture lati gba ayẹwo ti omi ara eegun fun aṣa
• Biopsy ara ati abawọn Giramu
• Itupalẹ Ito

Awọn idanwo ti o le paṣẹ lati ṣe iranlọwọ iwadii aawọ adrenal nla pẹlu:

• ACTH (cosyntropin) idanwo iwuri
• Idanwo ẹjẹ Cortisol
• Suga ẹjẹ
• Igbeyewo ẹjẹ potasiomu
• Idanwo ẹjẹ
• Ẹjẹ pH idanwo

Awọn egboogi ti bẹrẹ lẹsẹkẹsẹ lati ṣe itọju ikolu kokoro. Awọn oogun Glucocorticoid yoo tun fun ni lati tọju insufficiency ẹṣẹ adrenal. Awọn itọju atilẹyin yoo nilo fun awọn aami aisan miiran.

WFS jẹ apaniyan ayafi ti itọju fun ikolu aporo ba bẹrẹ lẹsẹkẹsẹ ati pe a fun awọn oogun glucocorticoid.

Lati yago fun WFS ti o ṣẹlẹ nipasẹ awọn kokoro arun meningococcal, ajesara kan wa.

Imukuro meningococcemia - Aisan Waterhouse-Friderichsen; Sepsis meningococcal ti o ni kikun - Aisan Waterhouse-Friderichsen; Ẹjẹ adrenalitis

• Awọn egbo Meningococcal lori ẹhin
• Iyokuro iṣan homonu adrenal

Stephens DS. Neisseria meningitides. Ni: Bennett JE, Dolin R, Blaser MJ, awọn eds. Mandell, Douglas, ati Awọn ilana ati Ilana ti Awọn Arun Inu Ẹjẹ Bennett. 9th ed. Philadelphia, PA: Elsevier Saunders; 2020: ori 211.

Newell-Iye JDC, Auchus RJ. Kọneti adrenal. Ni: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. Iwe ẹkọ Williams ti Endocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020: ori 15.