Bacterial Meningitis 12

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  • 8/9/2019 Bacterial Meningitis 12

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    Oc`e`os `e Ek{|acafp: ]bk}|kd}hke} ai Ldo}k|`dc Hke`ef`}`s ( D \kd~~|d`sdc

    Oc`e `os `e Ek{|a c afp]bk ]|kd}hke} ai Ldo}k|`dc Hke`ef`}`s

    D \kd~~|d`sdc\`obd|m Gdp

    @E]\AM[O]@AE]bk `e}|am{o}`ae ai s{c~baedh`mks `e }bk cd}k 40?>&s dem~ke`o`cc`e dem obca|dh~bke`oac `e }bk kd|cp 40;>&s |km{okm

    m|dhd}`odccp }bk ha|}dc`}p ai ldo}k|`dc hke`ef`}`s i|ah 0> +}a 4;+ `e }bk Vks}k|e oa{e}|`ks% Bavkyk|# `e |koke} pkd|s}bk|k bds lkke c`}}ck ky`mkeok ai i{|}bk| |km{o}`ae mks~`}k}bk dyd`cdl`c`}p ai de `eo|kds`ef e{hlk| ai de}`l`a}`os%I{|}bk|ha|k# dhaef }bk s{|y`ya|s }bk `eo`mkeok ai hdja|ek{|acaf`odc skt{kcdk bds |khd`ekm `e }bk a|mk| ai ?>+ "4)%@emkkm# o{||ke} s}{m`ks s{ffks} }bd} skesa|`ek{|dc mkdiekssds de kd|cp dem ai}ke `||kyk|s`lck oah~c`od}`ae hdp lk{e~|kyke}dlck kyke lp yk|p kd|cp }|kd}hke} ai }bkhke`ef`}`s " dem 6;+ ai dcc ldo}k|`d od{s`efhke`ef`}`s `e }bk [%_%D% dem [%G% |ks~ko}`ykcp% @e oae}|ds}#aecp _% ~ek{hae`dk |k}d`es s{ob ~|kmah`edeok "?+ ai ~d}`ke}s v`cc

    bdyk }bk ocdss`odc }|`dm ai ikyk|# s}`ii ekog dem dc}k|kmoaeso`a{sekss# l{} }b`s i|kt{keop `s c`gkcp }a lk h{ob cavk|`e }bk yk|p acm dem }bk yk|p pa{ef% ]bk mki`e`}`yk m`dfeas`s|ks}s ae }bk c{hld| ~{eo}{|k vb`ob sba{cm lk ~k|ia|hkm ,d}}bk }`hk `} `s }ba{fb} ai% Lkod{sk }bk oaeskt{keoks aih`ss`ef hke`ef`}`s d|k sa sk|`a{s# `} `s dr`ahd}`o }bd} ,dea|hdc s~`edc }d~ `e d ~d}`ke} v`}b oc`e`odccp s{s~ko}hke`ef`}`s `s ekyk| od{sk ia| d~acafp, ";)% Ae }bk a}bk|bdem# }bk t{ks}`ae dcvdps d|`sks ds }a vbk}bk| `} `s sdik }aod||p a{} }bk c{hld| ~{eo}{|k ia| }bk ikd| ai ~|ayag`efbk|e`d}`ae a| &oae`ef& ai }bk l|d`e% Fkek|dccp s~kdg`ef# }bk

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    Ja{|edc ai }bk Baef G a e f H k m ` o d c D s s a o ` d } `a e Y a c % ?0# Ea% ?# 4026|`sg `s b`fbks} vbke }bk|k `s |d`skm `e}|do|de`dc ~|kss{|k m{k}a d hdss cks`ae% O%]% sodee`ef `s }bk has} skes`}`ykh k}bam ai mk}ko}`ef de `e}|do|de`dc h dss dem sba{cm lk{emk|}dgke `i dookss }a `} maks ea} mkcdp {em{cp }bk `e`}`d}`aeai }|kd}hke}% A }bk|v`sk# od|ki{c oc`e`odc kydc{d}`ae `s|kt{`|km% D hdss cks`ae `s s{ffks}km lp s{l(do{}k b`s}a|p#~d~`ccakmkhd dem iaodc s`fes% Lkod{sk ai }bk m`yk|s`}p aia|fde`shs od~dlck ai od{s`ef hke`ef`}`s# `} `s ea}|koahh kemkm }a ah`} c{h ld| ~{eo}{|k dem `es}`}{}k}|kd}hke} lc`emcp vb`ob h dp vkcc i d ` c dem kemdefk| c`ik%D E ] @ L @ A ] @ O _ K C K O ] @ A EKh~`|`odc }bk|d~p `e hke`ef`}`s `s j{s}`i`km dem ekokssd|p`e }va s`}{d}`aes% ]bk i`|s} `s di}k| }bk c{hld| ~{eo}{|k l{}lkia|k }bk o{c}{|k dem skes`}`y`}p ai }bk O%_%I% `s geave7}bk skoaem `s vbke ldo}k|`dc hke`ef`}`s `s s}|aefcps{s~ko}km ae }bk lds`s ai O%_%I% ck{oaop}as`s dembp~afcpoa||dob`d# dem pk} }bk o{c}{ |k `s ekfd}`yk% ]bkskcko}`ae ai de}`l`a}`os kh~`|`odccp `s ldskm ae caodcgeavckmfk ai }bk has } c`gkcp ~d}bafke oaes`mk|`ef }bk~d}`ke}&s dfk dem `hh{ek s}d}{s de m vbk}bk| }bk `eiko}`ae `soahh{e`}p a| bas~`}dc dot{`|km a| ek{|as{|f`odccp |kcd}km%@e Baef G aef# lkod{s k ai }bk ~|kydckeok ai _% s{`shke`ef`}`s# }bk ~d}`ke}&s aoo{~d}`ae sba{cm lk dsok|}d`ekm `ea|mk| }a mk}k|h`ek `i `} l|`efs }bk ~d}`ke} `e}a oae}do} v`}b~`fs# ~a|g a| ~a|g(~|am{o}s `e dep vdp %O{||ke} |koahhkemd}`aes ds oae}d`ekm `e }bk hdja|}kr}laags "k%f% Aria|m ]kr}laag ai H km`o`ek# 4 02=7Bd||`sae&s ^|`eo`~ck ai @e}k|edc Hkm`o`ek# 4026) {s{dccpt{a}k dh~`o`cc`e "a| ~ke`o`cc`e F) ~c{s obca|dh~bke`oac "a|fke}dh`o`e `e }bk odsk ai ekaed}dc hke`ef`}`s) ds }bk i`|s}c`ek }|kd}hke} ai hke`ef`}`s ai {egeave k}`acafp% ]b`soahl`ed}`ae v`cc dmkt{d}kcp mkdc v`}b _% ~ek{hae`dk# E%hke`ef`}`m`s dem B % `ei c{kezdk# l{ } v`cc ea} oayk| }bk F|dh(ekfd}`yk ldo`cc` {eckss fke}dh`o`e `s do}{dccp {skm%[ eia|}{ed}kcp# }bk ~aa| c`~`m sac{l`c`}p ai dh`eafcpoas`mksc`h`}s }bk`| O%_%I% ~kek}|d}`ae# dem ek~b|a}ar`o`}p dema}a}ar`o`}p |ks}|`o} }bk dh a{e} }bd} ode lk f`yke%@e Baef Gaef# ds vk bdyk skke# }bk ~|a~a|}`ae aihke`ef`}`s od{skm lp F|dh(ekfd}`yk ldo`cc` hdp lk ds b`fbds ?>+% Kh~`|`odc }|kd}hke} bk|k h {s } }bk|kia|k ~|ay`mk|kc`dlck oayk| dfd`es} }b`s f|a{~ ai a|fde`shs ds vkcc ds# aioa{|sk# }bk ha|k ocdss`odc ~d}bafkes% @e }b`s oae}kr}# }bkekvk| "sa(odcckm }b`|m fkek|d}`ae) ok~bdcas~a|`es d~~kd| }asd}`sip }bk mkhdems ai dmkt{d}k O%_%I% ~kek}|d}`ae# ~a}ke}ldo}k|`o`mdc do}`y`}p# cav bas} }ar`o`}p dem v`mk de}`h`o|al`dcs~ko}|{h% Oc`e`odc }|`dcs "9) d|k lkf`ee`ef }a sbav }bd} }bkskok~bdcas~a|`es ( ~d|}`o{cd|cp Okia}dr`hk "Ocdia|de)#Oki}|`draek "\aok~b`e) dem Oki}dz`m`hk "Ia|}{h) ( d|k

    kiiko}`yk `e }bk } |kd}hke} ai hke`ef`}`s od{skm lp F|dh(ekfd}`yk ldo`cc`# vb`ck }bk`| do}`y`}p dfd`es} }bk ha|k ocdss`odc~d}bafkes `s dla{ } kt{`ydcke} }a dh ~`o`cc`e dcaek a| `eoahl`ed}`ae v`}b obca|dh~bke`oac% Vb`ck ok~bdcas~a|`es d|kea} ekokssd|`cp }bk m|{f ai oba`ok ia| ok|}d`e geave`eiko}`aes "k%f% }bkp d|k `ekiiko }`yk dfd`es} C`s}k|`d#{e~|km`o}dlck dfd`es} ^sk{maeahds dem {evde}km dfd`es}_}d~bpcaoaoo`)# `} `s c`gkcp }bd} va|cmv`mk dook~}deok ai }bk`|~cdok `e }bk kh~`|`odc }|kd}hke} ai ldo}k|`dc hke`ef`}`s v`cciaccav aeok cd|fk(sodck oae}|acckm }|`dcs bdyk lkkeoah~ck}km%

    Mki`e`}`yk }bk|d~p |k~cdoks kh~`|`odc }|kd}hke} aeok }bka|fde`sh `s `mke}`i`km dem `}s skes`}`y`}p geave% ]dlck < c`s}s}bk de}`l`a}`o |kf`hkes ia| }bk ha|k oahhae ldo}k|`dchke`ef`}`s% Oahhae dem dya`mdlck h`s}dgks d| k ia{em ea}ds h{ob ds `e }bk oba`ok ai de}`l`a}`os }bde `e }bk masdfkdem m{|d}`ae f`yke% ]b k masdfk h {s } lk cd|fk kea{fb }akes{|k b`fb O%_%I% m|{f oaeoke}|d}`aes dem ai}ke }b`s `sskyk|dc }`hks }bk dha{e} ai }bk sdhk m|{f aek va{cmea|hdccp f`yk ia| }bk } |kd}hke} ai a}bk| ckss skyk|k`eiko}`aes% ]bk m{ |d}`ae ai }bk|d~p `e h ke`ef`} s sba{cm lkd} ckds} 4 > mdps ia| }bk ocdss`odc ~d}bafkes dem ? vkkgs ia|}bk F|dh(ekfd}`yk ldo`cc`% @e}|dykea{s dmh`es}|d}`ae `shdemd}a|p dem s{ls}`}{}`ae ai a|dc }bk|d~p aeok }bk ~d}`ke}lkoahks dikl|`ck `s ea} |koahh kemkm%OAEOC[_@AE]bk a{}oahk ai ldo}k|`dc hke`ef`}`s mk~kems o|`}`odccp aekd|cp m`dfeas s dem ~|ah ~} }|kd}hke}# dem i{|}bk| |km{o}`aeai o{||ke} ha|}dc`}p dem ha|l`m`}p v`cc bdyk }a oahk i|ah`h~|aykhke}s `e }bk hk}bams ai mk}ko}`ae ds vkcc ds d|kd~~|d`sdc ai }bk|d~k{}`o a~}`aes% ]bk ekvk| ok~bdca(s~a|`es d~~kd| }a lk d~~|a~|`d}k dc}k|d}`yks ia| }bk kh~`|`odc}|kd}hke} ai hke`ef`}`s ai {eg eave k}`acafp `e Baef G aef%]bkp d|k dcsa |koahh kemkm ia| }bk h dja| }p ai F|dh (ekfd}`yk `eiko}`aes%

    \KIK\KEOK_4 % _vd|}z HE% Ldo}k|`dc hke`ef`}`s: ha|k `eyacykm }bde j{s} }bk h ke`efks% E% Kef} JHkm 402=7 ?44:04