Phlegmon

Description:

Phlegmon  (from Greek phlegmone - heat, an inflammation) - an acute diffuse purulent inflammation of a fatty tissue; unlike abscess has no clear boundary. The phlegmon which is usually beginning with emergence of the small site of skin on which the swelling is noticeable reddening and arises pain at a touch. In process of increase in area of reddening at the patient temperature, and sometimes even a fever, a perspiration and swelling of lymph nodes near area of the infected skin can rise.

Unlike impetigo, diseases of the skin mentioning only blankets, phlegmon – the infection getting to its deep layers – a derma and a hypodermic basis. The main bacterium provoking development of phlegmon is staphylococcus, the same bacterium in some cases causes impetigo. Sometimes, other bacteria also can act as causative agents of phlegmon.

Where there is phlegmon?
In some cases phlegmon develops about a site of application of an injury, developing of an ulcer or a section at operation. But most often this disease is shown in those places near which there are no injuries of skin. In such cases, remains to unknown from where bacteria appeared. The patients having diabetes or frustration of immune system (for example, as a result of influence HIV/AIDS or reception of the medical supplies weakening immune system), are especially subject to developing of phlegmon.

Phlegmon symptoms:

Symptoms of phlegmon match manifestations of inflammatory process to which the redness, warming of skin in the place of defeat, a turgidity and painful feelings belong. Any wounds or ulcers having these symptoms are capable to develop under the influence of phlegmon.

Other forms of a noninfectious inflammation can imitate flegmonny. For example, people with insufficient blood circulation in legs often have sites of the red skin covered with scales on shins and anklebones. This disease which is often confused to phlegmon is called haemo static dermatitis.

In the field of an inflammation there are severe pains, hypostasis and infiltration of fabrics; at distribution of process on blankets of hypodermic cellulose - a dermahemia; at emergence of sites of a softening fluctuation is defined. Usually regional lymphadenitis comes to light, and the general symptoms of a disease - weakness, thirst, fervescence to 39-40 °C, a fever quickly appear.

At deep phlegmons the general phenomena arise early, are brightly expressed and accrue very quickly. The headache, a frequent low pulse, a lowering of arterial pressure, an asthma, a Crocq's disease, an oliguria, yellowness of an integument are noted.

Chronic phlegmon develops at implementation of slabovirulentny strains of a streptococcus, staphylococcus, pneumococcus, etc. It is characterized by emergence of infiltrate of ligneous density over which skin gets a cyanotic shade.

Phlegmon reasons:

Golden staphylococcus – the most widespread bacterium causing phlegmon.

The second place on occurrence degree among bacteria which provoke emergence of phlegmon occupies a streptococcus. The form of the superficial phlegmon caused by golden staphylococcus is called an erysipelatous inflammation; it is characterized by the outlined site of skin extending bright red accurate with sharply raised borders. Upon, the so-called "carnivorous bacterium" is also a strain of staphylococcus which at severe forms of a disease can destroy fabric practically with the same speed with what it is cut by the surgeon.

Also other bacteria can cause phlegmon. At children under six years the hemophilic bacterium can provoke development of this disease. Especially often displays of phlegmon at children are noticeable on face skin, hands and an upper part of a trunk.

The phlegmon developing as a result of a sting of a cat or a dog or in connection with drawing scratch arises under the influence of a bacterium of Pasturella multocida which has very short incubation interval borrowing from 4 to 24 hours. The phlegmon developing as a result of the wound put with sea fish or a mollusk (a sting of fish, a prick of a fish fin or claws of a crab) is connected with activity of a bacterium of Erysipelothrix rhusiopathiae. The same bacteria can become the reason of the phlegmon resulting from the wound got on a farm, especially if it occurs in the course of work with pigs or poultry.

Phlegmon is a noncontagious disease as the infection affects deep layers of skin – a derma and hypodermic fabric, and the upper cover of skin (epidermis) blocks it access to distribution. In it the main difference of phlegmon from impetigo which is characterized by a superficial arrangement of an infection consists owing to what infection of other people is possible.

Treatment of Phlegmon:

First of all, it is important to establish whether really the inflammation of skin is caused by an infection. Most often, the case history and full survey happens enough to find out a cause of illness. Sometimes there is a need for calculation of leukocytes or a bakposeva.

If difficult or it is impossible to reveal existence or lack of communication of an inflammation with influence of an infection, the doctor can attribute antibiotics just in case. In the absence of any positive changes the doctor should address other methods which apply when the inflammation is caused in the noninfectious way. For example, if assume that the inflammation is connected with an autoimmune disorder, treatment has to be based on use of corticosteroids.

Antibiotics, such as derivatives of penicillin or other types of the antibiotics which are effective in fight against stafilokokka are used for treatment of phlegmon. If other bacteria revealed bakposevy are the reason of its distribution or patients have an allergy to penicillin, for treatment of phlegmon it is necessary to use other antibiotics.

The main method of treatment of phlegmon is surgery. Antibiotic treatment, novocainic blockade, physiotherapeutic treatment, administration of the drugs increasing protective forces of an organism of the patient are admissible only in an initial stage of a disease. In the absence of bystry positive effect (the termination of pains, normalization of body temperature, improvement of overall health and indicators of blood tests), increase of symptoms of intoxication the emergency operative measure is shown. An early operative measure allows to prevent considerable distribution of purulent process and development of intoxication.

In the postoperative period active impact on the course of inflammatory process is necessary that is reached by introduction to a wound of drainages for long flowing washing and active aspiration of exudate, treatment in the conditions of the abacterial managed environment is effective.