Dontogenous sepsis

Description:

Dontogenous sepsis - a generalized infectious disease at which as entrance gate for a contagium serves defect of solid tissues of tooth or a dentogingival attachment.

Reasons of dontogenous sepsis:

In the presence in an oral cavity of painful teeth, especially with manifestations of chronic inflammatory process (pulpitises and periodontitis, multiple caries), waste products of bacteria, disintegration of fabrics and toxins get into an organism, poison him and do more sensitive to many factors (to an infection, cooling, an injury, overfatigue and so forth).

Symptoms of dontogenous sepsis:

At dontogenous sepsis of people throughout a long time feels an indisposition, bystry fatigue, the increased perspiration, a loss of appetite, sleep disorders. There can be pain in heart, the speeded-up pulse, the increased nervousness, a headache and so forth.
Distinguish several phases of development of sepsis:
it is purulent - resorptive fever which is proper response to local infectious and inflammatory process.
initial phase of sepsis. It is purulent - resorptive fever remains. From blood pathogenic microorganisms can be sowed.
the septicaemia - remains sharply expressed is purulent - the resorptive fever which is not corresponding to pyoinflammatory process in maxillofacial area. From blood pathogenic microorganisms are sowed.
septicopyemia - long preservation is purulent - resorptive fever. From blood and metastatic suppurative focuses pathogenic microorganisms who cause specifics of a current and an outcome of a disease are sowed.

Treatment of dontogenous sepsis:

Treatment of dontogenous sepsis means simultaneous impact on the local center of an infection in parallel with implementation of actions of the general plan, aiming to change a reactive background.

Topical treatment includes urgent opening of primary suppurative focus and secondary (metastatic) abscesses, evacuation of contents, washing and methodically correct drainage.

Carefully carried out surgical treatment of primary suppurative focus begins with performance of rather wide layer-by-layer section of fabrics, then the full-fledged nekroektomiya, opening of zatek and manual audit of possible pockets is carried out. At a loyokalization of abscesses in temporal area, on the side surface of a face and neck for effective drainage of a wound resort to additional cuts - counteropenings. Operation is completed drainage of a purulent cavity silicon dvukhprosvetny drainage tubes through which its flowing and aspiration washing is carried out by antiseptic solutions: 0,1-0,2% solution hlorgeksidi-on, a dioxidin, 0,5% Furacilin solution. For non-political effect add proteolytic enzymes to antiseptic solution (chemical opsin, trypsin, chymotrypsin, Terrilytinum, гигролитин).

Medical actions of the general plan include providing optimum sanitary and hygienic conditions for the patient, suralimentation (food has to be protein-rich, vitamins, power substances - alcohol); care of an oral cavity; prevention of decubituses. The listed actions make a complex of an intensive care of any serious condition, but at sepsis they have to be carried out with special care and the methodical sequence. When finding septic patients in the territory of intensive care unit it is necessary to take measures to their isolation not to allow transfer of especially virulent infection to the operated patients and the victim with open damages.

The first course of antibacterial therapy is appointed empirically. At the same time estimate the following signs: anatomic localization of the center of an infection; condition of an immune responsiveness of the patient; allergic anamnesis; function of kidneys. It is reasonable to use a combination from 2 antibiotics.

If sepsis developed in the conditions of a hospital (nozokomialny sepsis), then in attention epidemiological data on structure of activators and their sensitivity to antibiotics undertake. So, if at the same time Methicillinum - resistant S. aureus prevails, then appoint Vancomycinum. At Gentamycin resistance of gram-negative nozokomialny microflora add Amikacin, In a complex with the called antibiotics appoint Metronidazole.