Clostridium wound infection
Introduction
Introduction to Clostridium wound infection Clostridium wound infection can be characterized by focal cellulitis, local or diffuse myositis, or the most severe progressive muscular necrosis (gas gangrene). Infection can occur several hours or days after the injury, often in limbs with severe crush injury or tissue necrosis after penetrating injury. Similar diffuse myositis or myogenic necrosis can also occur in surgical wounds, especially occlusion Patients with vascular disease. basic knowledge Sickness ratio: 0.0012% Susceptible people: no special people Mode of infection: contagious Complications: tetanus
Cause
Clostridium wound infection etiology
Clostridium infection in wounds often occurs in limbs with severe crush injury or tissue necrosis after penetrating wounds. Similar diffuse myositis or myogenic necrosis can also occur in surgical wounds, especially in patients with occlusive vascular disease. .
Prevention
Clostridium wound infection prevention
1. Correctly treat the wound. For general small wounds, first wash the mud and ash outside the wound with tap water or well water. If conditions permit, apply iodine and other disinfectant to the wound, then cover the wound. Clean cloth, gently wrapped and then go to the hospital for further treatment. For some large wounds, first press the wound with a clean cloth, and then quickly go to the hospital for treatment.
2, pay attention to maternal health.
3, injection vaccination.
4, oral Chinese medicine.
Complication
Clostridium wound infection complications Complications tetanus
The most serious complication of Clostridium wound infection is death, such as tetanus.
Symptom
Clostridium wound infection symptoms common symptoms cellulitis tissue fluid exudation gangrene wound infection purple spot
1. Focal cellulitis
It is an acute infection of soft tissue and is a serious condition. If the diagnosis is not timely or fails to get positive and reasonable treatment, it is even life-threatening.
Myositis
Refers to acute, subacute or chronic inflammatory lesions in the myocardium that are localized or diffuse.
3. Dilated muscle necrosis
Necrotic muscle tissue can be observed in muscle necrosis, the affected muscle is dull magenta, then dark red, and finally grayish green or purple spot color, X-ray examination can show local gas production, CT and magnetic resonance can help determine The range of gases and necrosis.
Examine
Examination of wound infection by Clostridium
It is often necessary to perform detailed surgical exploration of the wound and visually observe the affected tissue to confirm the diagnosis. For example, necrotic muscle tissue can be observed in muscle necrosis, the affected muscle is dull magenta, and then the deep red is finally grayish green or purple spotted. X-ray examination can show local gas production, and CT and magnetic resonance can help determine the range of gas and necrosis.
Wound exudates should be sent to culture for anaerobic and aerobic bacteria. Clostridium can be isolated from pure culture or cultured with other anaerobic bacteria or/and aerobics. The smear can be shown as Gram-positive. Clostridium, a typical exudate with almost no polymorphonuclear leukocytes, stained with Sudan can show free fat globules, many trauma, especially open trauma, can be both pathogenic and non-pathogenic fusiform Bacillus contamination without significant invasive disease, the significance of this situation needs to be judged from a clinical perspective.
Diagnosis
Diagnosis and identification of wound infection of Clostridium
diagnosis
Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.
Differential diagnosis
Other anaerobic or aerobic bacteria, including Enterobacter and Bacteroides, Streptococcus and Staphylococcus, alone or in combination, can cause severe Clostridium-like cellulitis of traumatic or post-operative wounds, extensive Fasciitis or gas gangrene. If the smear shows a large number of polymorphonuclear leukocytes and a large number of cocci in a chain arrangement, anaerobic streptococcus or staphylococcal infection should be considered. A large number of Gram-negative bacilli can indicate An Enterobacter or Bacteroides infection (see mixed anaerobic infection below). Determination of specific antigenic toxins in wounds or blood is only helpful for a small number of cases of botulism obtained through trauma. Clostridium can also occur But it doesn't make much sense.
