acute cellulitis
Introduction
Introduction to acute cellulitis Acute cellulitis is an acute diffuse suppurative infection of the subcutaneous, subfascial, intermuscular or deep cellulite. It is characterized by the fact that the lesion is not easily confined, and the spread is rapid, and there is no obvious boundary with normal tissues. Inflammation can be caused by infection after skin or soft tissue injury, or it can be caused by direct spread of local septic infections through lymphatic and blood flow. Acute cellulitis caused by hemolytic streptococcus, due to the action of streptokinase and hyaluronidase, the lesion spreads rapidly, sometimes causing sepsis, and cellulitis caused by staphylococci is more likely to be limited to abscess. basic knowledge The proportion of illness: 0.02% - 0.05% Susceptible people: no specific population Mode of infection: non-infectious Complications: superficial acute lymphadenitis and lymphangitis
Cause
Causes of acute cellulitis
Causes:
It is often caused by hemolytic streptococcus, Staphylococcus aureus, anaerobic bacteria or spoilage bacteria. Inflammation often occurs after skin and soft tissue injury. Chemical substances such as improper drug injection or foreign body retention in soft tissue can induce infection. Clinical manifestations are often caused by the type of bacteria, toxicity and location of the disease, and may cause sepsis when the condition is severe. Due to skin and mucous membrane damage, the subcutaneous loose connective tissue is caused by pathogen infection. It can also be caused by direct spread of local suppurative infection or by lymphatic and blood transmission. In immunodeficient patients, occasional cellulitis caused by Gram-negative bacteria.
Prevention
Acute cellulitis prevention
(1) Because acute cellulitis is diffuse inflammation, it is easy to spread to the surrounding area. The most important thing is to diagnose and treat the initial stage. The necessary decompression and timely decompression can prevent more extensive tissue necrosis.
(2) Pay attention to personal hygiene, actively treat small skin infections and other infected lesions, and open treatment should be meaningful to prevent the occurrence of this disease.
(3) Patients should rest in bed, drink more water, and those with severe systemic symptoms should be treated with symptoms. Raise the affected limb to reduce local swelling and pain. The affected area can be applied with moist heat to promote blood circulation. Avoid spicy and irritating foods.
Complication
Acute cellulitis complications Complications: shallow acute lymphadenitis and lymphangitis
Often complicated by lymphangitis and lymphadenitis.
Symptom
Acute cellulitis symptoms Common symptoms Difficulty breathing High heat laryngeal edema Difficulty chills Cellulitis Cellulite disappears or slightly bulges
First, it occurs in the lower limbs, feet, pain, vulva and perianal.
Second, the skin damage: the general affected area is diffuse redness, the boundary is unclear, blister can occur on it, central inflammation is obvious, local pain and tenderness, can appear fluctuations, ulceration, drainage, can not break, absorb, fade, Occurred in the finger (toe) called sputum, chronic cellulitis caused local hardening, atrophic cellulitis.
Third, often accompanied by fever, chills and other systemic symptoms.
Fourth, there may be local lymphadenitis, lymphangitis, and even metastatic abscess, sepsis.
Often due to the type of pathogenic bacteria, toxicity and pathogenesis, the depth and difference, superficial acute cellulitis, local redness, severe pain, and rapidly expand to the surrounding area, the lesion area and normal skin no significant boundary, the center of the lesion The site is often necrotic due to ischemia. If the tissue of the lesion is loose, such as the face, abdominal wall, etc., the pain is mild, deep in acute cellulitis, local redness and swelling are not obvious, often only local edema and deep tenderness, but the condition is serious Systemic symptoms, severe fever, chills, headache, general weakness, increased white blood cell count, etc., acute cellulitis of the mouth, submandibular and neck, can cause laryngeal edema and compression of the trachea, causing difficulty in breathing, and even suffocation; inflammation Sometimes or spread to the mediastinum, cellulitis caused by anaerobic streptococci, Bacteroides and various enterobacteria, also known as sputum cellulitis, can occur in the intestinal or urinary tract contents Contaminated perineum, abdominal wounds, local sputum pronunciation, necrosis of cellulite and fascia, accompanied by progressive skin necrosis, pus odor, systemic disease Serious.
Examine
Examination of acute cellulitis
Peripheral blood like white blood cells increased.
(1) White blood cell count: At the time of general infection, the white blood cell count was increased by >10×109/L. If the white blood cell count is > (20 ~ 30) × 109 / L, or < 4 × 109 / L, or immature white blood cells > 0.1%, or toxic particles, should be alert to septic shock and sepsis.
(2) Leukocyte differential count: elevated white blood cell count is often accompanied by elevated neutrophils.
Diagnosis
Diagnosis and diagnosis of acute cellulitis
diagnosis
Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.
Differential diagnosis
Differential diagnosis with erysipelas:
The erysipelas lesions are clear and superficial, with local edema and no pus.
