carbuncle
Introduction
Introduction to the project The sputum is an acute suppurative infection of multiple adjacent hair follicles and their associated sebaceous glands or sweat glands. The motherland medicine is called "mouth sores" or back. The lesions often have purple-red inflammatory infiltration, and the boundary is unclear. There are multiple pustules on the surface of the abscess. After the ulceration, it is honeycomb-shaped. When the infection is serious, the patient may be accompanied by systemic poisoning symptoms. The clinical need for early antibiotic and other systemic treatment. If the sputum is large, or continues to expand to the surrounding area after anti-inflammatory treatment, or when the systemic symptoms are serious, it is advisable to perform surgical drainage in time. basic knowledge The proportion of illness: 0.005% Susceptible people: adults Mode of infection: non-infectious Complications: bacteremia, sepsis and bacteremia
Cause
Cause
(1) Causes of the disease
The pathogenic bacteria are Staphylococcus aureus, which is more common in adults. It is most often found in the thick and tough skin of the posterior section. Sometimes it can be extended to the entire body. The skin is unclean, local abrasions, and the body's resistance is reduced. It is an important cause of infection. .
Diabetic patients are more susceptible to convulsions due to poor white blood cell function.
(two) pathogenesis
The infection often starts from the bottom of a hair follicle. Because the skin of the item is thick and tough, the infection is not easy to penetrate the surface, and the subcutaneous fat column along the weak resistance spreads to the deep loose subcutaneous tissue, and then spreads along the deep fascia. And many fat columns nearby; and then invade the hair follicle group to form a sputum with multiple "pust heads", the pathological features of which are invasive suppurative inflammation of the subcutaneous deep tissue, with multiple openings on the surface of the skin, the openings are The hair follicle extends out of the skin surface.
Prevention
Project prevention
Pay attention to personal hygiene, keep the skin clean. Treat sputum in time to prevent the spread of infection, and patients with diabetes should be treated aggressively.
Complication
Complications Complications bacteremia sepsis and bacteremia
Sudden complicated with sepsis, bacteremia and other systemic infections.
Symptom
Symptoms of sputum common symptoms ulcer appearance crater-like pustules high fever cold war pain edema fatigue anorexia diabetes
At the beginning of the lesion, a single pus can appear in the center of the lesion. The skin around the pus is swollen and hard, slightly uplifted, and the boundary is unclear. It is purple-red or bright red. Sometimes it can be changed like orange peel. The tenderness is obvious and fever, and then the redness gradually Intensified, a plurality of yellow-white pus heads appear in the center of the surface of the lesion. After the ulceration, it is honeycomb-shaped, and discharges more bloody pus. The skin between the pus and the pus is often necrotic and black, and then the entire central part of the tendon is gradually necrotic. It dissolves, falls off, forms a "crater" shape, contains a lot of necrotic tissue and pus, and local lymph nodes have tenderness.
Before the lesion is not confined, the sputum is easily spread to the surrounding and deep, spreading to a wide range, and finally a large ulcer surface can be formed.
The neck range is often large. Because the neck skin is thick and tough, dense and fixed, and the tissue pressure is large when edema, the patient often feels severe pain, affects sleep, and local necrosis, toxin absorption, and more obvious body Symptoms, such as chills, high fever, headache, anorexia, etc.
Check symptoms
1. History and clinical manifestations: The middle-aged person begins with a single pus, and then appears purple-red, with unclear flaky swelling, multiple "pust heads" on the surface, severe pain; local regional lymph nodes Swollen; may have chills, high fever, fatigue, headache and other general malaise.
2. Laboratory examination: the total number of white blood cells increased, neutrophils increased, accompanied by diabetes, fasting plasma glucose, glycated serum protein, glycosylated hemoglobin higher than normal.
Examine
Item inspection
Peripheral blood
(1) White blood cell count: The fever can have an increase in the total number of white blood cells.
(2) White blood cell classification and counting: When the total number of white blood cells is increased, neutrophils are often accompanied.
2. Diabetes related examination
(1) Fasting plasma glucose measurement: Both fasting blood glucose levels are measured twice, and the possibility of diabetes should be considered.
(2) Glycosylated serum protein: This test is not affected by clinical blood glucose fluctuations, and higher than normal to help diagnose diabetes.
(3) Glycated hemoglobin: The glycated hemoglobin value is positively correlated with blood glucose concentration and is irreversible, and diabetes is often 2 to 3 times higher than normal.
3. Bacteriological examination
(1) Bacterial culture: For multiple infections and repeated infections, the pus can be directly extracted from the abscess for bacterial culture, and the positive result is helpful for the diagnosis of sputum.
(2) Drug sensitivity test: While the pus bacterial culture, the drug sensitivity test can provide a scientific basis for clinical drug treatment.
Diagnosis
Diagnostic identification
Diagnosis is based on clinical performance and examination.
Need to identify with sputum, because is a single hair follicle infection, it is only local red, swollen, pain, induration, small range of lesions, and more often without symptoms of systemic poisoning.
