diffuse hemorrhage
Introduction
Introduction Diffuse bleeding: Sometimes all kinds of septicemia can be seen in the tissue with diffuse bleeding, septicemia caused by the invasion of the blood circulation caused by pathogenic bacteria, medically known as sepsis. Various pathogenic bacteria can cause sepsis. Clinically, the main manifestations are chills, hyperthermia, symptoms of toxemia, rash, joint pain, hepatosplenomegaly, septic shock, migratory lesions, etc. The vast majority of patients have acute course of disease, serious condition, poor prognosis, and now further consider sepsis It is a series of chain reaction processes caused by pathogens and their toxins and metabolites that activate and release inflammation mesons after entering the bloodstream. This process can lead to dysfunction and failure of multiple organs throughout the body, that is, not only the presence of pathogenic bacteria in the body, but also the immune response and results of the body. Inflammatory mesons are known to have complement components, arachidonic acid metabolites, tumor factors (TNF), interleukins (IL-s), interferons (IF-a), platelet activating factor (PAF), macrophages Inflammatory cytokines (MPIC), proteases, thromboxanes and oxygen free radicals.
Cause
Cause
Various pathogenic bacteria can cause sepsis. Commonly, there are Staphylococcus aureus, hemolytic streptococcus, Streptococcus pneumoniae, Escherichia coli, meningococcus, Pseudomonas aeruginosa, Proteus, Salmonella, Klebsiella and the like. When the body's resistance is reduced, bacteria with weak pathogenicity or conditional pathogens such as Staphylococcus epidermidis can also cause sepsis. In recent years, pathogenic bacteria have changed, and the sepsis caused by Gram-positive cocci has decreased, while Gram-negative bacilli, anaerobic bacteria and fungi have increased year by year, which is related to vessel intubation, foreign body in the body, etc. The development of new medical technologies has a certain relationship with the excessive application of antibiotics.
Examine
an examination
Related inspection
In vivo platelet activation marker platelet activating factor capillary fragility test capillary resistance test
1. Symptoms of infection poisoning:
Most of the onset of illness is abrupt, first chills or chills, followed by high fever, heat type, relaxation or heat retention. Frail, severe malnutrition and small babies can have no fever, and even lower body temperature. Apathetic or irritated, severe cases may appear pale or gray, unconscious. The extremities of the extremities are cold, shortness of breath, heart rate is accelerated, blood pressure is lowered, and jaundice can also occur in infants and young children.
2, skin damage:
Some children can be seen with various skin lesions, such as sputum, ecchymosis, scarlet fever-like rash, and measles-like rash. The rash is common in the limbs, trunk skin or oral mucosa. Meningococcal septicaemia can be seen in sputum or ecchymosis of varying sizes. Scarlet fever-like rash is common in streptococcus and staphylococcus aureus sepsis.
3, gastrointestinal symptoms:
Often vomiting, diarrhea, abdominal pain, and even hematemesis, blood in the stool; severe cases may appear toxic intestinal paralysis or dehydration, acidosis.
4, joint symptoms:
Some children may have joint swelling and pain, movement disorders or joint effusion, more common in large joints.
5, hepatosplenomegaly:
More common in infants and young children, mild or moderate swelling; some children can be complicated with toxic hepatitis. When the migration of Staphylococcus aureus causes liver abscess, liver tenderness is obvious.
6, other symptoms:
Severe children are often accompanied by symptoms of myocarditis, heart failure, confusion, lethargy, coma, oliguria or anuria. There are many migratory lesions in Staphylococcus aureus sepsis. Gram-negative bacterial sepsis often complicated by shock and DIC. Defects, ecchymosis, pus, cerebrospinal fluid, chest and ascites, etc. can also be directly smear, microscopic examination to find bacteria. Blood culture or bone marrow culture can be positive.
Diagnosis
Differential diagnosis
The disease should be differentiated from typhoid, miliary tuberculosis, allergic subsepsis, rheumatism, lupus erythematosus, certain viral infections, brucellosis, lymphoma, malignant histiocytosis.
1. Symptoms of infection poisoning:
Most of the onset of illness is abrupt, first chills or chills, followed by high fever, heat type, relaxation or heat retention. Frail, severe malnutrition and small babies can have no fever, and even lower body temperature. Apathetic or irritated, severe cases may appear pale or gray, unconscious. The extremities of the extremities are cold, shortness of breath, heart rate is accelerated, blood pressure is lowered, and jaundice can also occur in infants and young children.
2, skin damage:
Some children can be seen with various skin lesions, such as sputum, ecchymosis, scarlet fever-like rash, and measles-like rash. The rash is common in the limbs, trunk skin or oral mucosa. Meningococcal septicaemia can be seen in sputum or ecchymosis of varying sizes. Scarlet fever-like rash is common in streptococcus and staphylococcus aureus sepsis.
3, gastrointestinal symptoms: often vomiting, diarrhea, abdominal pain, and even hematemesis, blood in the stool; severe cases may appear toxic intestinal paralysis or dehydration, acidosis.
4, joint symptoms: some children may have joint swelling and pain, movement disorders or joint cavity effusion, more common in large joints.
5, hepatosplenomegaly: more common in infants and young children, mild or moderate swelling; some children can be complicated with toxic hepatitis. When the migration of Staphylococcus aureus causes liver abscess, liver tenderness is obvious.
6, other symptoms: severely ill children often accompanied by myocarditis, heart failure, confusion, lethargy, coma, oliguria or anuria and other physical organs involved symptoms. There are many migratory lesions in Staphylococcus aureus sepsis. Gram-negative bacterial sepsis often complicated by shock and DIC. Defects, ecchymosis, pus, cerebrospinal fluid, chest and ascites, etc. can also be directly smear, microscopic examination to find bacteria. Blood culture or bone marrow culture can be positive.
