Phlegmon. Learn all about the disease. Phlegmon of the abdominal wall

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One of the dangerous skin diseases is phlegmon, most often occurring in an acute form.

This is either a complication of inflammatory and purulent diseases, such as abscess, sepsis, pneumonia, and others, or an independent disease.

With phlegmon, inflammation is provoked by staphylococcal bacteria and less often by other microorganisms.

Phlegmon - what is it?

What is phlegmon? This is an acute inflammation of the subcutaneous adipose tissue. Unlike an abscess or a boil, this is a diffuse, not limited process - the phlegmon does not have a core.

Pus does not accumulate in a certain place, but evenly penetrates into deep tissues, which is fraught with the rapid spread of infection.

In the development of phlegmon, the reasons are associated with the reproduction in the tissues of bacteria. Pathogens can enter the subcutaneous tissues in different ways:

• with the flow of lymph and blood from other inflamed organs;
• with a breakthrough carbuncle, abscess;
• through damage to the skin and mucous membranes.

In most cases, phlegmon is caused by staphylococcus aureus. The second most common pathogen is streptococcus, for example, with a phlegmous form of erysipelas. Less commonly, it is Haemophilus influenzae and other types of bacteria.

The disease affects the deep layers of the skin - subcutaneous tissue and dermis. The epidermal layer does not let the infection out, so the closed phlegmon is not contagious.

Predisposing factors are:

• reduced immunity (HIV, taking certain drugs);
• diabetes;
• the presence of chronic inflammation;
• caries;
• soft tissue injury.

Where does phlegmon occur?

phlegmon photo on hand (finger)

Inflammation may be localized near an injury, ulcer, or other injury. It is a complication after surgery and appears near the surgical incision.

The inflammatory process of deep tissues often begins where the integrity of the skin is not broken. Phlegmons of the face and neck, thighs, feet, lower legs, and oral cavity are common.

Phlegmous inflammation can affect the anterior abdominal wall, and it can also be perirenal, intermuscular, subfascial, etc.

• Phlegmon can develop in any part of the body where there is fatty tissue.

Forms of phlegmon and features of the flow

Phlegmon disease can occur in several forms:

• serous;
• purulent;
• putrid;
• necrotic;
• anaerobic.

Serous phlegmon- is the initial form of inflammation, in which exudate is formed and the activity of leukocytes increases.

The border between the affected and healthy tissues is invisible, and a dense infiltrate is palpable on palpation.

• Without treatment, this form turns into a purulent or putrefactive phlegmon.

Purulent phlegmon- at this stage, leukocyte enzymes and pathogenic bacteria begin to corrode tissues. As a result, necrotization begins and a purulent secret is formed - it consists of dead bacteria and leukocytes and is colored greenish-yellow.

At the same time, ulcers and cavities covered with pus may appear. In severe cases, the infection spreads to muscle tissue and bones, destroying them.

putrid phlegmon- Affected tissues are green or brown in color, resemble jelly and emit a fetid odor. The causative agents are anaerobic bacteria.

With a putrefactive form, there is a high risk of blood poisoning with further damage to internal organs.

Necrotic phlegmon- Separate parts of the inflamed area die off, their delimitation from healthy tissues becomes noticeable. Abscesses form, which can break through on their own.

Anaerobic, or gas phlegmon- this is a rapidly progressive purulent-necrotic process that affects the loose tissue between the muscles, under the skin or under the fascia (unlike gas gangrene, which develops in the muscles).

The inflamed area is edematous, and necrosis begins in its central part, while foamy contents are released from the wound.

Phlegmous inflammation can also be:

• deep or superficial;
• acute or in rare cases chronic;
• limited or progressive.

Symptoms of phlegmon, the first signs

Phlegmous inflammation of the subcutaneous tissue has different forms, and the first signs of phlegmon are as follows:

• soreness of the affected area;
• puffiness;
• the skin becomes warm to the touch;
• redness appears if inflammation reaches the surface layers;
• enlargement of nearby lymph nodes;
• general weakness;
• the temperature can rise up to 38-40 °C.

Phlegmon develops, passing through two stages - infiltrative and purulent. In the first phase, a dense formation forms under the skin.

During the transition to the purulent stage, it softens, the symptoms are as follows:

• chills, fever (39-40 ° C);
• confusion, depressed or agitated mood;
• lack of appetite;
• weakness, feeling of weakness;
• tachycardia;
• headache.

In severe cases, the liver and spleen enlarge, the sclera of the eyes and mucous membranes turn yellow. Red stripes appear on the body along the inflamed lymphatic vessels. If the infection penetrates into the deep and superficial veins, thrombophlebitis develops.

Phlegmon of the mouth also called Ludwig's angina and develops when pathogens enter the submandibular region. The symptoms in this case are:

• swelling of the tongue, sometimes so severe that it blocks the throat, interfering with normal breathing;
• bad breath;
• pain in the area of ​​inflammation;
• increased salivation, pain when swallowing or inability to swallow;
• general loss of strength.

Phlegmon of the orbit develops rapidly and usually on one side. Symptoms:

• throbbing pain in the area of ​​inflammation;
• swelling and redness of the eyelid;
• malaise, nausea;
• inability to open the eye;
• fever.

At the same time, the risk of developing blindness is high. If inflammation affects the optic nerve, a purulent corneal ulcer, neuritis, is formed.

With late diagnosis due to eye atrophy, the chances of regaining vision are reduced to zero.

Phlegmon of the neck often accompanies purulent lymphadenitis. Angina, sinusitis, otitis media and other inflammatory diseases of the oral cavity and respiratory tract can become provocateurs.

The neck increases in diameter, when you try to turn your head, there is a sharp pain. There are also signs common to phlegmous inflammation - high fever, headache, weakness.

Abscesses and phlegmon of the maxillofacial region are dangerous because the infection can spread to the meninges and the brain, causing meningitis, brain abscess. If inflammation develops in the deep tissues under the fascia, then the risk of blood poisoning is high.

Treatment of phlegmon - drugs and methods

The treatment regimen for phlegmon includes:

1. Surgical opening to drain pus and reduce the risk of intoxication;
2. antimicrobial therapy;
3. Detoxification - drinking plenty of water, and in severe cases, the introduction of a solution of urotropine and calcium chloride intravenously;
4. Immunotherapy.

Surgical treatment of phlegmon

With phlegmon, the operation is the first and necessary therapeutic measure for phlegmon - this is the opening and drainage of the affected focus.

It is performed under general anesthesia, dissecting superficial and deep tissues. After the outflow of purulent contents, the cavity is washed and drained using tubes.

Then a bandage with antimicrobial ointment (Levomekol, Levosin) or hypertonic solution is applied to the wound. In the early stages after the operation, ointments based on fat or vaseline (tetracycline, Vishnevsky, synthomycin, etc.) are not used to treat the opening site, since they prevent the normal outflow of fluid from the wound. Sulyodopyron, Dioxidin, Miramistin are also used to treat the wound surface.

With phlegmon, recovery after surgery takes no more than a month.

If there are problems with the functioning of the immune system, then in addition to antibiotic therapy, immunoglobulin preparations are indicated at this stage. This protein helps stick together and deposit pathogens, which are then excreted from the body in the urine.

• At the initial stage of phlegmon, when the infiltrate has not yet formed, the operation is not prescribed.

In such cases, physiotherapy is indicated - warm compresses, sollux, UHF therapy, bandages with mercury ointment according to Dubrovin (the last two methods cannot be combined).

Drugs and antibiotics

In the treatment of abscesses and phlegmon, antibiotics are required. This is an essential addition to surgery.

In the first days, broad-spectrum antimicrobial agents are prescribed, and after determining a specific pathogen, the scheme is adjusted. For example, with pneumococcal origin, phlegmons use macrolides, beta-lactams, or lincosamides.

The course of antibiotic therapy lasts from 5 to 10 days, the exact duration is determined by the doctor.

If the antibacterial drug is canceled too early, then there is a risk of re-inflammation, and long-term use is fraught with the development of dysbacteriosis and negative effects on internal organs.

• The anaerobic form of phlegmon after opening is treated with antigangrenous sera administered subcutaneously or intramuscularly.

Enzyme products

For faster rejection of dead tissues of phlegmon, necrolytic preparations are used:

• enzyme ointments (Iruksol);
• proteolytic enzymes (Chimopsin, Trypsin).

They lyse (dissolve) necrotic tissues, increase the effectiveness of antibiotics, restore normal blood circulation in the affected area, and improve cellular metabolism.

Blood Purification

If phlegmon occurs in severe form with severe intoxication of the whole organism, extracorporeal blood purification is indicated:

• plasmapheresis - taking blood or parts of it, cleansing and introducing back into the bloodstream;
• hemosorption - outside the body, blood is passed through purifying sorbents and returned back;
• lymphosorption - a procedure for cleansing the lymph, similar to hemosorption.

Possible Complications

Complications of phlegmon legs photo

The spread of a purulent process can cause such complications of phlegmon:

• lymphadenitis, lymphangitis;
• erysipelas;
• pericarditis;
• sepsis;
• thrombophlebitis and, as a result, pulmonary embolism and death;
• purulent-inflammatory damage to the articular tissues;
• pleurisy;
• osteomyelitis;
• tendovaginitis.

There is also a risk of developing heart, liver, kidney failure. If purulent inflammation affects the arterial walls, there is a risk of severe bleeding and hemorrhagic shock.

Forecast

If the detection and treatment of the disease are carried out in a timely manner, then the prognosis of phlegmon is favorable.

The reverse picture occurs in the absence of therapy or its late onset, with rapidly developing purulent processes in the tissues between the internal organs. In this case, sepsis or other complications develop.

A spontaneous breakthrough of pus is considered a favorable outcome, but this happens in rare cases.

Which doctor should I contact with phlegmon?

Which doctors should you contact if you have phlegmon? This disease is treated by a surgeon.

With a certain localization of inflammation, the help of a narrow specialist in this field may be required - a thoracic, maxillofacial surgeon, etc.

Various formations under the skin are the result of an inflammatory process in the body. For greater convenience of natural classification, they were divided into several types. One of these formations will be considered in this article.

What is it - phlegmon?

What is it - phlegmon? This is a purulent inflammation of fatty tissue, which often occurs in an acute form and does not have clearly defined boundaries. If you do not engage in treatment, then it will spread to neighboring tissues, muscles, tendons. This process proceeds painfully and with an increase in temperature, general malaise.

Kinds

The different nature of phlegmon should be considered according to its types:

According to the mechanism of education:

• Primary (formed as a result of the introduction of microorganisms);
• Secondary (is a consequence of the spread of purulent inflammation from other organs).

According to the form of development:

• Acute;
• Chronic (woody).

Depth location:

• Superficial - damage to soft tissues;
• Deep - damage to the muscle layer.

For progressiveness:

• Delimited;
• Progressive.

According to the nature of inflammation:

• Serous - is formed at the initial stage, and then goes into a putrefactive or purulent form;
• Purulent - melting of tissues with the formation of pus;
• Necrotic - the formation of necrosis;
• Putrefactive - destruction of tissues with the formation of an unpleasant odor gas;
• Anaerobic - the formation of necrosis with gas.

By localization:

• Subcutaneous;
• Interorgan;
• Subfascial;
• retroperitoneal;
• Fibers of the mediastinum;
• Intermuscular;
• Persons;
• Jaws;
• brushes;
• Hips;
• Feet, etc.

Stages of development of the disease:

1. Edema
2. Seals (infiltration);
3. Abscess formation.

The formation of phlegmon in the cell space of any organ has its own name, to which the prefix "para" is attached: - inflammation of the fiber of the kidney, - inflammation of the fiber of the rectum, parametritis - inflammation of the tissue of the small pelvis next to the uterus, etc.

Causes

The main reason for the development of phlegmon is an infection that penetrates into fatty tissue through a wound or cut, through the bloodstream or lymph, from neighboring organs. Often, Staphylococcus aureus and Streptococcus aureus become pathogens, which provoke a purulent process. Proteus and Escherichia coli, putrefactive streptococcus provoke the putrefactive form of phlegmon. Various types of anaerobes are aggressive in nature, in which the disease develops quickly.

Thus, phlegmon is often the result of trauma, damage to the integrity of fatty tissue, penetration of infection into it also through blood or the spread of adjacent purulent inflammations. Often, phlegmon can develop as a result of chemical exposure: the introduction of gasoline, turpentine, etc. under the skin.

As concomitant factors is reduced immunity, which is observed with:

1. immunodeficiency, HIV or AIDS,
2. chronic diseases: tuberculosis, blood disease, diabetes mellitus
3. chronic intoxications: drug addiction, alcoholism.

Symptoms and signs of phlegmon of adipose tissue

The characteristic signs and symptoms of adipose tissue are:

• Temperature increase up to 40ºС.
• Headache.
• Sharp weakness.
• Thirst.
• Drowsiness.
• Chills.
• Vomit.
• Redness and swelling of the skin over the phlegmon.
• The limb swells if the phlegmon has developed on it.
• To the touch, the phlegmon is painful, motionless, hot.
• Skin shedding.
• Appetite disturbance.
• Decreased amount of urine.
• Movement provokes additional pain, which causes patients to lie motionless.
• The exudate becomes purulent, which makes the phlegmon softer.
• A breakthrough of pus either outward with the formation of a fistula, or inward, affecting neighboring tissues and organs.

With deep phlegmon, in addition to the symptoms described above, there is shortness of breath, a decrease in blood pressure, a weak, frequent pulse, cyanosis or yellowness of the skin, little urination, pain in the head.

Phlegmon in a child

It is quite possible for a child to develop phlegmon due to injury and infection. In this case, it is necessary to contact the pediatrician so that he eliminates it in the early stages of the disease.

Phlegmon in adults

In adults, injuries and injuries also occur. Often they neglect their own health, bringing other diseases to purulent inflammation. In both men and women, transmission of infection from another organ can occur. Here, too, one should not self-medicate, so as not to bring purulent inflammation to a chronic form and not cause complications.

Diagnostics

Diagnosis of phlegmon begins with a general examination, which shows all the symptoms of the disease. Additionally, analyzes are carried out to clarify the cause of its occurrence:

• Blood analysis.
• Sowing exudate on the pathogen.
• Analysis of urine.
• X-ray of the affected area.
• Ultrasound of the inflamed area.
• CT and MRI.

Treatment

Treatment of phlegmon is carried out exclusively in a stationary mode. Initially, it is necessary to eliminate pus, respectively, treatment begins with the evacuation of purulent exudate - opening and drainage. There is an excision of necrotic areas, as well as an additional opening and excision with the spread of pus. This procedure is not carried out only when the phlegmon is at the initial stage of its development, when pus has not yet formed.

How to treat phlegmon? Here, physiotherapy becomes effective:

• UHF therapy.
• Sollux lamp.
• Warm compresses and heating pads.
• Bandage according to Dubrovin (a compress with a yellow mercury mixture).
• Dermoplasty.
• infusion therapy.

Drugs that promote healing and rejection of dead tissue are actively used:

• proteolytic enzymes.
• Ointment with enzymes - iruksol.
• Sea buckthorn and rosehip oil.
• Troxevasin.
• Painkillers.
• Antibiotics.
• Antigangrenous sera.
• Urotropin solution.
• Calcium chloride solution.
• glucose solution.
• Adonilen, caffeine and other drugs that improve cardiovascular performance.
• Fortifying agents.
• Immunomodulators.

At home, treatment is not carried out, so as not to provoke a chronic disease or the spread of pus. Drinking plenty of water and eating foods rich in vitamins acts as a diet. The patient complies with bed rest with an overestimation of the limb that is affected.

life forecast

Phlegmon is a dangerous disease because it can be fatal. How long do patients live? It all depends on the area of ​​​​damage and the spread of pus. If you treat phlegmon, then the prognosis of life is favorable. But in the absence of medical assistance, complications are possible:

1. Thrombophlebitis.
2. Erysipelas.
3. Lymphadenitis.
4. Lymphangitis.
5. Sepsis.
6. Tendovaginitis.
7. Purulent meningitis.
8. Secondary phlegmon.
9. Purulent arthritis.
10. Purulent pleurisy.
11. Purulent arteritis.
12. Osteomyelitis.

In order to prevent neither the disease nor its complications, the prevention of the disease should be observed:

• Avoid injury.
• Treat infectious diseases promptly.
• At wounds to treat wounds and burns.
• Seek help if symptoms appear.

Phlegmon is a dangerous, acute inflammatory disease that requires immediate surgical and antibiotic treatment. With a decrease in immunity and the introduction of microorganisms into the places of damage to the skin and mucous membranes, they penetrate into the body and begin to actively develop in the intracellular space. The body, reacting to the pathogen, creates an accumulation of pus inside the human body. Purulent masses must be brought out, and for this purpose, a surgical opening of the inflammation is performed.

What it is

Phlegmon is an inflammatory process that occurs inside the subcutaneous fat and cellular spaces. Outside is defined as a dense formation, inside of which there is purulent contents. Phlegmon is provoked by a microorganism that often gets under the skin in the presence of external damage. Scratches, abrasions, bruises carry the risk of infection inside. In the future, the body begins to fight the pathogen, trying to prevent its spread throughout the body. In the place of localization of the microorganism, the inflammatory process begins and purulent contents are formed. In advanced form, phlegmon spreads to internal organs, bones, and muscles, and can be very life-threatening.

Causes

The occurrence of phlegmon is often provoked by a general weakening of the body's immune system and insufficient treatment of skin lesions. The main pathogens are microorganisms:

• staphylococcus;
• streptococcus;
• Pneumococcus;
• Pseudomonas aeruginosa;
• coli;
• proteus and others.

The most common causative agent of phlegmon is Staphylococcus aureus. The rapid development of resistance of this microorganism to drugs, good survival under adverse conditions, makes it an extremely dangerous pathogen for humans.

All these pathogens can normally surround a person in a normal habitat in a small amount. With a good state of immunity, the body is able to overcome a small number of pathogenic microorganisms.

In the presence of a chronic infection (caries, chronic tonsillitis, sinusitis, sinusitis), the immune system can be overloaded due to the constant fight against infection within the body and can not cope well with a new pathogen penetrating through skin lesions. If there is a disease that reduces immunity (tuberculosis, diabetes mellitus, HIV infection, and others), it is worth paying closer attention to the hygienic treatment of the skin in case of damage.

Thus, the cause of phlegmon is the penetration of the pathogen through skin lesions, while the state of immunity will be an important factor.

Frequent self-administration of antibiotics can cause pathogens to become resistant to these drugs. With subsequent inflammations, the usual antibiotic may not work, and you will have to look for rare drugs that the pathogen is not yet familiar with. This can lead to a longer and more difficult treatment.

Forms of phlegmon

There are five main forms of phlegmon. Each of them has its own flow characteristics. It is also possible the appearance of chronic phlegmon, which is characterized by a latent course.

Serous form

The serous form of phlegmon is the initial form, which over time can turn into a purulent or putrefactive form, depending on the treatment and the state of immunity. Outwardly, it is defined as swelling, itching and inflammation. There is no clear boundary between healthy and damaged areas. An exudate (liquid or effusion) forms inside the tissue at the site of infection, which at this stage is often a clear liquid consisting of a small amount of protein and white blood cells. This liquid may subsequently dissolve and leave no traces.

Necrotic form

This form differs from others in that the formation of dead tissue areas occurs. Subsequently, these areas are melted or torn off. The body separates the area of ​​inflammation from healthy tissue with the help of white blood cells and the formation of new connective tissue. But self-resorption of the exudate is impossible, an opening is required in an operative way, if there was no self-opening of the abscess.

putrid form

The infection spreads into the deep layers of the skin, the affected tissues acquire an unnatural color and an unpleasant odor. The putrefactive decay of tissues turns them into a loose semi-liquid mass and provokes severe internal poisoning of the body.

Purulent form

The form in which purulent contents are formed. Ulcers, fistulas may appear. Exudate takes the form of pus, soft tissues melt, and purulent inflammation begins to spread through the internal cavities of the body - ligaments, muscles, bones. They are destroyed and after treatment they cannot always fully recover.

anaerobic form

The presence of a fetid odor, which is due to the release of gas bubbles. The inflammatory process is common, with the appearance of dead areas, dark tissue color. A soft crunch when pressing on the affected area is a consequence of the presence of gas.

Chronic form

The above forms of phlegmon are characterized by a rapid course and severe intoxication. There is also a chronic form, which does not proceed so quickly and may appear in a patient with strong immunity, increased body resistance to the pathogen. The skin on the surface acquires a bluish tint, the internal accumulation of cells (infiltrate) is very dense.

Symptoms

The main forms of phlegmon are distinguished by an acute course of the process with severe intoxication (internal poisoning), an increase in temperature to 39-40 degrees. Severe weakness, chills and headache, the general serious condition of the patient often accompany the malignant process.

In the area of ​​phlegmon formation, redness, swelling, internal pain and itching, and an increase in the volume of the limb are characteristic. Regional lymph nodes are enlarged. In the area of ​​education, the general temperature is increased, there are no clear boundaries of inflammation. At the next stage, purulent contents appear inside the area of ​​​​inflammation, which requires an outlet. In the case of spontaneous exit, the formation of a fistula is possible. If this does not happen, the inflammation continues to spread to neighboring tissues. They also become inflamed, destroyed and increase the volume of purulent contents.

The general condition of the patient is characterized by:

• sharp and fast course of the process;
• rapid deterioration of the condition;
• high body temperature (39-40 degrees);
• feeling of soreness, abscess, redness, swelling in the inflamed area;
• chills;
• weakness;
• dizziness;
• pressure reduction;
• frequent and weak pulse;
• general intoxication (feeling of poisoning);
• yellowness of the skin;
• cyanosis of the extremities.

Phlegmon is distinguished from an abscess and on the basis of its lack of clear boundaries. It develops in any part of the body where fatty tissue is present.

Localization

Phlegmon can form in any part of the body, as a result of infection entering the body. If the skin or mucous membranes are damaged and pathogens dangerous to humans penetrate into the nearest internal cellular space, inflammation occurs with the formation of suppuration and the general serious condition of the patient.

With inflammation of the jaw due to caries, stomatitis or osteomyelitis, a phlegmon of the maxillofacial region may form. The penetration of the pathogen under the skin and mucous membranes due to odontogenic infections provokes the appearance of inflammation and purulent fusion of the inner layer of fiber. Most often, the pathogen penetrates through part of the tooth - the periodontium - the inner layer under the gum. In the event of a dental infection (caries, pulpitis) and late or unqualified treatment, the pathogen can penetrate deep into the tissues and provoke the occurrence of phlegmon.

Live healthy! Elena Malysheva talks about submandibular phlegmon.

On the neck

Phlegmon of the neck is one of the most dangerous options for the development of this process. It often leads to death. The causative agent, which is most often Staphylococcus aureus, leads to the appearance of neck phlegmon due to improper or untimely treatment of diseases.

Among them:

• angina,
• laryngitis,
• pharyngitis,
• caries,
• pulpitis,
• periodontitis,
• inflammation of the floor of the mouth,
• external damage to the skin of the neck,
• scarlet fever,
• diphtheria.

It is worth paying attention to the timely and competent treatment of these diseases. By following the doctor's prescription for the cure of these diseases, complications in the form of neck phlegmon can be avoided.

The main signs of phlegmon of the hand are high fever, pain and swelling of the hand. Redness and swelling also accompany this disease.

The main causes of phlegmon of the hand is the penetration of the pathogen through skin lesions - frostbite, burns, other skin lesions, including animal bites. When phlegmon of the hand appears, an operation should be performed to help cleanse the internal tissues of pus.

Phlegmon of the foot is characterized by an increase in the general body temperature, redness and swelling of the foot, pain. It is not always possible to identify phlegmon and distinguish it from diseases with similar symptoms, especially if it is located deep. It is worth paying attention to previous injuries or wounds of the foot. It is also possible the formation of this inflammation after untreated purulent diseases of the feet and fingers.

Phlegmon of the foot necessarily requires surgical treatment, otherwise further infection of the body with an infectious agent is possible.

The name phlegmon of the orbit is understood as inflammation with the formation of internal suppuration in the region of the orbital retina. Conditions that can result in orbital phlegmon include:

• injuries and operations in the eye area;
• squeezing and boils;
• puncture of the maxillary sinus in the treatment of sinusitis;
• dental diseases, especially in children, and others.

Symptoms of orbital phlegmon include common manifestations:

• increase in body temperature,
• headache,
• chills,
• brain phenomena,
• rave,

local reactions:

• swelling,
• pain,
• redness,
• deterioration of vision.

Phlegmon of the orbit is extremely dangerous for the health and life of the patient. An immediate visit to an ophthalmologist is recommended. Acute orbital phlegmon can occur within hours and requires immediate treatment.

Facial phlegmon is localized in the temples, masticatory muscles and jaws. This type of inflammation is also very dangerous for human life and requires immediate treatment from a specialist. Facial phlegmon can be distinguished by signs accompanying an acute inflammatory reaction - an increase in body temperature to 39-40 degrees, severe swelling and redness of facial tissues, pain, intoxication of the body and general poor health.

Phlegmon of newborns

Phlegmon in newborns is most often associated with Staphylococcus aureus. In most cases, the disease occurs on the 5-8th day. Due to the fact that the skin of a newborn is prone to violations of the integrity of its surface, the pathogen from the external environment can easily penetrate into the tissues. This is facilitated by:

• skin damage,
• diaper rash
• unhealed umbilical wound,
• contact with urine and faeces.

The skin of newborns has a good blood supply, which also facilitates the penetration of the pathogen.

Phlegmon in newborns is characterized by the appearance of a seal in the back, lateral and anterior surfaces of the chest. The initial swelling and redness of the affected area very quickly, within a few hours, acquires a purple or cyanotic hue.

Phlegmon of newborns is typical for children in the first weeks of life. During the first weeks of a child's life, contact with people suffering from purulent diseases is unacceptable. After the birth of a child, competent and complete care must be organized for him.

Treatment

Phlegmon refers to acute diseases that pose a direct threat to human life. For this reason, it is unacceptable to carry out treatment at home, folk or alternative methods. Only a qualified medical specialist will be able to treat phlegmon and avoid life-threatening complications.

In this regard, when symptoms of phlegmon appear, which generally include:

• increase in body temperature up to 39-40 degrees;
• general weakness;
• internal inflammation (pain, swelling, redness in any area),
• especially if this was preceded by external damage to the skin and mucous membranes (burns, frostbite, trauma, animal bites, dental treatment, etc.),

specialist advice should be sought immediately. Most often, phlegmon has a rapid course, actively progressing in a few hours. If left untreated, it threatens with an unfavorable outcome.

Modern medicine has proven phlegmon treatment regimens that will allow for optimal patient treatment.

Compulsory in the treatment of phlegmon is the use antibiotics And opening a wound to release pus. After surgical opening of the focus of inflammation, the patient's condition improves.

Means are also prescribed to reduce general intoxication (plentiful drinking, intravenous solutions, sorbents, extracorporeal neutralization of blood).

It is possible to prescribe immunotherapy drugs (immunoglobulins).

The modern range of drugs also includes bacteriophages, which act selectively, destroying the causative agent of the disease. The positive quality of these drugs is that the pathogen does not develop resistance to them.

It is unacceptable for the patient to independently reduce the period of taking antibiotics without the consent of the attending physician. An insufficient period of taking an antibiotic leads to the appearance in the body of pathogens that acquire resistance to the active substance of this drug and do not react to this substance in the future.

Surgeon Alexei Maksimov informs about the danger of acute purulent infection

Phlegmon is a rapidly developing acute inflammatory disease that threatens human life. This disease can be caused by a number of microorganisms, among which Staphylococcus aureus plays a leading role. If signs of internal tissue inflammation and deterioration of the general condition are detected, you should immediately contact the surgeon.

To prevent the occurrence of phlegmon, it is worth paying attention to improving the overall immunity of the body, treating emerging skin lesions.

Related Articles

Such inflammation does not have clear contours, in contrast to a similar abscess disease, limited by the walls of the inflammation cavity. Phlegmon tends to develop rapidly, capturing an increasing area, affecting the anatomical parts of the body located in the neighborhood. The disease can proceed as an idiopathic process or accompany, as a complication, previous purulent-inflammatory clinical forms (, abscess, etc.).

This life-threatening disease. The development of phlegmon usually begins on a relatively small area of ​​the skin surface, where there is swelling, swelling, redness and pain on pressure. The area of ​​such a lesion grows rapidly, the patient's temperature rises with all the symptoms accompanying this process, the lymph nodes located in the area of ​​​​the infected area increase.

Phlegmon develops, affecting not only the surface layers of the epidermis, but can also penetrate deep enough into the subcutaneous tissue, the dermis. The development of a purulent-inflammatory process in the tissue located in the region of a certain organ is called a word made up of two parts: “pair” and the name of the organ covered by phlegmon in Latin (paraproctitis, paranephritis, paraarticular, etc.).

More often disease caused by Staphylococcus aureus. In addition, streptococci, enterobacteria, Pseudomonas aeruginosa are isolated as pathogens, less often Escherichia coli is a provocateur. The development of infection is usually acute, but there are also chronic forms of phlegmon.

CAUSES

Phlegmon occurs due to the ingress of pathogens of pathogenic forms into the depths of the soft tissues of the subcutaneous tissue. They can be introduced through cuts and other traumatic injuries of the skin or mucous surfaces, as well as spread from the infectious focus through the blood and lymph. Possible contact infection with a breakthrough, abscesses. The disease also develops after the subcutaneous injection of various chemical liquids (turpentine, gasoline, etc.).

The nature of the flow of phlegmon is due to the varieties of pathogens.

For example, staphylococcus aureus and streptococcus provoke purulent inflammation, a more complex form - putrefactive processes - is caused by Escherichia coli or Proteus vulgaris.

The most severe are anaerobic phlegmons, the causative agents of which are obligate anaerobes - bacteria that develop in the absence of oxygen. They are able to quickly destroy tissues and provoke the rapid spread of the disease.

The main predisposing factor in the development of phlegmon is weakened human immunity. A decrease in its protective functions is caused by chronic diseases, exhaustion, immunodeficiency diseases, constant intoxication of the body with alcohol and drugs.

In children under six years of age, phlegmon may occur with localization in the upper body and head due to hemophilic infection.

CLASSIFICATION

Types of phlegmon are distinguished by the time of occurrence, development, the depth of tissue damage, the severity of the course of the disease, by localization, the nature of the impact and destruction.

By time of occurrence:

By development time:

• Acute phlegmon is characterized by swelling, induration and swelling at the site of the lesion, redness, fever in the patient, severe pain, limitation or complete lack of mobility of the affected part of the body. The deterioration of the patient's condition progresses, in the future, dense areas of infiltration soften, and foci of fluctuation appear.
• Chronic phlegmon (woody) develops in the case of high resistance of the human body and low virulence of pathogen strains. It is characterized by a slowly flowing inflammatory process affecting the subcutaneous connective and intermuscular tissues. There is an increase in temperature. Progressing, the tissues of the skin are involved in the pathological process, which acquire a bluish color and swelling characteristic of hyperemia. After a long period of time (from several weeks to several months), abscesses form in the place of phlegmon, without pain.

Depth of injury:

• Superficial - characterized by damage to the tissues of the subcutaneous tissue to the muscle layer.
• Deep - involved muscle tissue, intermuscular spaces and fatty tissue, enveloping the internal organs.

Distribution type:

• Delimited, is characterized by a local abscess, which is opened, drained after drug treatment with antibiotics at the initial stage of the disease.
• progressive phlegmon. When it develops, immediate surgical intervention is required. Affected tissues are opened along the entire length of the lesion, pus is removed, necrotic changes are excised, exudate is examined, subsequent surgical treatment of wounds, and antibiotic therapy are carried out.

By localization:

• Facial. Usually located in the segment of the temples, affects the jaws, inflammation covers the masticatory muscles, etc.
• Maxillary. It directly affects the tissues surrounding the jaw bones. There is a smell of decay from the mouth, the options for chewing, swallowing, and sometimes breathing are disturbed.
• Neck injury. In this case, it is impossible to predict how the disease will proceed. It often acts as a complication after inflammatory processes of the pharynx (,), and phlegmon is also the result of a neglected one.
• Carpal. It affects the central part, fingers and other segments of the palm.
• Phlegmon of the thigh, tissue damage makes it difficult for the patient to move.

According to the form of influence:

• Serous. This form develops at the onset of the disease. Serous inflammation passes with the accumulation of a characteristic exudate, the affected fatty tissue undergoes infiltration, acquires a gelatinous consistency, the tissues are saturated with a cloudy liquid fraction. The borders between the affected and healthy tissues are indistinguishable.
• Purulent form comes after the primary, serous. With this phlegmon, tissue histolysis occurs (their liquefaction with transformation into pus). The resulting turbid exudate is white, yellowish or greenish in color. At the site of the lesion, various kinds of fistulas and ulcerations appear. Purulent phlegmon can affect tendons, bone tissue, joints, muscles, and the latter, being saturated with pus, acquire a grayish color uncharacteristic for healthy tissues, there is no bleeding.
• putrid. Destroying tissue phlegmon, a gas of a specific putrefactive odor is released. Coloring of fabrics from dirty brown to dark green. The structure of the lesions is loose, the surface is slippery, and then they completely disintegrate to a mushy state. This form is accompanied by severe intoxication.
• Necrotic. Necrotic foci form on the affected areas, subsequently they melt or they are rejected, after which wound surfaces remain. With a favorable prognosis, a leukocyte wall is formed, followed by the formation of a granulation barrier. The inflammation is localized, at this place abscesses appear, opening on their own. If this does not happen, surgical intervention is performed.
• Anaerobic- the most severe form. Affected tissues have a fetid odor, acquire a dark gray boiled appearance without redness. When pressed, a slight crunch (crepitus) is heard, which indicates the presence of gas bubbles. Serous inflammation is accompanied by the formation of large necrotic areas.

The presented varieties of phlegmon have an acute course.

Taking malignant forms, they rapidly spread, affecting an increasing area of ​​the surrounding adipose tissue. The process is accompanied by severe intoxication.

SYMPTOMS

Phlegmon in acute forms develop rapidly. Patients have a significant increase in temperature above 40 ° C, which is accompanied by chills, headaches, thirst and dry mouth. Against the background of general intoxication, weakness, drowsiness are observed. Nausea and vomiting often occur. Increased blood pressure, disturbed heart rhythms. The number of urination in the patient is reduced up to their complete cessation.

On the affected area there is a seal with swelling, hot to the touch, the skin is shiny. It is not possible to determine clear boundaries of education. There is significant pain in this area, lymph nodes located near the focus of inflammation are enlarged. With the further development of the disease, the compacted areas tend to soften, form purulent cavities, the filling of which sometimes breaks out on its own through the fistula or spreads further to neighboring tissues, provoking further inflammation and destruction.

The symptomatology of deep phlegmon is more pronounced and manifests itself in the early stages.

DIAGNOSTICS

It is not difficult for a surgeon to diagnose phlegmon during a visual examination due to its pronounced clinical picture. Deep inflammations are studied with the help of ultrasound, radiographs, MRI and CT.

A general analysis of blood, urine is carried out as a standard, material is taken from the surface of the inflammation focus for sowing and detection of active bacterial forms, their sensitivity to antibiotics used for treatment is determined. In some cases, a puncture is prescribed from a deep focus of inflammation.

TREATMENT

The main method of treating phlegmon is a surgical operation to open them, clean them, further drain and wash the infected cavity.

It is possible to do without surgical intervention only if the disease is present at the earliest stages, before the formation of an infiltrate, when patients are prescribed antibiotic therapy and thermal procedures. In the postoperative period, treatment is continued with antibiotics, physiotherapy, immunomodulating therapy are prescribed.

COMPLICATIONS

Since serous-purulent fluids infected with pathogens spread throughout the body, entering the bloodstream and lymph, the development of diseases such as purulent thrombophlebitis, erysipelas, purulent, purulent lymphangitis, is possible. Facial phlegmon can provoke the occurrence of a purulent form of meningitis.

With the defeat of phlegmon of neighboring organs and tissues in the form of complications, the development of such purulent forms of diseases is possible: tendovaginitis, arthritis,. The most dangerous complication is productive-purulent arteritis, when the arteries become inflamed with their further softening and melting, resulting in profuse internal bleeding.

PREVENTION

Prevention of phlegmon is the prevention of skin damage, when receiving wounds and abrasions, the skin should treat with antiseptics. Also as a preventive measure is the prevention and timely treatment of various forms of pyoderma.

If the first signs of the initial stage of phlegmon appear, you should immediately seek qualified medical help.

PROGNOSIS FOR RECOVERY

With timely treatment of acute and woody phlegmon favorable prognosis. For advanced and severe forms of the disease (progressive, deep phlegmon, occurring between internal organs), as well as with facial lesions, the prognosis is often unfavorable.

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