Throat inflammation (inflammation of the larynx) - Gargle prepared with fenugreek seeds, with the addition of apple cider vinegar, very useful for colds. It is prepared like this: 2 tbsp. spoons of seeds pour 1 liter cold water and simmer for half an hour over low heat. Then the decoction

Section Description

Purulent skin diseases and subcutaneous tissue– a wide group of pathologies of various types, including lesions skin a wide variety of infectious agents. Anyone can encounter purulent pathologies.

Reasons

Many patients wonder why inflammation occurs under or on the skin? The reasons are usually the following factors:

• penetration of various infectious agents under the skin, which are often pathogenic microorganisms;
• exposure to various physical irritants followed by the addition of an infectious process;
• various mechanical injuries, such as bruises, sprains, can lead to a purulent process;
• Contact with chemical agents is another common cause of skin problems.

Doctors believe that another key factor that is necessary for the development of infection under the skin or on it is a decrease in the body’s immune defense. Often, if immunity is not reduced, the disease simply does not develop even if the infection is in the affected area.

Symptoms

If an area under or on the skin becomes inflamed, patients usually complain of a number of characteristic symptoms, which are difficult to confuse with other diseases. Noteworthy:

• availability local redness, strictly limited, without distribution in the initial stages;
• the presence of pain, which can be felt both at rest and when, for example, pressing on the problem area;
• formation in the affected area of ​​a specific red protrusion, at the end of which there may be a white inclusion (indicating the presence of a purulent core);
• local hyperthermia (increased skin temperature);
• with active processes affecting large areas, general symptoms may appear, such as increased body temperature, weakness, malaise, nausea, etc.

If infection occurs general symptoms, it is recommended to immediately consult a doctor, as this indicates the progression of the disease.

Species

Doctors today distinguish various types of skin inflammation. The division occurs based on the prevalence of the process, the location of the pathological focus and other data.

Abscess

An abscess is a purulent-necrotic process, which is often accompanied by the formation of a cavity, which is limited to the capsule.

Acne

Acne is a disease that develops most often on the face, accompanied by the formation of purulent foci due to improper functioning sebaceous glands and hair follicles.

Hidradenitis

Hidradenitis is an inflammation not of adipose tissue, but of the sweat gland, which is often accompanied by the formation of an abscess (the sweat glands in the armpits and groin are mainly affected if the patient neglects the rules of hygiene).

Atheroma

Atheroma is a type of inflammation under the skin that develops as a result of blockage of the sebaceous gland and is considered a tumor-like process.

Impetigo

Impetigo is a type of infectious skin lesion in children and adults, which is provoked by contact with streptococci or staphylococci.

Carbuncle

Carbuncle - abscess large sizes, most often found on the surface of the skin (in pathological process multiple hair follicles are involved).

Felon

Panaritium is an inflammation of the skin that affects only the fingers or toes (the upper extremities are more often affected; the nail plate may be involved in the process).

Paronychia

Paronychia is the localization of an infectious process in the area of ​​the nail fold.

Pyoderma

Pyoderma is a complication that can result from dermatitis, minor injuries and skin cuts of various origins if an infection settles on the wounds.

Bedsores

Bedsores are necrotic changes in tissue due to constant pressure placed on them, often accompanied by a purulent process.

Pimples

Pimples are small formations on the skin filled with purulent contents.

Sycosis

Sycosis is an inflammatory process in the hair follicles that occurs chronically, with regular relapses.

Streptoderma

Streptoderma is an infectious skin disease caused by streptococci, which mainly affects young children.

Trophic ulcers

Trophic ulcers are initially not an infectious, but a trophic process, which over a long period can be complicated by the addition of pathogenic microflora.

Folliculitis

Folliculitis is the involvement of hair follicles in the pathological process, which is accompanied by the formation of small heads on the skin filled with pus.

Furuncle

Furuncle is a melting of the sebaceous gland and hair follicle, which is purulent-necrotic in nature.

Which doctor treats purulent inflammations on the skin?

With the development of purulent inflammatory diseases skin, it is first recommended to consult a dermatologist, since he is the one who treats the skin. A dermatologist, if necessary, can involve a surgeon, infectious disease specialist, allergist and other doctors in working with the patient.

Diagnostics

Diagnosis of the disease is often not difficult, since the pathological focus is located close to the surface of the skin and is visible to the naked eye. To make a diagnosis, a doctor usually needs to visually identify the pathological area.

Additionally, if necessary, it is possible to take discharge and ulcers with subsequent examination to identify the causative agent. Once the causative agent is known, antibiotic susceptibility testing is recommended to improve the effectiveness of therapy.

General principles of treatment

Purulent skin pathologies are not always easy to treat. In this regard, it is recommended to use different tactics for treating children and adults.

Children

• local antibiotic therapy aimed at eliminating the infection;
• active vitamin therapy;
• prescribing a diet that will reduce the likelihood of relapses;
• physiotherapeutic and rehabilitation measures.

Adults

In adults, as in children, preference is given conservative treatment. It is possible to use antibiotics not only local, but also systemic action to achieve the best therapeutic effects. Symptomatic therapy is also carried out, aimed at eliminating signs of the disease that cause inconvenience to the patient (pain relief, dressings, eliminating symptoms of intoxication during an extensive process, etc.).

If the area of ​​inflamed skin is very large and the pus cannot be removed with conservative methods, use surgery.

Prevention

Since purulent inflammation of the skin and subcutaneous tissue is often infectious in nature, to prevent pathology it is recommended:

• promptly treat all skin lesions;
• treat chronic diseases that can cause skin damage with the subsequent development of an infectious process;
• observe the rules of hygiene;
• Perform manicures and other similar manipulations with care.

An inflamed area of ​​skin is always unpleasant, especially if the process is accompanied by the release of pus. A timely visit to a doctor will allow you to stop the process in time, preventing it from progressing too much.

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Purulent inflammation is characterized by the formation of purulent exudate. This is a creamy mass consisting of cells and tissue detritus of the inflammation site, microorganisms, shaped elements blood. The number of the latter is 17–29%, mainly viable and dead granulocytes. In addition, the exudate contains lymphocytes, macrophages, and often eosinophilic granulocytes. Pus has a specific odor, a bluish-greenish color of various shades, the protein content in it is more than 3–7%, globulins usually predominate, the pH of the pus is 5.6–6.9.

Purulent exudate contains various enzymes, primarily proteases, capable of breaking down dead and dystrophically changed structures at the site of damage, including collagen and elastic fibers, therefore tissue lysis is characteristic of purulent inflammation. Along with polymorphonuclear leukocytes that can phagocytose and kill microorganisms, the exudate contains bactericidal factors (immunoglobulins, complement components, etc.). Bactericidal factors produce viable leukocytes; they also arise from the breakdown of dead leukocytes and enter the exudate along with blood plasma. In this regard, pus inhibits the growth of bacteria and destroys them. Neutrophilic leukocytes of pus have a varied structure depending on the time of their entry from the blood into the area of ​​suppuration. After 8–12 hours, polymorphonuclear leukocytes in the pus die and turn into “purulent bodies.”

The cause of purulent inflammation is pyogenic (pyogenic) staphylococci, streptococci, gonococci, typhoid bacillus, etc. Purulent inflammation occurs in almost any tissue and organ. Its course can be acute and chronic. The main forms of purulent inflammation: abscess, phlegmon, empyema, purulent wound, acute ulcers.

● Abscess - limited purulent inflammation with the formation of a cavity filled with purulent exudate. It occurs in viable tissues after strong exposure to microorganisms or in dead tissues, where autolysis processes increase.

◊ Already a few hours after the onset of purulent inflammation, a shaft of blood cells is visible around the accumulation of exudate: monocytes, macrophages, lymphocytes, eosinophils, fibrin accumulations containing polymorphonuclear leukocytes. In this case, fibrin, which has chemotaxis to polymorphonuclear leukocytes, stimulates their emigration from the vessels and entry into the site of inflammation. On fibrin, deposition of circulating immune complexes occurs - chemoattractants for complement, which have pronounced histolytic properties. After three days, granulation tissue begins to form around the abscess and a pyogenic membrane appears. Through the vessels of the granulation tissue, leukocytes and partial removal from it decomposition products. With immunodeficiency, the patient has a tendency to melt the tissue surrounding the abscess. During the chronic course of the abscess, granulation tissue matures, and two layers appear in the pyogenic membrane: the inner one, facing the cavity, consisting of granulations, fibrin, detritus, and the outer one - from mature connective tissue.

● Phlegmon is a purulent diffuse inflammation with impregnation and separation of tissues with purulent exudate. The formation of phlegmon depends on the pathogenicity of the pathogen, the state of the body's defense systems, the structural characteristics of the tissues where the phlegmon arose and where there are conditions for the spread of pus. Phlegmon usually occurs in the subcutaneous fat, intermuscular layers, the wall of the appendix, the meninges, etc. (Figure 4-4). Cellulitis of fibrous fatty tissue is called cellulite.

◊ Phlegmon is of two types:

soft, if lysis of necrotic tissue predominates;

hard, when coagulation necrosis and gradual tissue rejection occurs in the inflamed tissue.

Rice. 4-4. Purulent leptomeningitis and encephalitis. Hematoxylin and eosin staining (x150).

◊ Complications of phlegmon. Arterial thrombosis is possible, resulting in necrosis of the affected tissues, for example, gangrenous appendicitis. Often the spread of purulent inflammation to lymphatic vessels and veins, in these cases purulent thrombophlebitis and lymphangitis occur. Phlegmon from a number of localizations, under the influence of the gravity of pus, can flow along the muscle-tendon sheaths, neurovascular bundles, fatty layers into the underlying sections, forming accumulations there that are not enclosed in a capsule (cold abscesses, or leaks). More often this spread of pus causes acute inflammation organs or cavities, for example, purulent mediastinitis - acute purulent inflammation of the mediastinal tissue. Rejection of necrotic and coagulated tissues with solid phlegmon can lead to bleeding. Sometimes complications arise associated with severe intoxication, which always accompanies purulent inflammation.

◊ Outcomes. Healing of phlegmonous inflammation begins with its delimitation with the formation of a rough scar. Typically, phlegmon is removed surgically, followed by scarring of the surgical wound. If the outcome is unfavorable, generalization of the infection with the development of sepsis is possible.

● Empyema is purulent inflammation of body cavities or hollow organs. The reasons for the development of empyema are as purulent foci in neighboring organs (for example, lung abscess, empyema pleural cavity), and a violation of the outflow of pus during purulent inflammation of hollow organs (gallbladder, vermiform appendix, fallopian tube etc.). In this case, local protective mechanisms are disrupted (constant renewal of the contents of hollow organs, maintenance of intracavitary pressure, which determines blood circulation in the wall of the hollow organ, synthesis and secretion of protective substances, including secretory immunoglobulins). With a long course of purulent inflammation, obliteration of the hollow organs occurs.

● Purulent wound - special shape purulent inflammation, which occurs as a result of suppuration of a traumatic, including surgical, wound or when a focus of purulent inflammation is opened into the external environment with the formation of a wound surface. There are primary and secondary suppuration in the wound.

◊ Primary suppuration occurs immediately after injury and traumatic edema.

◊ Secondary suppuration - relapse of purulent inflammation.

The participation of bacteria in suppuration is part of the process of biological cleansing of the wound. Other features of a purulent wound are related to the conditions of its occurrence and course.

◊ Complications of a purulent wound: phlegmon, purulent-resorptive fever, sepsis.

◊ The outcome of a purulent wound is its healing by secondary intention with the formation of a scar.

● Acute ulcers most often occur in the gastrointestinal tract, less often on the surface of the body. By origin, primary, secondary and symptomatic acute ulcers are distinguished.

◊ Primary acute ulcers occur on the surface of the body, in the esophagus or stomach with direct action on the skin or mucous membrane of damaging factors (acids, alkalis, thermal effects, microorganisms). Sometimes primary acute ulcers are a consequence of dermatitis (erysipelas, contact dermatitis etc.). Purulent-necrotic changes in tissue are characteristic, and the predominance of one or another component depends on etiological factor. Healing of such ulcers usually leaves scars.

◊ Secondary acute ulcers occur with extensive burns of the body, ischemia of the gastrointestinal tract, etc.

◊ Symptomatic acute ulcers can be caused by stress, endocrinopathies, medicinal, neuro-reflex, trophic, vascular, specific.

Morphology of secondary and symptomatic acute ulcers similar in many ways. Their localization is mainly the stomach and duodenum. It is not uncommon for several of these ulcers to occur. Their sizes are small at first, but multiple ulcers tend to merge. At the bottom of the ulcer there is necrotic detritus, saturated with fibrin and covered with mucus. In the submucosal layer, neutrophilic and sometimes eosinophilic infiltration is pronounced. Steroid ulcers are characterized by a mild inflammatory reaction around the ulcer and intense sclerosis.

◊ Complications of acute ulcers: vascular erosion and gastrointestinal bleeding, with steroid ulcers, sometimes perforation of the organ wall.

◊ The outcome of uncomplicated secondary acute ulcers is usually tissue healing.