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

Section Description

Purulent diseases of the skin and subcutaneous tissue is an extensive group of pathologies of various types, including lesions of the skin by a wide variety of infectious agents. Any person can face purulent pathologies.

Causes

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

• penetration under the skin of various infectious agents, which are often pathogenic microorganisms;
• exposure to various stimuli of a physical type, 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.

Another key factor that is necessary for the development of an infection under the skin or on it, doctors consider a decrease in the body's immune defenses. Often, if immunity is not reduced, the disease simply does not develop even if the infection is in the affected area.

Symptoms

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

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

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

Kinds

Doctors today distinguish various types of skin inflammations. 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 of the sebaceous glands and hair follicles.

Hydradenitis

Hidradenitis is an inflammation not of adipose tissue, but of a sweat gland, which is often accompanied by the formation of an abscess (mainly the sweat glands in the armpits and groin are 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 is a large abscess, most often located on the surface of the skin (several hair follicles are involved in the pathological process).

Felon

Panaritium is an inflammation of the skin that affects only the fingers or toes (the upper limbs suffer more often, the nail plate may be involved in the process).

Paronychia

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

pyoderma

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

bedsores

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

acne

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, with a long course, can be complicated by the addition of pathogenic microflora.

Folliculitis

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

Furuncle

Furuncle - melting of the sebaceous gland and hair follicle, which has a purulent-necrotic character.

Which doctor treats purulent inflammations on the skin?

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

Additionally, if necessary, it is possible to take discharge and abscesses, followed by a study to identify the pathogen. Once the pathogen is known, antibiotic susceptibility testing is recommended to improve the effectiveness of therapy.

General principles of treatment

Skin purulent pathologies are not always easy to treat. In this regard, different tactics are recommended for the treatment of children and adults.

children

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

adults

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

If the area of ​​​​inflamed skin is very large, and pus cannot be removed using conservative methods, surgical intervention is used.

Prevention

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

• promptly treat all skin lesions;
• engage in the treatment of chronic diseases that can provoke skin damage with the subsequent development of an infectious process;
• observe the rules of hygiene;
• carefully perform manicure and other similar manipulations.

An inflamed area of ​​\u200b\u200bthe skin is always unpleasant, especially if the process is accompanied by the release of pus. A timely visit to the 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 focus of inflammation, microorganisms, blood cells. 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 splitting dead and dystrophically altered structures in the lesion, including collagen and elastic fibers, so purulent inflammation is characterized by tissue lysis. Along with polymorphonuclear leukocytes capable of phagocytizing and killing microorganisms, bactericidal factors (immunoglobulins, complement components, etc.) are present in the exudate. Bactericidal factors produce viable leukocytes, they also arise from the decay of dead leukocytes and enter the exudate along with blood plasma. In this regard, pus retards the growth of bacteria and destroys them. Neutrophilic leukocytes of pus have a diverse structure depending on the time of their entry from the blood into the area of ​​suppuration. After 8-12 hours, polymorphonuclear leukocytes in 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 tissues and organs. Its course can be acute and chronic. The main forms of purulent inflammation: abscess, phlegmon, empyema, purulent wound, acute ulcers.

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

◊ A few hours after the onset of purulent inflammation around the accumulation of exudate, a shaft of blood cells is visible: monocytes, macrophages, lymphocytes, eosinophils, fibrin accumulations containing polymorphonuclear leukocytes. At the same time, fibrin, which has chemotaxis to polymorphonuclear leukocytes, stimulates their emigration from the vessels and entry into the inflammation site. On fibrin, circulating immune complexes are deposited - chemoattractants for complement, which has pronounced histolytic properties. After three days, the formation of granulation tissue begins around the abscess and a pyogenic membrane appears. Through the vessels of the granulation tissue, leukocytes enter the abscess cavity and partially remove decay products from it. With immunodeficiency, the patient has a tendency to melt the tissues surrounding the abscess. In the chronic course of an abscess, the 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, of mature connective tissue.

● Phlegmon-purulent diffuse inflammation with impregnation and exfoliation 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 features 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, appendix wall, meninges, etc. (Fig. 4-4). Phlegmon of fibrous fatty tissue is called cellulite.

◊ Phlegmon is of two types:

mild if lysis of necrotic tissues predominates;

hard, when coagulative necrosis and gradual rejection of tissues occur in the inflamed tissue.

Rice. 4-4. Purulent leptomeningitis and encephalitis. Stained with hematoxylin and eosin (x150).

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

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

● Empyema - purulent inflammation of body cavities or hollow organs. The reasons for the development of empyema are both purulent foci in neighboring organs (for example, lung abscess, empyema of the pleural cavity), and a violation of the outflow of pus in case of purulent inflammation of hollow organs (gall bladder, appendix, fallopian tube, etc.). At the same time, local defense mechanisms are violated (constant renewal of the contents of hollow organs, maintenance of intracavitary pressure, which determines blood circulation in the wall of a hollow organ, synthesis and secretion of protective substances, including secretory immunoglobulins). With a long course of purulent inflammation, obliteration of hollow organs occurs.

● A purulent wound is a special form of purulent inflammation that occurs as a result of suppuration of a traumatic, including a 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 trauma and traumatic edema.

◊ Secondary suppuration - recurrence 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 associated with 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 are most often 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 exposure, microorganisms). Sometimes primary acute ulcers are a consequence of dermatitis (erysipelas, contact dermatitis, etc.). Purulent-necrotic tissue changes are characteristic, and the predominance of one or another component depends on the etiological factor. The 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 occur with stress, endocrinopathies, medication, neuro-reflex, trophic, vascular, specific.

The morphology of secondary and symptomatic acute ulcers is largely similar. Their localization is mainly the stomach and duodenum. Often there are several such ulcers. Their size is initially small, but multiple ulcers tend to merge. At the bottom of the ulcer - necrotic detritus impregnated with fibrin and covered with mucus. In the submucosal layer expressed neutrophilic, sometimes eosinophilic infiltration. Steroid ulcers are characterized by a mild inflammatory reaction around the ulcer and intense sclerosis.

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

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