Phlegmon: Symptoms and Treatment

Phlegmon — an ailment, which is characterized by the formation of diffuse inflammation of a purulent nature. It affects mainly cellulose. Pathology has one, characteristic only for it, a feature — the process of inflammation does not have clearly delineated boundaries. He can freely and quickly spread to soft tissues, posing a threat not only to health, but also to the life of the patient.



In the risk group of the phlegmon of the face or other area of ​​the body, there are newborn children, people aged 17 to 35 years, and also elderly.

Pathogens

The phlegmon of the wrist, thigh or other part of the body develops due to the introduction of pathogenic microorganisms into the tissue. That is why clinicians divide phlegmon into two main types:


  • the development of which is provoked by absolutely pathogenic microorganisms
  • caused by conditionally pathogenic microorganisms that normally are present on the mucous membranes and skin of a human.

The main causative agents of this ailment are:


  1. Pneumococci
  2. Staphylococci
  3. Anaerobes are non-spore forming
  4. Streptococci
  5. E. coli
  6. Proteus

Reasons

The main cause of the progression of this inflammatory disease is the pathogenic activity of microorganisms that affect soft tissues. But it is worth noting that not all people who have been identified with these microbes developed phlegmon. This suggests that the appearance of this pathology requires a combination of such factors:


  • presence or absence of allergization in the body
  • the state of the immune system
  • total number of microorganisms that have entered the focus (soft tissues)
  • virulence of pathogenic microbes
  • blood circulation condition
  • the presence of drug resistance in microorganisms that penetrated the primary focus.

Views

In the medical literature phlegmon is classified by many features. Nonspecific phlegmon is of three kinds — anaerobic, purulent and putrefactive.

Classification by type of pathogen:


  1. gonococcal;
  2. fungus
  3. Staphylococcal;
  4. Streptococcal
  5. Pneumococcal
  6. clostridial;
  7. colibacillary;
  8. mixed infection.

Classification according to the mechanism of occurrence:


  • The independent form. In this case, the phlegmon of the hip, hand, foot and other parts of the body develops independently, and not against the background of other pathologies;
  • develops as a complication of surgical ailments
  • develops after surgery (phlegmon of the hernial sac)
  • phlegmon can occur due to damage to a certain part of the body.

Depending on the localization of the inflammatory process:


  1. phlegmon brush
  2. neck of phlegmon
  3. phlegmon of the century
  4. phlegmon of the foot;
  5. phlegmon of the lacrimal sac;
  6. Flegmon Fournier
  7. the phlegm of the orbit and the like.

Forms

Depending on the pathogenesis, this pathological entity is divided into the following forms:


  • serous. It is also called the initial stage of the development of the disease. It is characterized by the formation of an infiltrate, the formation of an inflammatory exudate, as well as the increased attraction of white blood cells to the focus of inflammation. At this stage, there is no clear boundary between healthy and affected soft tissues. If you do not start to treat phlegmon, then it quickly goes into a purulent or putrefactive form;
  • purulent. At this stage, because of the pathological activity of microorganisms, tissue necrosis starts, which leads to the formation of a purulent secretion. Its color is yellowish green. On the surface of the skin, erosions and ulcers begin to form, which are covered with a suppurative coating on top. If the body’s immune system weakens and does not sustain such a load, the inflammation from the tissues will pass to the bones and muscle structures — their destruction will begin;
  • putrefaction. The development of this form is provoked by anaerobic microorganisms. Its distinctive feature is that in the course of its life the bacteria secrete unpleasant odors. Therefore, wounds also exude them. Affected tissues are green or brown in color. If they try to remove, they will begin to disintegrate and give off an unpleasant smell;
  • necrotic. A distinctive feature of this form is the formation of necrotic tissue sites that are restricted from healthy tissues by the leukocyte shaft. This restriction becomes the reason that abscesses are formed in the localization of pathological foci, which can themselves be opened. Often there is a necrotic phlegmon of the newborn;
  • anaerobic. The process is serous. Of the places where necrosis occurs, specific gas bubbles are released.

Symptoms

Phlegmon has both local and general symptoms. Local — these are the classic signs that correspond to any inflammatory process:


  1. tissue swelling
  2. pain;
  3. redness of the skin;
  4. Local temperature increase;
  5. the affected organ weakly performs its functions.

The process of phlegmon progression can be divided into two stages — infiltration and purulent lesion. At the first stage there is a dense formation under the skin, which can not be detected by palpation. When a purulent lesion, softening occurs. If you carefully examine the affected area, you can see that there are red stripes around it — these are inflamed lymph vessels (a characteristic symptom).

Common symptoms that indicate a progression of a purulent-inflammatory process:





  • headache;
  • chills;
  • hepatomegaly;
  • splenomegaly
  • fever of up to 40 degrees;
  • impaired consciousness
  • decreased appetite
  • icterus of mucous membranes
  • general weakness.

In the case of severe pathology, violations are observed from the side of important organs:


  1. collapse
  2. liver failure
  3. kidney failure
  4. failure in the operation of the large and small intestine

Also, the symptoms of pathology depend on the site of the localization of the inflammatory process.

Education on the neck

In this case, in the chin or submandibular region (in the region of the lower jaw), inflammatory formations arise. This process is accompanied by general weakness, fever, malaise, headache. The affected area swells. Phlegmon neck is dangerous because it is rapidly progressing, covering all new tissues. As a result, the lower jaw, facial tissues, and even the brain (purulent meningitis) are affected. The phlegmon of the neck should be treated as soon as possible in order to avoid dangerous complications. Treatment of the phlegmon of the neck is handled by a surgeon.

Phlegmon of the century

The phlegmon of the century is manifested by the following symptoms:


  • In the region of the century, a diffused compaction is formed;
  • the eyelid swells
  • Local temperature increase (per century)
  • soreness of the affected area
  • edema rapidly spreads to the entire eye, as well as to the second eyelid
  • increase in regional lymph nodes
  • headache;

Fournier disease

Fournier’s pathology is one of the most dangerous and rapidly developing. The causative agent is an anaerobic infection. Phlegmon Fournier begins acutely, the scrotum tissues die quickly. In this case, the patient’s condition is very difficult.

Symptoms of Fournier disease:


  1. chills;
  2. malaise
  3. temperature increase;
  4. headache;
  5. tachycardia
  6. severe pain in the scrotal area
  7. body size increases;
  8. hyperemia and swelling of the skin
  9. Fournier’s disease in the testes accumulates effusion
  10. the scrotum acquires a «woody» consistency;
  11. regional lymphadenitis
  12. If Fournier’s disease does not begin to be treated in a timely manner, blisters with serous-hemorrhagic contents and brown spots will form on the skin of the scrotum. This already indicates that gangrene develops;
  13. Without the treatment of phlegmon, Fournier becomes the cause of complete melting of the scrotum.

Formation of the focus on the hand

The phlegmon of the hand develops because of the penetration of purulent infection into the tissues. Usually education is formed in the center of the palm, on the wrist or on the tip of the thumb. In this case, the patient will feel unpleasant twitching and pulsation in the limbs. Also, the affected area hurts.

Ophthalmic phlegmon or lacrimal sac

The phlegmon of the lacrimal sac is very rare. As a result of its appearance, the affected area swells and becomes sharply painful. The patient does not practically open the eye, near which the phlegmon of the lacrimal sac was formed.

Ophthalmic phlegmon is an extremely dangerous pathology. It must be diagnosed as early as possible and treated, since delay can cause irreparable harm to health. If the phlegm of the orbit passes to the optic nerve, then the person will go blind. And to restore the nerve endings then it will be impossible.

The phlegmon of the orbit is manifested by the appearance of severe headaches, pain in the eye area, fever, sometimes nausea. These unsettling symptoms can not be ignored, since inflammation can spread very quickly and affect nearby tissues. The phlegmon of the orbit can also spread to the brain.

Education on the lower jaw

Phlegmon on the lower jaw is a dangerous disease that can affect the deep layers of the jaw and the branch of the nerve. The main reason for the progression of the disease is the trauma of the mouth or lower jaw, through which the infection could penetrate into the tissues (tooth extraction, strokes, therapeutic treatment of the canals, etc.).

The phlegmon of the lower jaw is manifested by such symptoms:


  • putrid odor from the mouth
  • swelling of the tongue
  • severe edema on the lower jaw
  • pain in the neck and lower jaw. The patient may initially feel that his teeth ache until the edema appears;
  • high temperature;
  • the asymmetry of the face
  • violation of speech and swallowing function
  • the patient can not fully open his mouth

The phlegmon of the jaw should be treated as soon as possible, and not only because it can cause loss of teeth. If the edema spread to the entire jaw, neck and respiratory tract, that is a high risk of developing meningitis, asphyxia, vein thrombosis on the face, sepsis.

Newborn phlegmon

Separately it is necessary to allocate phlegmon for newborns. This is a purulent-infectious disease that provokes staphylococci. In children, it is particularly difficult, since the reactivity of the body is not yet formed. Development of phlegmon in newborns can be preceded by mastitis or intertrigo.

Symptoms:


  1. increase in body temperature;
  2. the child is restless
  3. Poor sucking of the chest
  4. edema and redness of the skin mostly on the back. The spot grows and acquires a blue tint. If you feel it, you can note its density, and in the center — fluctuation.

Diagnostics


  • Inspection;
  • Ultrasound;
  • CT;
  • MRI
  • laboratory tests
  • Diagnostic puncture if necessary.

Treatment

Treatment phlegmon (on the brush, Fournier, on the face) is based on the following principles:


  1. phlegmon opening to ensure a normal outflow of pus and reduce symptoms of intoxication
  2. antibiotic therapy for the destruction of pathogenic microorganisms
  3. detoxification therapy
  4. Immunotherapy.




It is especially important to treat Fournier’s disease as soon as possible, since delay or incorrectly chosen tactics of treatment can cause gangrene progression. Treatment of any type of phlegmon is carried out only in a hospital and under the supervision of qualified surgeons.