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皮下软组织感染 - Infection of subcutaneous soft tissue

文章导读

很多人的皮肤软组织经常会感染,最开始的时候会出现红肿和疼痛,随着时间的增大开始排出脓液,并且很少会有炎症扩散的情况,但是患者的身体上会很明显的出现寒冷,头晕,头痛,精神萎缩等全身的症状,患者需要根据实际的临床表现,选择合适的方法治疗

皮下软组织感染 - Infection of subcutaneous soft tissue

病因

致病菌常见有金黄色葡萄球菌、溶血性链球菌、厌氧菌等细菌,侵入毛囊丰富的部位或者组织损伤部位引起感染,也可以继发于其他疾病,通过淋巴或血液传播而感染。

皮下软组织感染 - Infection of subcutaneous soft tissue

临床表现

1.疖

本病临床特点为局部出现红肿和疼痛小结节,以后逐渐增大,呈锥形隆起。继之,在其中央出现一个脓头,脓头可自行溃破,排出脓液而自愈,很少有炎症扩大形成周围蜂窝织炎或脓肿。一般无明显全身症状。若炎症反应较严重,可出现毒血症,可表现为明显畏寒、寒战、发热、头痛、精神萎靡等全身症状及血白细胞计数升高。

皮下软组织感染 - Infection of subcutaneous soft tissue

2.痈

初起时局部呈一片稍微隆起的紫红色浸润区,质地坚韧,界限不清,明显疼痛,继之在中央部的表面有多个粟粒状脓栓,破溃后呈蜂窝状,以后中央部发生组织坏死、溶解、塌陷,像"火山口",其内含有脓液和大量坏死组织。痈易向四周和深部发展,周围呈浸润性水肿,疼痛剧烈。局部淋巴结有肿大和疼痛。患者多有明显的全身症状,如畏寒、发热、全身不适、食欲不振等,易并发全身性化脓性感染。唇痈易引起颅内的海绵状静脉窦炎及急性化脓性脑膜炎,危险性更大。

3.丹毒

本病开始即有恶寒、发热、头痛、全身不适等。病变多见于下肢、面部。局部表现为皮肤发红且鲜艳(早期)、灼热、疼痛、稍微隆起,境界较清楚,按压红色区颜色变淡,离开后迅速复红。病变范围扩展较快,有的可起水泡,其中心处红色稍褪,隆起也稍平复。近侧的淋巴结常肿大、有触痛。丹毒继续加重时全身性脓毒症状加重,而皮肤和淋巴结的病变却少见化脓破溃。本病可能复发,反复发作可使淋巴管阻塞和淋巴淤滞导致皮肤粗厚和肢体肿胀(象皮肿)。


Article reading guidance

Many people's skin and soft tissue will often be infected. At the beginning, there will be swelling and pain. With the increase of time, pus will be discharged, and there will be little spread of inflammation. But the body of patients will be very obvious cold, dizziness, headache, mental atrophy and other systemic symptoms. Patients need to choose appropriate treatment according to the actual clinical manifestations. 。

皮下软组织感染 - Infection of subcutaneous soft tissue

Pathogeny

The common pathogenic bacteria are Staphylococcus aureus, Streptococcus hemolyticus, anaerobic bacteria and so on. They invade the rich parts of hair follicles or tissues to cause infection. They can also be secondary to other diseases and spread through lymph or blood.

皮下软组织感染 - Infection of subcutaneous soft tissue

Clinical manifestation

1. furuncle

The clinical features of this disease are local swelling and pain nodules, then gradually enlarged, showing a conical protuberance. Secondly, a pus appears in the center of the lesion. The pus can burst and discharge pus and heal spontaneously. Few inflammation enlarges to form peripheral cellulitis or abscess. Generally, there are no obvious systemic symptoms. If the inflammation reaction is serious, toxicemia can occur, which can be manifested as obvious chills, chills, fever, headache, mental malaise and other systemic symptoms, as well as elevated white blood cell count.

皮下软组织感染 - Infection of subcutaneous soft tissue

2. carbuncle

Initially, there was a slightly raised purple-red infiltration area with tough texture, unclear boundaries and obvious pain. Then there were many miliary pus plugs on the surface of the central part, which were honeycomb-shaped after the breakdown. After that, tissue necrosis, dissolution and collapse occurred in the central part, such as the "crater", which contained pus and a large number of necrotic tissues. Carbuncles tend to develop to the surrounding and deep areas with infiltrating edema and severe pain. Local lymph nodes are swollen and painful. Most patients have obvious systemic symptoms, such as chills, fever, general discomfort, loss of appetite and so on. They are easily complicated with systemic purulent infection. Lip carbuncle is easy to cause intracranial cavernous sinusitis and acute suppurative meningitis, which is more dangerous.

3. erysipelas

The disease begins with chills, fever, headache, general discomfort and so on. Lesions mostly occur in lower limbs and face. Local manifestations are red and bright skin (early), burning, pain, slightly raised, clearer realm, pressing red area color pale, quickly reddening after leaving. The scope of lesion expands rapidly, some can blister, the red color in the center fades slightly, and the protuberance is also slightly restored. The proximal lymph nodes are often swollen and tender. When erysipelas continues to aggravate, systemic sepsis symptoms become more severe, while skin and lymph node lesions are rare. This disease may recur. Recurrent attacks can cause lymphatic obstruction and lymphatic stasis leading to thick skin and swelling of limbs (elephant derma).