Deep chest wall soft tissue infection
Introduction
Introduction to deep soft tissue infection of the chest wall Deep soft tissue of the chest may be caused by trauma, epidermal acute suppurative infection, acute suppurative mastitis, empyema and sepsis caused by loose connective tissue inflammation called deep wall soft tissue infection. basic knowledge The proportion of illness: 0.0003%-0.0005% Susceptible people: no special people Mode of infection: non-infectious Complications: lung abscess septic shock sepsis
Cause
Causes of deep soft tissue infection in the chest wall
(1) Deep soft tissue of the chest may cause loose connective tissue inflammation due to trauma, acute suppurative infection of the epidermis, acute suppurative mastitis, empyema and sepsis.
(2) Milk deposition: This is an important cause of the disease. The causes of milk deposition are: nipple dysplasia (too small or invagination) hinders breastfeeding; excessive milk or low sucking of the baby, the milk can not be completely empty; the milk duct is impassable, affecting milk discharge.
(C) bacterial invasion: rupture of the nipple, skin erosion around the areola, this is the main way of infection. Infant mouth infection, breast pumping or nipple-sleeping, which causes bacteria to enter the milk duct directly is also one of the ways of infection.
Prevention
Prevention of deep soft tissue infection in the chest wall
(1) In the late pregnancy, always warm the water, often scrub the breasts, nipples, and develop habits to strengthen their skin.
(2) pregnant women with nipple retraction, can often try to squeeze the lifting method to correct, or take a piece of walnut into two halves, go to the meat, the edges are polished, respectively, buckled on the two nipples, and then shrink with a bandage Tight (do not use too much force to avoid avascular necrosis of the nipple), so that the nipple is exposed.
(3) Develop the habit of regular breastfeeding, pay attention to the cleansing of the nipple, and suck the milk every time you breastfeed. If there is siltation, you can use a hot towel to iron, or use a breast pump to help discharge the milk. After breastfeeding, apply milk to the nipple and On the skin around the areola.
(4) If the maternal milk is too much, and it has not been exhausted after breastfeeding, it can be squeezed with a breast pump or by hand to drain the milk and prevent siltation.
(5) If the nipple is broken or chapped, use sesame oil, egg butter or white jade cream.
(6) When weaning, we should first reduce the number of breastfeeding, and then weaning. Before weaning, we use malt, 60 grams of hawthorn, or 15 grams of fried soup for the sake of breast; if the breast is aggravated, it can be applied externally with skin nitrate. Promote its dissipation.
Complication
Complications of deep soft tissue infection of the chest wall Complications, lung abscess, septic shock sepsis
1 large amount of fluid exudation and poor control of the disease, resulting in low blood volume and septic shock,
2 bacteremia: bacteria in the inflammatory lesions invade the bloodstream through blood vessels or lymphatic vessels, bacteria can be found from the bloodstream, but no symptoms of systemic poisoning.
3. Septicemia: Bacteria invading the blood grow and multiply, and produce toxins, causing systemic poisoning symptoms and pathological changes, called sepsis.
4 bacterial toxins or toxic products are absorbed into the blood, causing symptoms of systemic poisoning, called toxemia. Clinically, there are symptoms of high fever, chills and other poisoning, often accompanied by degeneration or necrosis of parenchymal cells such as heart, liver and kidney, but blood culture is negative, that is, no bacteria can be found. In severe cases, toxic shock can occur.
Symptom
Chest wall deep soft tissue infection symptoms common symptoms chest wall pain fever soft tissue infection chills cellulitis shoulder movement restricted
Under the chest muscle cellulitis often caused by acute lymphadenitis and empyema in the axilla, the position is deep, the chest wall can be diffuse swelling, early can appear fever, chills symptoms, late local swelling or shoulder and back restriction.
Cellulitis under the scapula is often caused by inflammation of the chest wall, chest infection, and osteomyelitis. Due to the deeper position, the symptoms on the surface of the body are not obvious. In the late palpation, swelling, pain or local fluctuation can be seen along the scapula.
Local infection of the chest wall is not obvious, and there may be fever, local pain is obvious, the most valuable diagnosis is based on puncture and pus extraction.
Examine
Examination of deep soft tissue infection of the chest wall
1, the clinical manifestations are mainly red, swollen, hot, painful lesions, and some cases may be accompanied by fever, increased white blood cells.
2, physical examination: local redness, increased skin temperature, tenderness, induration, lumps or centripetal spread of red pain strips, local fluctuations, necrosis, ulcers and dysfunction, regional lymphadenopathy.
3, laboratory tests: blood routine, check blood sugar if necessary, because diabetes patients are prone to skin and soft tissue infections.
4, ultrasound examination and / or diagnostic puncture: deep abscess should be excluded from tuberculous abscess, aneurysm and tumor. The most valuable diagnostic basis is pus extraction through puncture.
Diagnosis
Diagnosis and diagnosis of deep soft tissue infection of chest wall
diagnosis
Diagnosis is based on clinical performance and laboratory tests.
Differential diagnosis
1. Cellulitis under the scapula
It is often caused by inflammation of the chest wall, chest infection, and osteomyelitis. Because of the deep position, the symptoms on the surface of the body are not obvious. When the palpation is in the late stage, swelling, pain or local fluctuation can be seen along the scapula.
2, intercostal neuritis
Found in the 2nd and / or 3rd costal cartilage and sternum joint, occasionally seen in other ribs or sterno-lock joints. More than one lesion. The cause may be related to viral infection or trauma. The course of the disease can last for hours or days, but it can recur, often self-healing within a few months, and can last for several years.
