Acute purulent infection of the hand
Introduction
Introduction Acute suppurative infections in the hand are mainly caused by trauma and are rarely caused by blood. The pathogenic bacteria are mainly Staphylococcus aureus. The anatomical features of the hand determine the specificity of the hand infection. More common in hand infections are paronychia (under-abdominal abscess), purulent finger inflammation and acute suppurative tenosynovitis, bursitis, and deep palm interstitial infection. Acute suppurative infections in the hands are more common. Small injuries that are easily overlooked, such as abrasions, stab wounds, reverse peeling and cuts, can sometimes cause serious infections in the hands. The principle of treatment of this disease is mainly in the early stage of infection, the affected part is used for moist heat, and the antibacterial drugs are given according to the condition. After these treatments, most of the infections can be cured.
Cause
Cause
Paronychia is an infection of the sulcus or its surrounding tissues, mostly caused by damage to the sulcus. The pathogen is mainly Staphylococcus aureus. At the beginning, the subcutaneous tissue on the side of the nail is red and swollen, and then spread to the subcutaneous and contralateral nails of the nail. If the drainage is not cut, it can spread further under the nail to form an abscess under the nail.
Purulent finger inflammation is a subcutaneous tissue purulent infection on the volar side of the finger, and the pathogenic bacteria are mostly Staphylococcus aureus.
Acute suppurative tenosynovitis and deep palm interstitial infections are mostly caused by Staphylococcus aureus infection of the palmar sac, palmar space, and inter-family space.
Examine
an examination
Related inspection
The only nitrogen source test carbon source utilization test
1. Fever, local redness, pain, tenderness, limited mobility, abscess formation.
2. The total number of white blood cells is increased and the number of neutral cells is increased.
3. There is pus in the hand and palm.
Auxiliary inspection
1. Patients with simple finger inflammation and paronychia are mainly treated by outpatient treatment;
2. The symptoms of severe tenosynovitis, bursitis, and deep palm infection are checked to check the limits of "A" and "B";
3. The examination box for patients with advanced symptoms such as severe septic sepsis may include "A", "B", and "C".
Diagnosis
Differential diagnosis
First,
The etiology and pathology are an acute suppurative infection of the hair follicle and its sebaceous glands, often extending to the subcutaneous tissue. The pathogens are mostly Staphylococcus aureus and Staphylococcus epidermidis. The hair follicles and sebaceous glands of human skin usually have bacteria to rub and stimulate, which can cause convulsions. It often occurs in areas rich in hair follicles and sebaceous cowards, such as the neck, head, face, back, ankle, groin, and perineum and calves.
Second,
The etiology and pathology are acute suppurative infections of multiple adjacent hair follicles and their sebaceous glands or sweat glands, or a fusion of multiple ticks. The pathogen is Staphylococcus aureus. Chinese medicine is called . The neck sputum is commonly called "mouth sore", starting at the bottom of the back. Due to the thick skin, the infection can only spread to the subcutaneous tissue without weak resistance. The submucosal tissue spreads along the deep fascia, invading many fats nearby, and then is introduced into the hair follicle group to form multiple pus. The head of the cockroach. Diabetic patients are more susceptible to convulsions. Because of their poor white blood cell function, swimming is slow.
Fourth, the newborn gangrene
Etiology and pathology Neonatal subcutaneous gangrene is also an acute cellulitis, often caused by Staphylococcus aureus, which occurs in the back or lumbosacral area where the newborn is easily stressed, occasionally in the occiput, shoulders, legs and perineum. It is more likely to occur in winter. The skin of the newborn is thin and tender, and the local skin is susceptible to pressure in the winter. It is not easy to keep clean, so the bacteria easily invade from the damaged skin and cause infection. Due to poor immune defense function of newborns (such as lack of immunoglobulin and low activity of neutrophils), neonatal subcutaneous gangrene has an acute onset and rapid expansion of lesions. If not treated promptly, it can be complicated by sepsis, bronchitis and lung abscess. Etc., so the mortality rate is higher.
Five, erysipelas
Etiology and pathology erysipelas is an acute inflammation of the skin and its reticular lymphatic vessels, caused by the invasion of tiny wounds of the skin and mucous membrane by -hemolytic streptococcus. The erysipelas spreads very quickly, with little tissue necrosis or suppuration.
Six, acute lymphangitis and acute lymphadenitis
Etiology and pathogenic pathogens invade from damaged skin or mucosa, or invade from other infectious lesions, blemishes, athlete's foot, etc., and enter the lymphatic vessels through the lymphatic space of the tissue, causing acute inflammation of the lymphatic vessels and their surroundings. Called acute lymphangitis. There are bacteria, coagulated lymph and exfoliated cells in the lymphatic lumen. If acute lymphangitis continues to spread to local lymph nodes, or purulent lesions spread to the lymph nodes of the region through the lymphatic vessels, it can cause acute lymphadenitis. Infections of the upper extremities, breast, chest wall, back and ventral wall above the umbilicus cause axillary lymphadenitis; infection of the lower extremities, the wall below the umbilicus, perineum and buttocks can occur in the inguinal lymphadenitis; head, face, mouth, neck and shoulders Infection, causing lymphadenitis in the submandibular and neck. The pathogens of acute lymphangitis and acute lymphadenitis are often Staphylococcus aureus and hemolytic streptococcus.
Seven, abscess
After the acute infection of the cause and pathology, the tissue or organ in the tissue or tissue is necrotic and liquefied, forming a localized pus accumulation, and a complete purulent wall, known as abscess. Most of the pathogens are Staphylococcus aureus. Abscesses are often secondary to various purulent infections, such as acute cellulitis, acute lymphadenitis, sputum, etc.; can also occur in localized hematoma or foreign body retention. In addition, an abscess can be formed by distant blood flow from a distant infection.
