Boil

Introduction Earthworms are acute suppurative infections of individual hair follicles and their sebaceous glands caused by the invasion of S. aureus from hair follicles or sweat glands, and inflammation often extends to subcutaneous tissues. Multiple mites occur simultaneously or repeatedly in various parts of the body, called rickets, and are common in malnourished children or diabetics. basic knowledge Sickness ratio: 14% Susceptible people: no special people Mode of infection: non-infectious Complications: sepsis, headache, coma

Cause

Infection (30%):

Infection occurs when the skin is unclean, bruised, the ambient temperature is high, or the body's ability to fight infection is low. It can occur in any skin area with hair follicles, often with friction on the head, face, neck, underarms and buttocks. The location is more common.

Pathogenic bacteria (30%):

The pathogenic bacteria of cockroaches are mainly Staphylococcus aureus, streptococcus, Staphylococcus epidermidis, etc., and the local and systemic anti-infective ability is the main cause of this disease, so infants, malnourished people, diabetes The patient is a good group of the disease, the skin is unclean, the skin is scratched, and the ambient temperature is high, which is often the direct cause of local infection.

Abscess (30%):

After the bacteria invade the hair follicle and its sebaceous glands and sweat glands, it rapidly multiplies in the hair follicles and surrounding tissues, producing toxins, causing local tissue degeneration and necrosis, and forming the center of the sputum, which is characterized by local congestion, exudation, induration, and aggregation. The granulocytes destroy damaged tissue cells and pathogens, causing them to gradually necrosis and dissolve, forming an abscess under the dermis. Because the toxin of Staphylococcus aureus contains coagulase, it forms a pus, which protrudes outward and is clinically visible. There is a yellow-white pus in the center of the redness and induration. This is a characteristic of the infection of Staphylococcus aureus. After the pus is drained, the abscess is gradually repaired by new fibrous tissue.

Prevention

Pay attention to clean skin, change underwear and avoid skin injury in time, especially in the summer, bathe, wash your hair, cut hair, change clothes, cut your nails, especially for children. Use honeysuckle, wild chrysanthemum decoction for tea, and around. The skin should be kept clean and applied with 70% alcohol to prevent the infection from spreading to nearby hair follicles.

Complications Complications sepsis headache coma

If squeezed or spurted, the infection easily enters the cavernous sinus of the skull along the internal iliac vein and the ocular vein, causing suppurative cavernous sinusitis, which is progressive redness and induration extending to the eye and surrounding tissues. With pain and tenderness, and headache, chills, high fever and even coma, the condition is very serious, the mortality rate is very high, and generally there are very few serious complications, but if the body immunity is extremely low, or improper extrusion, The pus is inserted into the blood, and the bacteria spread with the blood, which can also cause serious diseases such as rickets, sepsis and intracranial infection.

Symptoms common symptoms edema abscess papules chills tissue necrosis chills leukocytosis lymphadenopathy toxic anorexia

Because of the location, severity, clinical performance may vary.

Local redness, swelling, pain and induration: no systemic symptoms at the beginning of the disease, only local red, swollen, pain, no more than 2cm in diameter, small nodules gradually enlarge, papular bulge, and the lesion expands about 3 to 5cm after a few days. The knot gradually softens, the center is white, the touch is slightly fluctuating, and then the pus is broken, and the yellow-white pus plug appears. The pus plug falls off. After the pus runs out, the inflammation gradually subsides and heals, and some have no pus. Bolts (so-called headless sputum), a little later than self-destruction, need to try to promote their pus discharge.

Fever, swollen lymph nodes: When the infection is severe, the lymph nodes in the local area are swollen, tender, and may be accompanied by systemic fever, and sometimes lymph nodes form abscesses. The facial paralysis of the nose, upper lip and its surroundings (called "dangerous triangle"), when aggravated or squeezed, the bacteria can enter the skull through the internal iliac vein and the ocular vein, causing intracranial suppurative infection. Fever, headache, vomiting, confusion, etc. In the early stage, the hair follicles were red, swollen, hot, painful, indurated, and white at the center of the purulent, with fluctuations, which may be accompanied by systemic fever, increased white blood cell count and differential count.

Awkward inspection

Peripheral blood

(1) White blood cell count: The fever can have an increase in the total number of white blood cells.

(2) White blood cell classification and counting: When the total number of white blood cells is increased, neutrophils are often accompanied.

2. Diabetes related examination

(1) Fasting plasma glucose measurement: Both fasting blood glucose levels are measured twice, and the possibility of diabetes should be considered.

(2) Glycosylated serum protein: This test is not affected by clinical blood glucose fluctuations, and higher than normal to help diagnose diabetes.

(3) Glycated hemoglobin: Glycated hemoglobin is positively correlated with blood glucose concentration and is irreversible, and diabetes is often 2 to 3 times higher than normal.

3. Bacteriological examination

(1) Bacterial culture: For multiple infections and repeated infections, the pus can be directly extracted from the abscess for bacterial culture, and the positive result is helpful for the diagnosis of pathogenic bacteria.

(2) Drug sensitivity test: While the pus bacterial culture, the drug sensitivity test can provide a scientific basis for clinical drug treatment.

Diagnostic diagnosis

diagnosis

1. Local red, swollen, hot, painful nodules, conical.

2. Inflammation continues to develop, nodules increase, and pain increases.

3. After a few days, the central tissue of the nodules was necrotic, dissolved and formed an abscess, the induration became soft, and the pain was relieved. Most of the central pus was ruptured by itself, and the pus was discharged, and the inflammation subsided and healed.

4. generally no obvious systemic symptoms, but if it occurs in the blood-rich part, the systemic resistance is weakened, it can cause discomfort, chills, fever, headache and anorexia and other symptoms of toxemia.

5. Facial edema, such as intracranial infection, facial swelling is serious, can be accompanied by chills, high fever, headache and other cavernous sinus infection embolism.

Differential diagnosis

1. Multiple sweat gland abscess is also common in summer, more common in infants and frail maternal heads, forehead, skin lesions for multiple subcutaneous abscesses, superficial tenderness, mild inflammation, no pus, residual scars, usually With a lot of scorpions, the general is called scorpion venom, and some people call it Pseudofurunculosis.

2. Suppurative sweat gland inflammation is more common in young women, the skin lesions are subcutaneous induration, forming subcutaneous abscess, followed by red, swollen, hot, painful, ruptured scars, skin lesions occur in the armpit, groin, genital and perianal , umbilical week, etc.

3. When the acne acne is mildly infected, there are red, swollen, and painful, but the lesion is small, and the top is a little gelatinous.

4. Sebaceous cysts Sebaceous cysts are red, swollen, and painful, but have been rounded and painless for a long time, and the epidermis is as usual.

5. There are red, swollen and painful sputum, but at the same time there are multiple hair follicle infections, and the lesion range is relatively large.

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