Pulmonary purulent infection

Introduction Pathogenic bacteria such as pneumococcal invade the human blood circulation, and grow or reproduce in it or produce toxins, causing severe symptoms of lung infection or symptoms of poisoning. It is most common with pyogenic bacteria. Common features of suppurative inflammation, namely redness, swelling, heat, pain and dysfunction.

Cause

Pulmonary purulent infection refers to pathogenic bacteria invading the human blood circulation, growing and producing toxins, causing serious symptoms of lung infection or poisoning symptoms. It is most common with pyogenic bacteria. Common features of suppurative inflammation, namely redness, swelling, heat, pain and dysfunction. Inhalation injury, tracheotomy or intubation, aspiration, pulmonary edema, atelectasis, shock, surgical anesthesia, wound invasive infection, suppurative thrombophlebitis.

an examination

Related inspection

Thoracic chest CT examination

1. Pay attention to whether there is inhalation injury, tracheotomy or intubation, aspiration, pulmonary edema, atelectasis, shock, surgical anesthesia, wound invasive infection, suppurative thrombophlebitis.

2. Pay attention to whether there is difficulty in breathing, changes in body temperature, cough, increased sputum and sputum traits. Clinical symptoms should be distinguished from burn toxemia or sepsis.

3. Physical examination. In severely burned patients, there are many burns on the chest, making it difficult to obtain accurate chest signs. Therefore, care should be taken to check carefully for any changes in breathing and sound.

4. In order to clear the infected bacteria, the airway secretions should be cultured regularly, preferably for bronchopulmonary lavage fluid to prevent pollution.

5. Chest X-ray examination. The diagnosis of most lung infections after burns depends on X-ray examination. Chest radiographs should be taken routinely after injury and reviewed regularly. X-ray findings of pneumonia can be divided into small lesions, large lesions and large lobe, and small focal pneumonia is the most common.

Differential diagnosis

1. Most of the pulmonary fungal diseases are caused by chronic diseases of the respiratory tract or lungs, or due to long-term application of antibiotics or immunosuppressive agents, resulting in dysbacteriosis and low immune function. Common pulmonary fungal diseases include pulmonary candidiasis, pulmonary aspergillosis and pulmonary actinomycosis. X-ray performance: good hair in the middle and lower lung field, showing a patch, flocculent shadow. The mold culture is positive, the anti-inflammatory and anti-tuberculosis treatments are ineffective, and the anti-fungal treatment is effective.

2, Mycoplasma pneumoniae pneumonia is more common in the middle and lower lung fields, X-ray shows that the lesions absorb faster, can be migratory. The blood condensation test is positive, and erythromycin and josamycin are effective.

3, pneumonia caused by Legionella pneumophila, more common in the elderly, patients with chronic diseases and those receiving immunosuppressive therapy. The onset is slow, and there is general malaise, anorexia, excessive sweating, fatigue, and myalgia at the beginning. 1 to 3 days of onset often occur with high fever, chills, difficulty breathing, with nausea, vomiting, abdominal pain, neuropsychiatric symptoms. In the early stage of X-ray, there was a small infiltration of shadows. The following lung fields were more common. Patients often had hematuria, abnormal liver and kidney function, and Legionella antibodies increased more than 4 times before and after.

4, patients with Staphylococcus aureus pneumonia often have a history of aspiration, skin infections such as: folliculitis, cellulitis history. Acute onset, often with chills, high fever, shortness of breath, cough, blood stasis, and a large amount, some patients may have pus pneumothorax. The X-ray is a large piece of flocculent shadow. Some patients can see the honeycomb translucent area, and the white blood cells are obviously increased, reaching tens of thousands. Staphylococcus aureus can be found in sputum or blood culture, and antibiotic treatment is effective.

5, pneumococcal pneumonia is more common in winter and spring, there is a history of cold, fatigue, rapid onset, chills and fever, common cold sores, hemoptysis or rust. The X-ray showed a uniform flaky shadow on the lung segment or the lung lobes, and the absorption was faster. The total number of white blood cells and neutrophils increased significantly, and the symptoms of antibiotic treatment improved rapidly.

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