Migratory abscess

Introduction Abscess is a localized pus accumulation in tissue, organ or body cavity due to necrosis and liquefaction of the diseased tissue during acute infection. There is a complete pus wall around it. The common pathogen is Staphylococcus aureus. The abscess can be caused by an acute suppurative infection, or by a pathogen of a distant source of infection through the bloodstream or lymphatic vessels. Acute bacterial endocarditis, staphylococcal infection can be complicated by lung abscess, brain abscess and other migration abscess, manifested as cough, difficulty breathing, convulsions, hemiplegia and so on.

Cause

The common pathogen is Staphylococcus aureus. The abscess can be caused by an acute suppurative infection, or by a pathogen of a distant source of infection through the bloodstream or lymphatic vessels. It is often caused by necrosis and dissolution of inflammatory tissue under the action of toxins or enzymes produced by bacteria, forming a abscess cavity, exudate in the cavity, necrotic tissue, pus cells and bacteria to form a pus. Because fibrin in the pus forms a reticular scaffold, the lesion is restricted to the local area, and the other part of the abscess is filled with edema and leukocyte infiltration. The resulting granulation tissue proliferates mainly in the wall of the abscess. Abscesses may have different clinical manifestations due to their different locations. Acute bacterial endocarditis, often caused by bacteria with strong pathogenicity, is more common with Staphylococcus aureus, hemolytic streptococcus, pneumococcus, influenza bacillus, Proteus and Escherichia coli. These bacteria have strong virulence, acute onset, serious illness, and infections often occurring in other parts, which are part of systemic infections, such as meningitis, pneumonia, thrombophlebitis, etc., sometimes accompanied by metastatic suppuration of other organs. Lesion. Usually occurs in normal heart.

an examination

Related inspection

White blood cell count (WBC) blood routine

1, superficial abscess slightly higher than the body surface, red, swollen, hot, painful and fluctuating. Small abscess, deep position, thick wall, the sense of fluctuation is not obvious.

2, deep abscess generally no fluctuation, but the surface of the abscess often has edema and obvious local tenderness, accompanied by symptoms of systemic poisoning.

Acute bacterial endocarditis: mainly for the clinical manifestations of sepsis, especially when the heart is free of noise, the disease is often covered by the primary infection, easy to miss the diagnosis, for more than one week of fever, need to pay attention to cardiac auscultation changes, skin bleeding points And embolism. Often need to be identified with influenza, acute arthritis, acute suppurative meningitis, acute pyelonephritis. In recent years, due to advances in cardiac surgery and the widespread use of antibiotics, atypical or special types of infective endocarditis have increased, such as prosthetic valve replacement, hemodialysis or congenital heart disease correction. Increased opportunities for endocardial infection, and patients with postoperative fever should be vigilant.

Differential diagnosis

Abscess into the chest: common in the elderly lung abscess chest pain, inflammatory lesions involving the pleura, increased pain during breathing. If the abscess breaks into the chest, it can form empyema and pus, and it can also form a wrapped empyema due to cellulose wrap. The patient's respiratory movement is limited and the shortness of breath is aggravated.

Septicemia or multiple migratory abscess: is the basis for the diagnosis of anaerobic pneumonia in the elderly. Anaerobic pulmonary infection is inflammation of the trachea, bronchi, lung parenchyma, and pleural cavity caused by anaerobic bacteria. Anaerobic bacteria have a wide variety of virulence and pathogenicity, which is one of the common pathogens causing lung infection.

Anterior and parasitic soft tissue swelling or abscess: It is one of the important features of the diagnosis and differential diagnosis of spinal tuberculosis, especially the calcification of abscess is often specific. The degree of swelling of the soft tissue of the paravertebral soft tissue is different. It is characterized by localized thickening of the soft tissue adjacent to the invading vertebrae, oval or round mass, uniform density, and enhanced thin wall envelope.

Ridge rib bulging: diagnosis of retroperitoneal abscess, physical examination found perirenal abscess, ridge bulging bulging tenderness, lumbar muscle spasm, lumbar skin with edema.

A retroperitoneal abscess is a localized suppurative infection that occurs in the retroperitoneal space. It occurs often in the abdominal organs, retroperitoneal organs, spinal or twelfth rib infection, pelvic retroperitoneal abscess, and bacteremia. Abscess can invade and mediastinum, flow down the femoral canal into the thigh, or penetrate into the abdominal cavity, gastrointestinal tract, pleura, bronchus, and even form a chronic persistent fistula.

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