Mixed bacterial infection

Introduction Mixed infection of bacteria is a common complication after deep burns. It can be a mixed infection of single bacteria or most bacteria, and can even be caused by fungi. Generally, most of them are single bacteria in the early stage, and mixed infections in the late stage. It occurred mostly within 2 weeks after burn, and it occurred on the 2nd day at the earliest. There was less chance of granulation after wound formation. Common pathogens are Staphylococcus aureus, Pseudomonas aeruginosa, Proteus and Escherichia coli. The clinical manifestations of general sepsis are living, can be high fever (up to 42 ° C), but also low temperature (below 36 ° C), mostly relaxation heat. After the occurrence of sepsis, the tachycardia after the original burn is more significant, and toxic myocarditis, toxic hepatitis, shock, etc. may occur. Paralytic tympanic bowel is also a common symptom, which can be accompanied by changes in consciousness. The wound surface can be deteriorated for a short time, the color is dark, the necrotic tissue and secretions are increased, and bleeding is easy.

Cause

Cause of disease

Human factor

Deficiency of the body's defense against immune function is the most important cause of sepsis. After the invasion of the pathogen, the healthy person usually only shows transient bacteremia. The bacteria can be quickly eliminated by the body's immune defense system, and does not cause obvious symptoms, but various immune defense function defects (including local and systemic barrier function) Loss), are easy to induce sepsis.

(1) Neutrophil deficiency or reduction caused by various causes is an important cause of sepsis, but the incidence of sepsis is significantly increased when neutrophils fall below 0.5×109/L, which is more common in acute leukemia and bone marrow transplantation. After, patients with malignant tumors receive chemotherapy, as well as patients with aplastic anemia.

(2) Immunosuppressive agents such as adrenocortical hormone and broad-spectrum antibiotics, radiation therapy, the application of cytotoxic drugs, and the development of various major operations are all important causes of sepsis.

2, bacterial factors: Staphylococcus aureus can produce a variety of each and exotoxin, of which the main pathogenic role of plasma coagulase, alpha - hemolytic toxin, leukocidin, enterotoxin (A - E, more common in type A ), botanic toxins, erythrotoxin, etc. can cause severe sepsis, and enterotoxin F isolated in recent years is associated with the occurrence of toxic shock syndrome (TSS).

an examination

Related inspection

Blood routine

In patients with anti-acute fever, white blood cells and neutrophils are significantly increased, and when it is not limited to acute infection in a certain system, the possibility of sepsis should be considered. Medical history inquiry and detailed physical examination have certain significance for assisting diagnosis. Anyone with recent skin infections, trauma, especially those with crushed sores; or infected lesions such as urinary tract, biliary tract, and respiratory tract; or various local infections that have been treated with effective antibacterial drugs, but whose body temperature can not be controlled, The possibility of sepsis should be highly suspected.

Differential diagnosis

Fungal infections: The diseases caused are called fungal diseases. The highest incidence of candidiasis and dermatophytosis is caused by the fungus of the normal flora of the human body. The infection can be distinguished as: surface infection, skin infection, subcutaneous tissue infection, deep infection and Conditional infection.

Viral infection: An infectious disease caused by a virus that can be parasitic in the human body and can cause disease. Mainly manifested as fever, headache, general malaise and other symptoms of systemic poisoning and local symptoms caused by inflammatory damage caused by viral hosts and invading tissues and organs.

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