Phlegmon

WikiDoc Resources for Phlegmon
Articles
Most recent articles on Phlegmon Most cited articles on Phlegmon Review articles on Phlegmon Articles on Phlegmon in N Eng J Med, Lancet, BMJ
Media
Powerpoint slides on Phlegmon Images of Phlegmon Photos of Phlegmon Podcasts & MP3s on Phlegmon Videos on Phlegmon
Evidence Based Medicine
Cochrane Collaboration on Phlegmon Bandolier on Phlegmon TRIP on Phlegmon
Clinical Trials
Ongoing Trials on Phlegmon at Clinical Trials.gov Trial results on Phlegmon Clinical Trials on Phlegmon at Google
Guidelines / Policies / Govt
US National Guidelines Clearinghouse on Phlegmon NICE Guidance on Phlegmon NHS PRODIGY Guidance FDA on Phlegmon CDC on Phlegmon
Books
Books on Phlegmon
News
Phlegmon in the news Be alerted to news on Phlegmon News trends on Phlegmon
Commentary
Blogs on Phlegmon
Definitions
Definitions of Phlegmon
Patient Resources / Community
Patient resources on Phlegmon Discussion groups on Phlegmon Patient Handouts on Phlegmon Directions to Hospitals Treating Phlegmon Risk calculators and risk factors for Phlegmon
Healthcare Provider Resources
Symptoms of Phlegmon Causes & Risk Factors for Phlegmon Diagnostic studies for Phlegmon Treatment of Phlegmon
Continuing Medical Education (CME)
CME Programs on Phlegmon
International
Phlegmon en Espanol Phlegmon en Francais
Business
Phlegmon in the Marketplace Patents on Phlegmon
Experimental / Informatics
List of terms related to Phlegmon

Please Take Over This Page and Apply to be Editor-In-Chief for this topic: There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us [1] to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.

Phlegmon is a spreading diffuse inflammatory process with formation of suppurative/purulent exudate or pus.

Etiology

Commonly by bacteria - staphylococci, streptococci, pneumococci, spore and non-spore forming anaerobes, etc.

Factors affecting the development of phlegmons are virulence of bacteria and human's immunity strength defenses.

Classifications

By clinical course

1. Acute
2. Subacute

By severity of condition

1. Mild
2. Average
3. Severe (with spreading to other location(s))

By location

1. Superficial

a) Cutaneous

b) Subcutaneous

c) Interstitial tissue

d) Intramuscular

1. Deep

e) Mediastinal

f) Retroperitoneal

By etiology

a)single b)mix (eg:spore and non-spore forming anaerobes)

By pathogenesis

a)per continuitatem (through neighbouring tissues) b)hematogenous (through non-valvular veins like venous plexus of face eg: v. pterygoideus plexus → inflamation of veins (phlebitis) → thrombus formation in veins → embolization of thrombus into sinus venousus systems) c)odontogenous

By exudative character

a)purulent phlegmon b)purulent-hemorrhagic phlegmon c)putrefactive phlegmon

By presence of complications

a)with complications (disturbance of mastication, ingestion, speech, cardiovascular and respiratory system, peritonitis, lymphadenitis, loss of conscious if very severe, etc) b)without complication

Clinical Pictures

1)Systemic features of infection like increased body temperature (up to 38-40°C), general fatigue, chills, sweatings, headache, loss of appetite). 2)Inflammatory signs - dolor(localized pain), calor(increase local tissue temperature), rubor (skin redness/hyperemia), tumor(either clear or non-clear bordered tissue swelling), functio laesa(diminish affected function).

NB: severity of patient condition with phlegmons is directly proportional to the degree of intoxication level i.e the severe the condition, the higher degree of intoxication level.

Diagnostics

1. Complaints and clinical appearances
2. Anamnesis
3. Visual and Palpations
4. Blood test - leucocytosis (up to 10-12x109/L), decrease or absence eosinophils level, shift of leucocyte formula to the left (neutrophilos), increase ESR (up to 35-40 mm/hr).
5. Urine test - presence of bacteria in urine, increase urinary leucocyte counts.
6. X-ray test
7. Ultrasound test on pus

Treatments

The main goal treatment remove the cause of phlegmonous process in order to achieve effective treatment and prevention of residives.

If patients condition is mild and the signs of inflammatory process is presence without signs of infiltrates, then conservative treatment with antibiotics is sufficient.

In severe condition, immediate operation is necessary with application of drainage system. All of these are done under general anaesthesia. During operation, the cavity or place of phlegmonous process are washed with antiseptic, antibiotic solutions and proteolyic ferments.

In post-operative period, i/v drips of detoxification, antibiotics, haemosorbtion, vitaminotherapy. Additionally, the use of i/v or i/m antistaphylococci γ-globulin or anatoxin can be taken as immunotherapy.

During operation of phlegmon dissection at any location, it is important:

1. to avoid spreading of pus during operation
2. take into account the cosmetic value of operating site especially phlegmmonous process of face.
3. during dissection, avoid damaging nerves especially facial nerves. Use the correct incision line.