cellulitis

Phlegmon: description

A phlegmon is a diffuse, bacterial inflammation of the connective tissue. There are, depending on the affected body region, different types of phlegmons. One differentiates the following phlegmon forms:

• Hand phlegmon (such as V phlegmon)
• Foot Cellulitis
• Facial phlegmons (such as oral phlegmon or orbital cellulitis)
• Sehnenscheidenphlegmone

Phlegmons in the head area are rare. Tongue, floor and neck phlegmon accounts for less than one percent of all phlegmonous inflammations.

Phlegmon: symptoms

There are both general symptoms of phlegmon and special ones that arise depending on the location of the inflammation. The common signs of phlegmons include:

• reddening
• swelling
• Pressure or spontaneous pain
• fever
• Sickness, fatigue
• high heart rate (tachycardia)
• possibly respiratory distress and circulatory collapse (shock)

Other symptoms depend on the location of the phlegmon:

• V-phlegmon: Thumb and little finger are held in flexion position and the palm in claw position. In addition, the back of the hand is swollen.
• Tongue phlegmon: Patients have pain in speaking and swallowing and the swelling may cause shortness of breath.
• Orbitophlegmone: Patients are noted for a protruding eye (exophthalmos), swollen eyelid, blurred vision, conjunctival edema (chemosis), and restricted eye movement.

Phlegmon: causes and risk factors

Phlegmons are caused by bacteria. These include, in particular, Staphylococcus aureus and Streptococcus pyogenes. These spread in deep layers of the skin, where they cause purulent inflammation. Especially patients with weakened immune systems or with large, open wounds are at an increased risk of developing a phlegmon. They can also be caused by medical interventions, such as the spreading of the germs during an abscess opening.

Phlegmon: emergence of various phlegmons

Tendon sheath phlegmons are usually caused by a trivial injury such as a cut or puncture wound. It initially develops a swelling at the site of the injury. This presses on the vessels that supply the tendon sheath so that it is no longer supplied with nutrients. As a result, the tissue dies, providing a gentle target for bacteria. Bites can also lead to phlegmons.

A V-phlegmone is termed as such because it spreads along the tendon sheaths of the thumb and little finger. These are connected to each other at the wrist. If there is a phlegmon of the index, middle or ring finger, it remains limited to the affected finger, since there are no connections between these tendon sheaths.

Orbital cellulitis is usually the result of inflammation of the sinuses or head injury. However, the bacteria can also enter the eye socket (orbita) from another part of the body via the blood (hematogenous).

Phlegmon: contagious?

Many patients ask themselves, “Is a phlegmon contagious?” Basically humans have numerous bacteria on their skin (among other things also the Staphylococci), which can be triggers of a phlegmon. These are not dangerous with intact skin and stable defense system. Nevertheless, one should protect oneself from direct contact with the wound secretion of a phlegmon by gloves.

Phlegmon: examinations and diagnosis

If you have pain, swelling and redness of the skin as well as fever, consult your family doctor. First, he asks you in detail about your medical history (anamnesis). He will ask you the following possible questions:

• Since when are you having those complaints?
• Have you been ill recently or have you been injured?
• Are you suffering from a disease that weakens your immune system?
• How high is your fever?

Subsequently, your doctor will examine you physically. He looks at the affected area first exactly. When suspecting a hand phlegmon he pays close attention to whether there is a swelling of the back of the hand. If a flexor phlegmon is present, the doctor can cause pain by punctiform pressure on the tendon sheath. Phlegmons between the fingers, the doctor recognizes that the affected fingers are in Abspreizstellung and forms a skin fold between them.

If possible, your doctor will make a swab of the inflammation in the open wound to determine the pathogens in the lab. So the therapy can be optimized. In addition, values ​​that indicate an infection, such as C-reactive protein (CRP), can be determined in a blood test.

If you suffer from orbital cellulitis, your doctor will also perform an imaging of the eye socket and paranasal sinuses, such as computed tomography (CT). He will also send you referrals to the ophthalmologist and the ear, nose and throat specialist to find the cause of the infection.

Phlegmon: treatment

The phlegmon therapy consists of different stages, depending on the severity of the infection. What you can and should do is the affected body region

• immobilize
• hochzulagern
• and to cool.
• To take pain medications such as ibuprofen. They relieve the pain and inhibit the phlegmonous inflammation.

Further treatment is performed by your doctor. Because it is a bacterial infection, antibiotics help fight phlegmon. Either they kill off the bacteria or inhibit their reproduction. Penicillins are usually used for phlegmon therapy as they are very effective against staphylococci and streptococci.

In addition, a surgical opening of the phlegmon must be considered. The phlegmonous skin is cut several times. Then it is rinsed. In some cases, open wound treatment is performed. This means that after surgery, the wound will not be surgically closed. Thereafter, the wound is rinsed several times at intervals, drained and kept sterile with antiseptic dressings.

Phlegmon: disease course and prognosis

A phlegmon is a serious disease and can develop into a dramatic clinical picture. In the course of infection, phlegmon can cause complications. The infection can spread to neighboring structures. These are on the hand, among other things, the back of the hand and the middle hollow hand.

A phlegmon can also spread to the bone and bone marrow. Depending on the location of the infection, it may also spread to the pleura (mediastinum) causing respiratory distress or leading to sinus vein thrombosis, a life-threatening vein of venous blood. Meningitis (meningitis) can also result in a cellulitis be.