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'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''
{{Phlegmon}}
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==[[Phlegmon overview|Overview]]==


'''Phlegmon''' is a spreading [[diffuse]] [[inflammatory]] process with formation of suppurative/purulent [[exudate]] or [[pus]].
==[[Phlegmon classification|Classification]]==


==Etiology==
==[[Phlegmon pathophysiology|Pathophysiology]]==
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.
==[[Phlegmon causes|Causes]]==


==Classifications==
==[[Phlegmon differential diagnosis|Differentiating Phlegmon from other Diseases]]==
===By clinical course===
#Acute
#Subacute


===By severity of condition===
==[[Phlegmon epidemiology and demographics|Epidemiology and Demographics]]==
#Mild
#Average
#Severe (with spreading to other location(s))


===By location===
==[[Phlegmon risk factors|Risk Factors]]==
#Superficial
:*Cutaneous
:*Subcutaneous
:*Interstitial tissue
:*Intramuscular
#Deep 
:*Mediastinal
:*Retroperitoneal


===By etiology===
==[[Phlegmon natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
#Single
#Mixed (eg:spore and non-spore forming anaerobes)


===By pathogenesis===
==Diagnosis==
# Per continuitatem (through neighbouring tissues)
[[Phlegmon history and symptoms|History and Symptoms]] | [[Phlegmon physical examination|Physical Examination]] | [[Phlegmon laboratory findings|Laboratory Findings]] | [[Phlegmon chest x ray|Chest X Ray]] | [[Phlegmon CT|CT]] | [[Phlegmon MRI|MRI]] | [[Phlegmon ultrasound|Ultrasound]] | [[Phlegmon other imaging findings|Other Imaging Findings]] | [[Phlegmon other diagnostic studies|Other Diagnostic Studies]]
# 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)
# Odontogenous


===By exudative character===
==Treatment==
a)purulent phlegmon
[[Phlegmon medical therapy|Medical Therapy]] | [[Phlegmon surgery|Surgery]] | [[Phlegmon primary prevention|Primary Prevention]] | [[Phlegmon cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Phlegmon future or investigational therapies|Future or Investigational Therapies]]
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==
==Case Studies==
1)Systemic features of infection like increased body temperature (up to 38-40°C), general fatigue, chills, sweatings, headache, loss of appetite).
[[Phlegmon case study one|Case #1]]
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.
[[Category:Disease]]


==Diagnostics==
#Complaints and clinical appearances
#Anamnesis
#Visual and Palpations
#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).
#Urine test - presence of bacteria in urine, increase urinary leucocyte counts.
#X-ray test
#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:
#to avoid spreading of pus during operation
#take into account the cosmetic value of operating site especially phlegmmonous process of face.
#during dissection, avoid damaging nerves especially facial nerves. Use the correct incision line.
{{SIB}}
[[Category:Inflammations]]
[[Category:Inflammations]]
[[Category:Infectious diseases]]
[[de:Phlegmone]]
[[et:Flegmoon]]
[[fr:Phlegmon]]
[[nl:Flegmone]]
[[ja:蜂窩織炎]]
[[pl:Ropowica]]
{{WH}}
{{WH}}
{{WS}}
{{WS}}

Latest revision as of 18:42, 18 September 2017

For patient information click here

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Classification

Pathophysiology

Causes

Differentiating Phlegmon from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Chest X Ray | CT | MRI | Ultrasound | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

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Case #1 Template:WH Template:WS