United States or Latvia ? Vote for the TOP Country of the Week !
This form usually follows upon infected wounds of the fingers especially of the thumb or little finger and is a frequent sequel to whitlow; it may also follow amputation of a finger. Once the infection has gained access to the sheath, it tends to spread, and may reach the palm or even the forearm, being then associated with cellulitis.
The treatment of diffuse cellulitis depends to a large extent on the situation and extent of the affected area, and on the stage of the process. In the limbs, for example, where the application of a constricting band is practicable, Bier's method of inducing passive hyperæmia yields excellent results.
On another occasion we had to knock down a partition in a tiny cottage, make a full-length wooden bath, pitching the seams to make it water-tight, in order to treat a severe cellulitis.
It is also met with in the groin following on inflammation and suppuration of the inguinal glands, and cases are recorded in which the sloughing process has implicated the femoral vessels and led to secondary hæmorrhage. Cellulitis of the scalp, orbit, neck, pelvis, and perineum will be considered with the diseases of these regions.
Cellulitis is an acute affection resulting from the introduction of some organism commonly the streptococcus pyogenes into the cellular connective tissue of the integument, intermuscular septa, tendon sheaths, or other structures.
Cellulitis of the axilla may originate in suppuration in the lymph glands, following an infected wound of the hand, or it may spread from a septic wound on the chest wall or in the neck. In some cases it is impossible to discover the primary seat of infection. A firm, brawny swelling forms in the armpit and extends on to the chest wall.
#Complications.# Diffuse suppurative cellulitis is the most serious local complication, and results from a mixed infection with other pyogenic bacteria. Small localised superficial abscesses may form during the convalescent stage. They are doubtless due to the action of skin bacteria, which attack the tissues devitalised by the erysipelas.
#Clinical Varieties of Bacillary Gangrene.# #Acute infective gangrene# is the form most commonly met with in civil practice. It may follow such trivial injuries as a pin-prick or a scratch, the signs of acute cellulitis rapidly giving place to those of a spreading gangrene.
If it is not let out by incision, the pus, travelling along the lines of least resistance, tends to point at several places on the surface, or to open into joints or other cavities. Prognosis. The occurrence of septicæmia is the most serious risk, and it is in cases of diffuse suppurative cellulitis that this form of blood-poisoning assumes its most aggravated forms.
Subcutaneous Whitlow. In this variety the infection manifests itself as a cellulitis of the pulp of the finger (Fig. 9, c), which sometimes spreads towards the palm of the hand. The finger becomes red, swollen, and tense; there is severe throbbing pain, which is usually worst at night and prevents sleep, and the part is extremely tender on pressure. When the palm is invaded there may be marked œdema of the back of the hand, the dense integument of the palm preventing the swelling from appearing on the front. The pus may be under such tension that fluctuation cannot be detected. The patient is usually able to flex the finger to a certain extent without increasing the pain a point which indicates that the tendon sheaths have not been invaded. The suppurative process may, however, spread to the tendon sheaths, or even to the bone. Sometimes the excessive tension and virulent toxins induce actual gangrene of the distal part, or even of the whole finger. There is considerable constitutional disturbance, the temperature often reaching 101° or 102°
Word Of The Day