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Updated: June 23, 2025
The post-mortem appearances are those of pyæmia. Differential Diagnosis. Acute osteomyelitis is to be diagnosed from infections of the soft parts, such as erysipelas and cellulitis, and, in the case of the tibia, from erythema nodosum. Tenderness localised to the ossifying junction is the most valuable diagnostic sign of osteomyelitis.
Vaccines may be had recourse to in those of bacterial origin. Definition Pus Varieties Acute circumscribed abscess Acute suppuration in a wound Acute Suppuration in a mucous membrane Diffuse cellulitis and diffuse suppuration Whitlow Suppurative cellulitis in different situations Chronic suppuration Sinus, Fistula Constitutional manifestations of pyogenic infection Sapræmia Septicæmia Pyæmia.
In the deeply placed cervical glands, especially in cases of streptococcal throat infections, the suppuration rapidly involves the surrounding cellular tissue, and the clinical features are those of an acute cellulitis and deeply seated abscess. When this is incised the necrosed glands may be found lying in the pus, and on bacteriological examination are found to be swarming with streptococci.
Clinical Features. The reaction in cases of diffuse cellulitis is severe, and is usually ushered in by a distinct chill or even a rigor, while the temperature rises to 103°, 104°, or 105°
It may become purulent as a result of infection, and this may be the starting-point of lymphangitis or cellulitis. The skin should be disinfected and the blisters punctured. When infected, the separated horny layer must be cut away with scissors to allow of the necessary purification.
It has been divided in accidental wounds, by a scythe, for example, in incising for cellulitis, and in performing subcutaneous tenotomy of the biceps tendon. Cases have been observed of paralysis of the nerve as a result of prolonged acute flexion of the knee in certain occupations.
On account of the anatomical arrangement of the tendon sheaths, the process may spread into the forearm directly in the case of the thumb and little finger, and after invading the palm in the case of the other fingers and there give rise to a diffuse cellulitis which may result in sloughing of fasciæ and tendons.
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