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Updated: May 19, 2025
The primary infection is usually in a wound for example, a compound fracture but cases occur in which the point of entrance of the bacteria is not discoverable. The dissemination of the organisms takes place through the medium of infected emboli which form in a thrombosed vein in the vicinity of the original lesion, and, breaking loose, are carried thence in the blood-stream.
Whether milk or any other substance containing lime makes fibrin deposits on the ulcerative surfaces more likely or more profuse, and therefore emboli more liable to occur, is perhaps an undeterminable question. In instances in which hemorrhages so frequently occur, as they do in this form of endocarditis, calcium is theoretically of benefit.
Critically ill people may have, among other things, any of the following diagnoses: advanced cancer, advanced aids, heart failure, very high blood pressure, kidney failure, advanced liver disease, advanced emphysema, pneumonia or other catastrophic infections, especially those that seem unresponsive to antibiotics, strokes, emboli, sclerotic vessels as found in arteriosclerosis, severe nerve degeneration interfering with nerve transmission to vital organs.
The true pathology of the elephantoid diseases may thus be briefly summarized: A parent filaria in a distant lymphatic prematurely expels her ova; these act as emboli to the nearest lymphatic glands, whence ensues stasis of lymph, regurgitation of lymph, and partial compensation by anastomoses of lymphatic vessels; this brings about hypertrophy of tissues, and may go on to lymphorrhoea or chyluria, according to the site of the obstructed lymphatics.
Portions of malignant tumours also may form emboli, and their impaction in the vessels may lead to the development of secondary growths in distant parts of the body. Fat and air embolism have already been referred to. Pyogenic. Non-suppurative inflammation of the coats of an artery may so soften the wall of the vessel as to lead to aneurysmal dilatation.
#Treatment of Ulcers.# An ulcer is not only an immediate cause of suffering to the patient, crippling and incapacitating him for his work, but is a distinct and constant menace to his health: the prolonged discharge reduces his strength; the open sore is a possible source of infection by the organisms of suppuration, erysipelas, or other specific diseases; phlebitis, with formation of septic emboli, leading to pyæmia, is liable to occur; and in old persons it is not uncommon for ulcers of long standing to become the seat of cancer.
Occasionally the ulcerations become serious, and ulcerative endocarditis or malignant endocarditis develops on the mild inflammation. In this form the little vegetations are liable to become loosened, fly off into the blood stream, and cause emboli in different parts of the body. Anat. u. z. allg.
Phlebitis and thrombosis are common sequelæ of varix, and may prove dangerous, either by spreading into the large venous trunks or by giving rise to emboli. The larger the varix the greater is the tendency for a thrombus to spread upwards and to involve the deep veins.
Embolism plays an important part in determining one form of gangrene, as has already been described. Infective emboli are the direct cause of the secondary abscesses that occur in pyæmia; and they are sometimes responsible for the formation of aneurysm.
When infected with pyogenic bacteria, the thrombus becomes converted into pus and a localised abscess forms; or portions of the thrombus may be carried as emboli in the circulation to distant parts, where they give rise to secondary foci of suppuration pyæmic abscesses.
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