Professional Documents
Culture Documents
Overview
The problem of management of suppurative infections is one of the longest standing in the history of pediatric surgery. Widespread use of anti-bacterial madication and consequent microbial resistance to these medications has lead to changes in the type and characteristics of infecting microbes. Important aspects of the study of this problem includes early diagnosis with etiopathogenetic treatment and prevention of these infections in childhood.
Infection
Burnes, , pancreonecrosis ss
(SIRS) ()
Massive bleeding
Trauma
Neonatal phlegmon
Neonatal phlegmon-acute soft-tissue infections in childhood. Types: simple, toxic and septicopyemic. Etiology: most common-Staphylococcus epidermidis Typical localizations: lumbar area, back, anterior and lateral superficies of the thorax Local symptoms: pain, local rise in temperature, hyperemia, swelling.
Neonatal phlegmon
Neonatal phlegmon
Adyponecrosis
Erysipelas
Neonatal mastitis
Neonatal mastitis is a local bacterial infection during the first mounth (first weeks) of life Causative organisms. Staphylococcal organisms (S.epidermidis,S.aures) The male:female ratio is 1:1 Physiological enlargement of mammalian glands is a prepodisposatary factor for the development of the disease General symptoms Local symptoms (tenderness, swelling, hyperemia, local rise in temperature, fluctuation)
Neonatal mastitis
Operative aproach (wide excision of the infection site) Drainage Collection of pus for culture Special features of surgical management of neonatal phlegmont (multiple cuts in the zone of the lesion including the border with healthy tissue and frequent dressing every 6 8 hours) Special features of surgical management of neonatal mastitis depending on clinical type Peculiarities of placement and removal of sutures
Acute hematogenous osteomyelitis(AHO)-bacterial infections of bones with subsequent involving of the surrounding soft-tissue Antacedent infections -Immunological disbalance widesread by way of bloodstream -hematogenous abscess in the marrow cavity The most common pathogen culture is Staphyloccus aureus The male: female ratio is 3:2 The most common involving long tubular bones
Most common organisms S. aureus, Enterobacter species, and group A and B Streptococcus species
S. aureus, group A Streptococcus species, Haemophilus influenzae, and Enterobacter species S. aureus (80%), group A Streptococcus species, H. influenzae, and Enterobacter species S. aureus and occasionally Enterobacter or Streptococcus species
Adult
In general, microorganisms may infect bone through one or more of three basic methods: via the bloodstream, contiguously from local areas of infection (as in cellulitis), or penetrating trauma, including iatrogenic causes such as joint replacements or internal fixation of fractures or root-canaled teeth. Once the bone is infected, leukocytes enter the infected area, and, in their attempt to engulf the infectious organisms, release enzymes that lyse the bone.
Pus spreads into the bone's blood vessels, impairing their flow, and areas of devitalized infected bone, known as sequestra, form the basis of a chronic infection. Often, the body will try to create new bone around the area of necrosis. The resulting new bone is often called an involucrum.
On histologic examination, these areas of necrotic bone are the basis for distinguishing between acute osteomyelitis and chronic osteomyelitis. Osteomyelitis is an infective process which encompasses all of the bone (osseous) components, including the bone marrow. When it is chronic it can lead to bone sclerosis and deformity.
Bone marrow phlegmon Periosteal abscess Soft tissue phlegmone Dermal fistula
Other localization
In infants, the infection can spread to the joint and cause arthritis. In children, large subperiosteal abscesses can form because the periosteum is loosely attached to the surface of the bone
Computed tomogram.
Differential diagnosis
Bone
tuberculosis. Inflammation diseases soft tissues. Articular syndrome for systemic diseases. Benign lesions of the bone. Malignant tumor of the bone.
Cronical osteomyelitis
Albuminous osteomyelitis
Sclerosing osteomyelitis