Phlegmons L03.8

Author: Prof. Dr. med. Peter Altmeyer

Co-Autor: Dr. med. Jeton Luzha

Last updated on: 16.02.2023

Definition
This section has been translated automatically.

Diffuse, purulent, necrotizing, bacterial inflammation (subcutaneous, subfascial, intramuscular) spreading into tissue clefts with broad tissue fusion.

S.a.

Glossitis phlegmonosa

blepharitis phlegmonosa

Necrotizing fasciitis.

Etiopathogenesis
This section has been translated automatically.

Frequently streptococcus (Streptodermia phlegmonosa) or staphylococcus infection (Staphylodermia phlegmonosa), also gram-negative germs and mixed flora. After minor injuries, e.g. panaritia, erysipelas, thrombophlebitis, rapid invasion of the bloodstream and lymphatic system.

You might also be interested in

Advertisment

Dermatology

Folic acid

Folic acid (lat. folium= leaf, after the occurrence of folic acid in green leaves), is a water-insoluble, i...

Clinical features
This section has been translated automatically.

Hot, red, painful, doughy, inflammatory, circumscribed edema. Rarely purulent subcutaneous abscesses, breakthrough through the skin. Lymphangitis and lymphadenitis, fever.

Laboratory
This section has been translated automatically.

Leukocytosis, BSG elevation.

Therapy
This section has been translated automatically.

Immobilize and, if possible, elevate affected body parts.

External therapy
This section has been translated automatically.

Moist dressings with antiseptic additives such as potassium permanganate (light pink) or quinolinol (e.g. quinosol 1:1000 or R042 ).

Internal therapy
This section has been translated automatically.

Antibiosis after antibiogram, initial dicloxacillin (e.g. InfectoStaph) 2-4 g/day in 4-6 ED. Furthermore, due to the mixed infection of staphylococcus and streptococci, effective treatment with clindamycin or flucloxacillin is possible. In severe and resistant cases, hospital admission and targeted i.v. antibiotics, initially e.g. gentamicin (e.g. refobacin) once/day 240 mg p.o. and ceftriaxone (e.g. rocephin) once/day 2 g i.v. Ultima ratio: surgical debridement

Operative therapie
This section has been translated automatically.

In case of fluctuation, wide incision, irrigation with antiseptic solutions such as polyvidon-iodine solution (e.g. Betaisodona), drainage/ladder insert and then antiseptic dressings with polyvidon-iodine ointment (e.g. Braunovidon).