Phlegmon


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Phlegmon

 

an acute, diffuse, purulent inflammation of adipose tissue. Unlike an abscess, a phlegmon lacks precise boundaries.

Phlegmons are classified by site. They may occur in many parts of the body, including the foot and the hand, and may be subcutaneous, subfascial, intermuscular, retroperitoneal, paranephric (paranephritis), pararectal (paraproctitis), or mediastinal. The causative agents are primarily staphilococci, other pyogenic microorganisms, and, less commonly, Escherichia coli and anaerobes. Phlegmons may also be classified according to the characteristics of the causative agents as suppurative, putrefactive, and anaerobic.

The causative agents penetrate the tissue through breaks in the skin or from nearby foci of infection, such as furuncles, dental caries, or suppurating lymph nodes. Sometimes they are brought to the site hematogenously—that is, through the bloodstream— from foci at some distance.

The symptoms of phlegmon include pain, edema, elevated body temperature, and chills; subcutaneous phlegmon has the added symptom of cutaneous hyperemia. The inflammatory process may spread to neighboring organs, and sepsis may develop.

Phlegmon is treated by exposing and draining the suppurative focus and by antibiotic therapy. It is prevented by keeping the skin clean, attending to minor injuries, and promptly treating pyodermas and other local foci of infection.

REFERENCES

Voino-Iasenetskii, V. F. Ocherki gnoinoi khirurgii, 3rd ed. Leningrad, 1956.
Struchkov, V. I. Gnoinaia khirurgiia. Moscow, 1962.

A. G. KISSIN

References in periodicals archive ?
Although our patient presented with obvious symptoms and signs of appendiceal phlegmon, it is possible that the previous use of oral nonsteroidal anti-inflammatory drugs prevented an early presentation to our ED.
Phlegmon formation Case 5 Case 6 Age/sex 36/male 32/male Precipitating Sneeze Swallowing and bending event over Symptoms/ Odynophagia and Odynophagia, dysphagia, signs dysphonia.
An odontogenic focus of the inflammation, and developing on its base inflammatory infiltration, abscess, and phlegmon in the surrounding soft tissue may be the source of inflammatory processes located in the regional and distant soft tissues, such as in the mediastinum, facial bones of the skull, paranasal sinuses, orbit, cavernous sinus, meninges, and the cerebrum as well as the spinal canal [5].
Cellulitis is defined as a diffuse inflammatory process that spreads along fascial planes and through tissue spaces without gross suppuration where as phlegmon is an acute suppurative inflammation affecting the subcutaneous connective tissue.3,4 On the other hand, abscess is defined as a localized accumulation of suppuration in a confined space formed by tissue disintegration.3
We took biopsy from lymph node in 31 patients, gut specimen was taken in 14, peritoneal biopsy in 13 patients and 2 had omental phlegmon biopsy.
Imaging findings were in keeping with disco-ostemolyelitis with epidural and paraspinal phlegmon formation.
Controversy exists regarding the difference between primary and secondary Fournier's gangrene, and the condition has several other names: necrotising fasciitis, peri-urethral phlegmon, phagedena and necrotising cellulitis.
CT can accurately identify extra-luminal complications such as an abscess, phlegmon, adjacent organ involvement, or fistula, as well as recognising other alternative diagnoses such as appendicitis, pelvic inflammatory disease, tubo-ovarian abscess or inflammatory bowel disease (22).
Group B streptococcal late onset sepsis with submandibular phlegmon i a premature infant after beginning of breast feding.
In another retrospective analysis, complicated diverticulitis has been defined as diverticulitis with free perforation, abscess, phlegmon and fistula.
Intraoperatively, the patient was found to have a phlegmon in her right upper quadrant involving the gallbladder, liver, duodenum, and omentum.