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Leptospira

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[Intro]

Leptospirosis (Leptospira) referred to as leptospirosis, many types can be divided into pathogenic leptospira and non-pathogenic leptospira two categories. Pathogenic hook physical cause human and animal leptospirosis, referred to as leptospirosis, around the world are widely popular a zoonotic, most areas have different levels of popular, especially in the southern provinces most serious, and great harm to the health of the people, is one of the Chinese focus on prevention and treatment of infectious diseases.


Introduction

mycelium slender, of varying lengths, usually 6 ~ 20um, width 0.1 ~ 0.2um, with delicate and regular spiral bacteria one or both ends bent hook, often to "c , "s" and other shapes. The tiny beads of leptospirosis like a bunch of shiny, lively movement visible in the darkfield microscope to flex and move back and forth or around the long axis of fast rotation (see Figure 16 ~ 2). Electron microscopy leptospirosis cylindrical structure, the outermost layer of the sheath by

leptospira


lps and protein composition within the cell wall, and then within the serosa twisted into a two-axis wire axis, located in the bacterial side of the cell wall and subserosal. leptospirosis is the entire cylindrical bacterial wound axis from leptospirosis cell wall composition and Gram-negative bacilli similar.

leptospirosis gram stain

the leptospirosis leather blue staining was negative, can not easily be basic dye coloring commonly used silver staining method,

leptospirosis


bacteria France dyed brown, but the silver grain accumulation, the spiral can not be displayed. leptospirosis is the only available artificial medium spirochetes, and the optimum humidity 8 to 30 ℃, pH 7.2 to 7.5, commonly Kesuo fu (korthoff)'s liquid medium, slow growth, 3 to 4 days after inoculation, begin to reproduce, After 2 weeks, the liquid medium was translucent go to haze growth.

leptospirosis resistance

leptospirosis on the physical and chemical factors of resistance compared to other pathogenic spirochetes, can survive for several weeks to several months in water or wet soil, which in this the spread of bacteria, the spirochete and drying, heat, direct sunlight resistance are weak, 56 ℃ for 10 minutes to kill, 60 ℃ within 10 seconds, to commonly used disinfectants such as 0.5% to the Soviet Union, 0.1 sensitive% carbolic acid, 1% bleach, 10 to 30 minutes to kill, sensitive to penicillin, chlortetracycline and other antibiotics.

antigen of pathogenic leptospira

pathogenic leptospira antigen composition, antigen typing is mainly there are two

leptospirosis cause disease


kinds: one is the surface antigen (p antigen), the other is an internal antigen (s antigen); The former exists in the surface of the spirochete, with a specificity of protein polysaccharide complexes. ; while the latter exists in the internal of the spirochete, leptospira sub-basis, is the class of lipopolysaccharide complex, with genus-specific, as the basis of leptospirosis clustering. The world have been found 20 serogroups and more than 200 serotypes, China has found at least 18 serogroups, more than 70 serotypes.

pathogenic

pathogenic substances
1. hemolytic toxin: heat, oxygen stable, with the role of phospholipase-like, enable the cell membrane dissolved, when injected into the lamb in vivo, can lamb anemia, hemorrhage and necrosis, hepatomegaly and jaundice, hematuria.
2. Cytotoxic factor: in vitro cytopathic effect on mammalian cells, the brain of mice inoculated with 1 to 2 hours after the muscle spasms, difficulty breathing, and finally death.
3. Endotoxin-like substances; its nature is different from the general bacterial endotoxin, but also to allow the animal to heat, causing inflammation and necrosis.
In addition, the metabolites of leptospirosis in the host body, such as toxic lipids and certain enzymes: lipase, dehydrogenase, the enzyme of naphthalene amide, three oleic acid lipase, urease enzymes may be damage to capillary walls, so that permeability increases, causing extensive bleeding, damage to the kidney can cause hematuria, proteinuria, and so on.
the pathogenesis and clinical type
leptospirosis natural foci of disease in wild and domestic animals are widely popular. leptospirosis in the tubular growth and reproduction, from the urine. renal long-term colonization of mice and pigs are an important reservoir host and the source of infection of leptospirosis. Pig, rat urine contaminated water, rice fields, streams, ponds, etc. as contaminated water, to participate in field sports, flood control, fishing and other contact with contaminated water, there is a strong invasion force, due to leptospirosis can wear had normal or broken skin and mucous membranes, and invade the human body. Eating contaminated food or drinking water of the diseased mice droppings, leptospirosis can be through the gastrointestinal mucosa into the human body, can also infect the fetus through the placenta to cause abortion; In addition, leptospirosis can be transmitted by blood-sucking insects.
crowd of ordinary susceptible to leptospirosis, but the incidence of high and low exposure to contaminated water opportunities and immunity related. To farmers, agriculture, foreign personnel, breeder and rural young people have a higher prevalence. leptospirosis in rainy, rodents and other animals frequent the summer, autumn epidemic At this time of environmental leptospira pollution is serious, plus the busy people with contaminated water exposure opportunities.
leptospirosis through the skin and mucous membranes invade the body, about locally by an incubation period of 7 to 10 days, and then enter the bloodstream and multiply, causing early leptospirosis septicemia. In the meantime, the role of leptospirosis and the release of toxic products, fever, chills, body aches, headache, conjunctival hyperemia, gastrocnemius muscle pain. leptospira in the blood about a month or so, followed by leptospirosis invade the liver, spleen, kidney, lung, heart, lymph nodes and central nervous system and other tissues and organs, causing damage and signs of the relevant organs and organizations. leptospira bacteria, the virulence of different number and strength of immunity, progression and severity of symptoms vary widely, a common clinical the following types:
1. typhoid influenza type: early symptoms of leptospirosis septicemia, clinical manifestations, such as influenza, mild, general internal damage is also lighter.
2. jaundice Blood: In addition to the symptoms of fever, chills, body sore spot bleeding, jaundice, liver and kidney damage. bleeding may be associated with capillary damage, leptospirosis of toxic substances in vascular endothelial cells, so that the increased capillary permeability, leading to systemic organs, mainly liver, spleen, kidney point-like bleeding or bruising, blood in the stool and elbow cells damage, jaundice.
3. pulmonary blood type: hemorrhagic pneumonia symptoms such as chest tightness, cough, hemoptysis, cyanosis, dangerous conditions, often died of massive hemoptysis, the mortality rate is high.
In addition, there are meningoencephalitis., renal failure, type, gastroenteritis type, etc., showed symptoms of organ damage; some patients recovering from complications may also occur, such as uveitis, cerebral arteritis, blindness, paralysis may be caused due to allergy.
no fixed relationship between leptospirosis serotype leptospira clinical genotyping, clinical classification with the progression of the disease can also be changes.

immunity

early stages of infection the body through non-specific immune killing leptospirosis, but the effect is not strong. 1 to 2 weeks after infection specific antibodies in the blood, with conditioning, aggregation and dissolution leptospirosis, enhanced phagocytic role. The emergence of specific antibodies to the rapid removal of blood leptospirosis is generally 7 to 10 days in organ leptospirosis clear, but the kidney in leptospirosis is less affected by antibody to maintain a long time. Therefore a longer period of time (several weeks to several years) row of bacteria in urine.
leptospirosis latent infection or disease lasting immunity to the same type of leptospirosis are available, mainly humoral immunity, cellular immunity little effect.

laboratory examinations

pathologic examination
incidence of one week within to take blood, take urine after the second week, meningitis symptoms take the cerebrospinal fluid to check.
1. Microscopic examination of direct microscopic examination: take anti-clotting 1000 r/min, and centrifuged for 10 minutes, remove the blood cells; plasma and then to 10 000 rev/min, centrifuged 40 minutes, remove the supernatant to take precipitate dark-field microscopic examination. Staining,: Fontana silver staining, the smears. In addition, you can check by immunofluorescence or immunoenzyme staining.
2. isolation and Identification of blood a few drops of vaccination in the Coriolis (Korthoff) medium (4.5 to 5ml) of each specimen inoculated with 2 ~ 3, at 30 ℃ for 5 days every 3 to 5 days, dark-field microscopic examination time. If leptospira growth, re-transmission of culture, with the growth of good bacteria for identification, negative at least for 30 to 40 days, yet to be found to the report. Urine specimens generally need to concentrate (centrifugal), training, and culture need to add antibacterial agents such as 5 - fluorouracil; specimens were inoculated in the abdominal cavity of guinea pigs were separated.
serological test
general early in the disease and the incidence of 2 to 3 weeks of each blood collection time the following tests.
1. Microscopic agglutination test
currently used methods, the standard strain or local common bacteria Jurassic antigen and different dilutions of serum mixed with the patient, respectively, at 37 ℃ for 2 hours, then drops copies for a dark-field microscopic examination . If a certain type of antibodies in the sera and visible The leptospirosis condensate integrated group, shaped like small spiders, most patients agglutination titer of serum in 1:400 above or advanced than the early serum titer four times in the same type of antigen Kong the above diagnosis.
2. Indirect agglutination test for leptospira genus-specific antigen adsorption on the carrier as has the leptospira genus-specific particulate antigen, common carrier sheep red blood cells, activated carbon, latex particles, the particles of the antigen on the slide with the patient serum the corresponding antibody role, there may be a visible agglutination. The sensitivity of this method is poor, but quick and easy, in particular, carbon agglutination and latex agglutination test, suitable for primary health care unit for a secondary diagnosis of leptospirosis.
In addition, the complement fixation test, indirect immunofluorescence test, ELISA and other serological methods can be used for diagnosis.

cause illness

leptospirosis is caused by leptospirosis (Leptospira) a.
the leptospirosis is burgdorferi head (Spirochaetales) spirochetes Branch (Spirochaetaceae,). There are two kinds, which leptospira interrogans (Leptospirainterroans) is a bacterial parasite of humans and animals. Divided into 18 serogroups, there are over 160 serotypes, of the group under which the Bowmore take group (L.pomona), the dog population (L.canicola), Tarasov group (L.tarassovi), jaundice and bleeding the group (L.icterohemorrhaiae,), seven days a the flu typhoid group (L.rippotyphosa) fever group (L.hebdomadis) is the important pathogens of livestock. Some herd be infected several serogroups and serotypes. This disease is prevalent in countries around the world, China also have occurred, and the provinces south of the coastal and the Yangtze River is more common.
the leptospira natural host rodents, is also a certain group of hosts. leptospirosis by excreted in the urine of sick animals and carriers to invade through the mucosa or injured epithelial surface of carcasses, nasal cavity, throat, oral and esophageal mucosa and the conjunctiva is often the portal of infection. Different clinical diagnosis of pigs and adult pigs often do not appear or have mild symptoms, but when the outbreak of the disease, and Piglets, the main symptoms of jaundice, fever, death is not common. The pigs are often long-term carriers and exclusive bacteria. The cow's symptoms can be divided into acute, subacute and chronic type 3. The most acute form often occurs in pregnant cows, the incidence of sudden, high fever, mucosal depth of yellow dye. subacute type occurred in the dairy cow, stage of disease for about two weeks and rarely death. milk yield, reduced milk, red, or blood clots; visible jaundice. chronic stage of disease may be extended to two months or more, most obvious symptoms. calf symptoms are high fever, jaundice and hematuria, commonly known as calf hematuria disease and high mortality. In horses is generally not the onset of symptoms, sub-clinical diagnosis of infection more common, acute cases of short-term fever, and then develop jaundice, hemolytic anemia and mucosal point of bleeding. Some horses pre Although there were no symptoms, and late periodic ophthalmia. dog incidence caused by jaundice and bleeding group bacteria, showing a high fever, jaundice, a few hours after the onset of symptoms to death within a few days. Caused by the canine group of bacteria, jaundice is not common, tongue and oral mucosa, ulceration and necrosis, oliguria, and finally died due to urinary sepsis. Cat symptoms. sheep less risk of the disease.
available agglutination test and complement fixation test or fluorescent antibody method for diagnosis. Also to leptospirosis separation can be used for diagnosis. Collected urine inoculation of young guinea pigs or direct training, inspection and leptospirosis in the acute phase of the disease in blood or in the acute phase after two weeks. Take the dead animal liver, kidney slices, with silvering France staining, is also a test method. Early treatment with antibiotics. streptomycin sulfate treatment on carrier row bacteria animals can be used. Inoculated with the vaccine is commonly used methods of prevention. rodent control is also an important measure to cut off the source of infection.

control measures

First, avoid the dogs and infected animals (especially pigs and rodents) and urine contaminated water, feed, contact. pollution of the environment, can be used 2 to 5 percent bleach solution, or 2% sodium hydroxide, or 3 percent to Su children disinfection.
Secondly, flooding control, rodent control.
disease meat and contaminated animals in the third, is strictly prohibited feeding raw meat and other products.
Fourth, the larger group of dogs a year 1 quarantine and found dogs and suspicious infected dogs should be isolated. Penicillin, streptomycin of the disease have a good effect, especially in the early applications, the better. But it must be continuous treatment for 3 to 5 days in order to play to eliminate the role of leptospira in the kidneys.
Fifth, take the drug prevention. At present, there is no canine leptospirosis vaccine, combined with the combined vaccine with other vaccines at home and abroad, can give the dog vaccination, but vaccine must include the local popular type of bacteria. If there is no vaccine, and drug prevention in the epidemic period (per kilogram of feed oxytetracycline 0.75 to 1.5 grams) or tetracycline (1 to 1.5 mg/kg body weight), and oxytetracycline in the feed, even feed 7 days to control infection of dogs.
Sixth, feeding the dogs, the staff not to contact with the health dogs.


[Cause]

boil is caused by what the?

infection and skin dirty, scratches, high ambient temperature or lower the body resistance to infection-related. Boils can occur in any follicles of the skin area, often to the head, face, neck, armpits and buttocks so often by the friction of the parts is more common.

(a) causes

boil the pathogenic bacteria Staphylococcus aureus based, Streptococcus, Staphylococcus epidermidis, are also caused by the disease. Local and systemic skin's resistance to infection is reduced mainly due to Benbingfasheng, so infants, malnutrition, diabetes is a good risk of this disease. Dirty skin, skin abrasions, high ambient temperatures often lead to local infection such as the direct cause.

(B) the pathogenesis

bacteria invade the hair follicle and their sebaceous glands and sweat glands, in hair follicles and surrounding tissue multiply rapidly, producing toxins, causing local tissue degeneration, necrosis, and the center of the formation of boils, the performance of local congestion, exudation, induration. Aggregation of neutrophils to the damaged body tissue cells and bacteria to be destroyed, and he gradually necrosis and dissolution, the formation of abscesses in the dermis. Due to Staphylococcus aureus, coagulase contain toxins, so the formation of pus bolt, protruding outward. Swelling and induration clinically visible in the center of a yellow-white pus plug. This is Staphylococcus aureus infected lesion characteristics. Ulceration after discharge pus, abscess gradually by the new fibrous tissue repair and healing.

[Sign]

boil the early symptoms?

1. redness, swelling, heat, pain summary, cylindrical cone.

2. inflammation to the development of nodules increases, the pain intensified.

3. A few days later nodules central necrosis, abscess formation, dissolution, soft induration, pain relief, the central pus head most of the self-rupture, discharge pus, inflammation subsided recovery.

4. furuncle usually no obvious symptoms, but if the blood flow occurred in the rich parts of the body resistance weakened, it can cause discomfort, chills, fever, headache and loss of appetite and other symptoms of toxemia.

5. Facial Boil such as intracranial infection, facial swelling and severe, may be associated with chills, fever, headache, sinus infections and other embolization.

boil because of location, severity of different clinical manifestations may vary.

local swelling and pain sclerosis: no systemic symptoms of early disease and more, only infection redness, swelling, pain, range of not more than 2cm in diameter, small nodules gradually enlarged, as papules bulge. A few days later lesions extended about 3 ~ 5cm, nodules gradually softened, the center was white, a slight touch of the fluctuations; then ulceration pus, and the emergence of yellow-white pus plug. Pus bolt off, pus shed, the inflammation subsides and healing. There is no pus boil bolt (the so-called headless boil), since the collapse a bit late, need to find ways to promote its pus discharge (Figure 2 ).

fever, swollen lymph nodes: furuncle serious infection, the local area of ​​the lymph nodes, tenderness, and may be associated with body heat, and sometimes lymph node abscess formation.

nose, upper lip and around (called "dangerous triangle") of the surface boil, add or pushed in touch, the bacteria via the angular vein, ophthalmic vein into the brain, causing intracranial suppurative infection. At this point may have fever, headache, vomiting, consciousness disorders.

early follicular redness, swelling, heat, pain, induration. After the white purulent center, there is volatility. May be associated with systemic fever, elevated white blood cell count and differential count.

[Aftertreat]

boil ate?

therapeutic side:

1. composed of: a single head of garlic, honey, 9 grams. Usage: pound evenly wrap the affected area.

2. consists of: single head of garlic amount. Usage: Peel and slice into 2 to 3 mm, with the first affected area with warm salt water when dry wash, and then sticking garlic, and gently massage the 10 to 20 minutes, 2 or 3 times a day, 2 3 There is no more. Indications: Boil, folliculitis. Note: In severe cases, such as local irritation may reduce the massage time, a serious condition should be added to serve anti-inflammatory drugs.

3 . composed of: tea 2 grams of dried honeysuckle 1 gram. Usage: boiling water 6 minutes after each meal drink in a cup. Indications: Boil, exogenous heat.

4. composed of: fresh Malan first 100 grams, the amount of liquor. Usage: Add a little salt before blindly smashed wine Ban Cheng paste, coating the surface of the skin furuncle carbuncle. Indications: furuncle, carbuncle.

5. Composition: rosin 10 grams of white wine. Usage: rosin research to fine tune white wine into a paste, resisting heat, wrap the affected area after dissolution, for the degree of responsibility to cover all of the above and then covered with wax paper and tape securely, to enhance efficacy, can drop a few drops of wine, rosin to keep moist. Indications: furuncle, carbuncle, folliculitis.

6. smashed topical papaya leaves, swollen boil carbuncle treatment drug.

7. fresh peach leaf, plug smashed the lesion, treatment of nasal furuncle.

8. rhizome or fresh banana leaves smashed Jiao Zhi, coating the surface of the skin, cure carbuncles, boils, swelling.

9. almond powder with sesame oil paint, heat treatment boil.

10. Purple cane coal deposit of the skin, powder, paint the affected area or sesame oil dressing, boil carbuncle treatment, stomatitis , eczema.

11. raw taro add a little salt, smashed drunk wrap the affected area twice a day replacement, bones can cure pain, swelling of unknown drugs, pediatric head hot boil, finger boil.

12. raw loofah (or leaf), smashed juice, coated surface of the skin, soak sore treatment days, yellow water sores, heat boils, urticaria .

13. mung bean sugar kelp: seaweed 60 grams, shredded, green beans, 150 grams, with the soup, add brown sugar to taste food. There Sedative, diuretic, soft-kin, Phlegm, scattered gall tumor effect. For hypertension, beriberi edema, neck lymphadenopathy, simple goiter, prickly heat boils hot summer day in children poison, phlegm cough embolism.

14. yi melon soup: melon (not peeled) 500-600 g, yi 50-100 grams of soup. Can be flavored with sugar or salt, on behalf of the tea used, heat, hot weather, diuretic, dehumidification effect. Drugs for Rush boils, eczema athlete's foot, yellow urine deficient.

15. Daozhi raw turnip, vinegar and rub the affected area transfer, heat treatment boil.

16. green beans 30 grams of powder, each 10 grams, water delivery service, boils cure breast swelling and pain.

17. failure to adopt the open rose 3 - 5 朵 wash, add water, two pregnant, suffering from a cup of low heat, ice sugar 30 grams, made of rose soup, until the temperature dose, to cure blood stasis amenorrhea, boils Chung pain, traumatic swelling and pain.

18. boils and pus ulceration of the skin sore or eczema, rinse with water, tea, allow the wound clean and promote healing.

19. a white sweet potato, peeled and chopped, smashed, can also be added with the same amount of fresh Houttuynia smashed, spreads in the affected area, apply to the local heating that line replace (about two three hours long), and even apply a few days more, boils cure mastitis.

20. soybeans amount, turn on the water immersed soft, add a little alum were smashed drunk, external surface of the skin, swollen boils boil treatment.

21. adzuki beans with water until soft, mash with water or vinegar, or honey or egg amount, into a paste, external surface of the skin, cure mumps, hot boil.

22. Kapok 30 - 50 grams of sugar amount, fry a bowl with water and drink two bowls and a half. Favorable moisture, heat effect. For enteritis, urethritis, eczema, summer boil embolism.

23. fresh buckwheat leaves 60 grams, Shuijianbi day one; or fried yellow noodles with the vinegar into a paste, applied to the lesion, sooner or later be replaced. Governance sore, swollen boils, erysipelas, mastitis, and swelling of unknown drugs.

appropriate patients to eat what?

1, edible grapes plus zinc salt or zinc, other foods such as soy, sunflower seeds, wheat bran, yeast, brown sugar and so on.

2, Yi Shi taste light, the cold food, such as Malan head, purslane, melon, red and white radish, bitter gourd, sponge gourd, mung bean, red bean, lily, chrysanthemum brain and celery.

patients unfit to eat what?

not eat ginger, pepper and other spicy foods , as well as mustard, yellow croaker, shrimp, crab, chicken head, goose, Zhu Tourou so fat objects.

should avoid fried foods and meat, edible oil cans.

data only refer to the specific, please ask a doctor.

[Prevent]

how to prevent boils?

boil is born of acute suppurative superficial skin disorders, widely available health, children, young people more common. "Surgical management case" that: "boil persons, birth processes, floating red rootless feet, swollen found in the skin, only the width of an inch, there is less pain, a few days later Microsoft, thin peel, the beginning of the blue water, the latter from breaking the pus out of. "The disease occurs in the summer and autumn, protruding roots shallow, swelling potential limitations, lift the red pain, mostly in the range of about 3cm, easily swollen, easy to collapse, Yi Lian. Early can be divided into a head, without the first two kinds of general light and easy to cure the symptoms, so the saying goes, "no boil the size of a pus like." ;;; ;;;;; ;;;;; ;;;;; But also due to the formation of improper treatment or care "mole cricket boils," or repeated seizures, lack of disunion. Multiple furunculosis ", is difficult to cure.

[Treat]

boil precautions before treatment?

attention to the skin clean, timely replacement of underwear and avoid skin injuries, especially in the summer, to bathe, wash your hair, hair, changing clothes, nails, children in particular should pay attention. With honeysuckle and wild chrysanthemum Jiantang tea. Boil the surrounding skin should be kept clean and coated with 70% alcohol to prevent infection spread to nearby hair follicles.

boil Chinese medicine treatment methods

total boil caused by the toxic heat treatment to detoxify the basic principles.

A Differential Treatment:

1. Heat toxin Accumulation card: lesion processes, such as cone, burning pain, or fever, thirst, tongue pink, yellow fur, rapid pulse. Detoxification. Flavors disinfection decoction.

2. Shushi heat Melancholia: seen in summer and autumn, the affected area, such as agglomeration cone, single or multiple, burning pain, chest tightness, anorexia, deficient urination, red tongue, greasy or yellowish, veins slippery. Qingshu dampness, detoxification swelling. Qingshu Decoction.

3. Is virtual evil love cards: distributed in the body, local color dark red, pus scarce, one after another, delayed healing, with fever, irritability, thirst, or fatigue, limb soft, red tongue thin yellow, rapid pulse. Righting detoxification. Liu Wei Di Huang Decoction.

Second, external treatment and other treatment:

1. The beginning of detoxification should be swelling, moderate to henbane, water reconcile, wrap the affected area. Or wishful golden powder for external application. Or green cream Waicha.

2. Pus, the clip bolt out the pus.

3. Unhealed after the collapse, sores can be a little ninety-one Dan to drugs or drug line twist into sores, topical berberine gauze.

4. Oral Meihuadianshe Dan, Niuhuangjiedu, Fang Feng Tong Sheng Wan, Liushen other medicine.

5. Unilateral prescription: Silver Flower 30g, licorice 10g, decoction, on behalf of the tea.

Western boil treatment

1. Local treatment, such as heat, physical therapy, 10% ichthyol coated ointment. Facial Boil should rest in bed should not squeeze or prick Boil, so as not to spread to the brain.

2. Swelling or have a large range of obvious symptoms, should give systemic antibiotics (third-generation cephalosporin antibiotics).

3. The formation of abscess, incision and drainage should be timely but should be avoided Boil the face cut.

(a) treatment

1. The principles of early treatment to promote inflammation subsided, after early drain purulent pus; timely elimination of systemic adverse reactions.

2. Local treatment

(1) Physical therapy: early, ultraviolet micro-irradiation, can promote local anti-inflammatory, to prevent proliferation. Swelling stage, the selection of FM, infrared and other heat, promote Boil liquid. 2 to 3 times / d, 20 ~ 30min / times.

(2) Drug eraser: 0.5% povidone-iodine scrub, the drug not only for skin irritation, and the role of long-lasting, no pigmentation. Can also be used erythromycin, tetracycline ointment.

(3) topical cream: local swelling and a small pustules, use ichthyol, wishful golden powder, Gyokuro powder and so on.

(4) incision and drainage: Boil into pus, nodules soften, a sense of volatility, you can make a small incision drainage or fire needle drainage. Taboo squeeze purulent lesions.

(5) to keep local clean and dry: adhere to local skin cleaning, daily showers are the best conditions. Young children with skin, topical lip after taking a bath in summer, to avoid the formation of multiple Boil.

3. Systemic treatment usually does not require systemic treatment of boils. But facial boils or accompanied by chills, fever, headache, general malaise, etc., should be given antibiotics. Clinical observations and experimental results show that the efficacy of penicillin, cephalothin, cefazolin and amikacin better effect.

(B) the prognosis

generally good prognosis after active treatment, without sequelae.

[Examine]

boil should be how?

1. Peripheral blood

(1) white blood cell count: fever, elevated WBC count may have.

(2) white blood cell count: white blood cell count was elevated often accompanied by increased neutrophils .

2. diabetes check

(1) fasting plasma glucose measurement: two fasting blood glucose were increased, should consider the possibility of diabetes.

(2) glycated serum protein: This clinical trial is not the impact of fluctuations in blood glucose higher than normal to help the diagnosis of diabetes.

(3) glycosylated hemoglobin: glycosylated hemoglobin and blood glucose were positively correlated, and the irreversible reaction. Diabetes is often higher than the normal 2 to 3 times.

3. bacteriologic

(1) bacterial culture: the multiple, repeated infections, abscesses can be extracted directly pus for bacterial culture, positive results will help the diagnosis of pathogens.

(2) drug susceptibility testing: bacterial culture in the pus, while line drug susceptibility testing can provide the scientific basis of clinical drug treatment.

[Diff]

boil diseases easily confused?

1. Multiple sweat gland abscesses are summer disease, more common in infants and young children and frail mother's head, forehead, etc .. Lesions of multiple subcutaneous abscesses. Surface tenderness, inflammation lighter. No pus bolt, left scars. Usually accompanied by a lot of prickly heat. Generally known as prickly heat poison. It was also known as pseudo furunculosis (Pseudofurunculosis).

2. Hidradenitis suppurativa common in young women, lesions of the skin induration. Subcutaneous abscess formation, followed by skin redness, swelling, heat, pain, ulceration scarring. Lesions occur in the armpits, groin, genital and perianal, umbilical, etc.

3. acne acne mild infection, red, swollen, painful, but the disease is small, the top a little bit like creamy.

4. sebaceous cysts sebaceous cyst infection are redness, swelling, pain, but the previous round has been painless mass over an extended period , the epidermis as usual.

5. carbuncle carbuncle with redness, swelling, pain, but there are several hair follicle infection, lesions larger than the boil.

[Disease]

hump-related diseases

juvenile osteochondrosis of vertebral osteoporosis youth sexual hump sore scoliosis ankylosing spondylitis vitamin D deficiency disease

more back symptoms

small blisters appear back back pain back spasms, back pain does not have subtle linen spine back pain sinus pain Road with sensory ataxia spinal nerve root damage spinal cord hemisection syndrome, spinal cord lesions of hemorrhagic infiltration of the spinal cord injury spinal cord infarction, cauda equina involvement across the spinal cord within the spinal cord gliosis in the spinal cord anterior horn of the spinal cord lesion cavity formed spinal thalamic tract compression

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