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Suppurative tonsillitis

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[Intro]

basic overview

pathogens the majority of hemolytic streptococcus, followed by haemophilus influenzae, Streptococcus pneumoniae, Staphylococcus aureus. Often acute onset, obviously sore throat accompanied by high fever (temperature up to 39 degrees Celsius) examination can be found in the enlarged tonsils, congestion, surface yellow purulent discharge. Sometimes accompanied by submandibular lymph node swelling, tenderness, no abnormal signs and lung examination.
Clinical manifestations: the incubation period is about 3-4 days, sore throat and began to side, following bilateral throat pain, swallowing pain got worse. Patients with systemic symptoms of malaise, chills, fever, pain in the limbs and so on. In addition, some patients may have ipsilateral earache, tinnitus and hearing loss phenomenon. Check the pharyngeal hyperemia, red and swollen tonsils, the surface of the purulent exudate, and can be connected into a film such as pseudo-membranous, but easy to wipe away without leaving a bleeding wound. Lymph nodes on both sides of the mandibular angle is often pain and swelling. May cause fever.



etiology

The main pathogenic beta-hemolytic streptococcus, staphylococcus, pneumonia and meningitis. adenovirus can also cause this disease. Bacteria and viruses, mixed infections are not uncommon. Bacteria may be the intrusion of the outside world may also be the Department of hidden bacteria within the tonsil crypts, when suddenly lower body resistance due to the cold, wet, excessive fatigue, physical weakness, excessive smoking and drinking, harmful gases to stimulate factor, the bacterial growth to strengthen due. Sometimes compared with the prodromal symptoms of acute infectious diseases such as measles and scarlet fever. acute tonsillitis is often repeated acute exacerbation of chronic tonsil on the basis of.

symptoms

1, tonsil was swollen, general congestion and massive neutrophil infiltration, crypt filled with purulent exudate.
2, the lesions heavier, the majority of lymphoid follicles increased, purulent, and the formation of multiple follicular abscess and can be worn to the crypt or surface, the formation of ulcers, small abscess can be integrated, resulting in whole tonsil purulent.
3, rapid onset, high fever, sore throat, obviously, when swallowing, especially, can lead to children with poor feeding.
4, examination showed throat congestion, enlarged tonsils with a yellowish-white pus point or pus moss, significantly enlarged neck lymph nodes swollen tonsils, widespread congestion and massive neutrophil infiltration, crypt filled with purulent exudate. Severe lesions, the majority of lymphoid follicles increased, purulent, the formation of multiple follicular abscesses, and can be worn to the crypt or surface, the formation of ulcers, small abscess can be integrated, resulting in the entire tonsil suppuration.



prevention conditioning

1. chronic tonsillitis patients should develop good habits to ensure adequate sleep time, with changes in the weather to change clothes, remove damp indoor air are important. For sick children, to develop not picky eaters, but the food's good habits.
2. Exercise, improve the body's ability to fight disease, but the degree of physical exertion after exertion should be timely adjusted the rest. Refrain from smoking, is the prevention of chronic tonsillitis.
3. Suffering from tonsils of acute inflammation should be thoroughly cured, and to avoid future trouble.
4. Prevention of various infectious diseases, epidemics. Fluids, or semi-liquid food, high fever cho alcohol sponge bath to assist in cooling.

treatment

(1) preferred effective antibiotics, this disease is a bacterial infection, mostly streptococcal infection, antibacterial anti-inflammatory may be preferred to penicillin. Those who are allergic to penicillin can be used erythromycin, lincomycin, or Vanguard ADM. Of course, the best way is to smear for bacterial culture and susceptibility testing, targeted selection of antibiotics.
(2) symptomatic selection of antipyretic analgesics tonsillitis complicated by high fever headache and body aches can be used paracetamol (acetaminophen) or ibuprofen, both antipyretic and analgesic, antimicrobial agents play a high-performance .
(3) caution hormone Some doctors prefer to use the hormone cooling, indicating the effect, in fact, desirable. In the absence of effective antimicrobial agents, not blindly use of adrenal corticosteroids such as prednisone, dexamethasone, which would only cause the condition to get the illusion of control, cover up the disease.
(4) topical choice of 3% hydrogen peroxide solution of l% zinc oxide, l% ~ 2% iodine glycerin, 10% tannic acid glycerin coating tonsil surface, 1 day, 10 course of treatment.
patients should be appropriate isolation, adequate rest, drinking water, maintain defecate unobstructed, the consumption of liquid food.
(5) while the medication, topical iodine wipe the tonsils, the course of the disease can shorten speedy recovery.
specific methods, replace bamboo sterile cotton ball, or with sterile tweezers folder sterile cotton ball, dipped 2 percent tincture of iodine, and quickly wipe the surface of suppurative tonsillitis.
Note: where those who are allergic to iodine and alcohol, is absolutely forbidden to use this method.


[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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