Purulent inflammation: description, causes, types and treatment features. Treatment of a boil in the nasal cavity

Pus in the nasopharynx can appear for many reasons. It is almost impossible to make a diagnosis on your own. Only an otolaryngologist can accurately name the disease after a thorough examination. But in any case, if this alarming symptom appears, you need to seek help as soon as possible. Self-medication can lead to complications and other sad consequences, so you should not put off visiting a doctor.

The main reasons for the appearance of pus in the nasopharynx include the following diseases:

Purulent pharyngitis. This is one of the most dangerous forms acute pharyngitis, requiring immediate treatment. Purulent pharyngitis is an inflammation of the mucous membrane of the pharynx, which is accompanied by pain when swallowing, discharge of pus, and sometimes fever. This disease can occur due to severe acute rhinitis, pathogens can also be bacteria or viruses. In addition to purulent discharge from the nasopharynx, swelling of the tongue, headaches, ulcers on the tonsils, and enlarged lymph nodes may be observed.
Nasopharyngitis. This is an inflammation of the mucous membranes of the nasopharynx of a bacterial or viral nature, accompanied by purulent discharge, as well as the formation of mucus in the nasopharynx. The most common cause of nasopharyngitis is infection. This disease may be a consequence of rhinitis or rhinorrhea, an abnormality in the structure of the nasopharynx, or frequent colds.
Tonsillitis. Tonsillitis is inflammation palatine tonsils, which most often occurs as a consequence of sore throat. With this disease, there is a painful sensation in the throat, a sensation of a foreign body, difficulty swallowing, and purulent plugs in the throat. Tonsillitis can spread the infection through the blood to other organs. Therefore, when the first signs of this disease appear, you must consult a doctor and begin treatment.
Diphtheria sore throat. It's inflammatory infectious disease, the causative agent of which is the Klebs-Leffler bacillus. With diphtheria sore throat there is sharp pain sore throat, lethargy, low temperature body, the appearance of ulcers and purulent formations on the tonsils.
Sinusitis. With sinusitis, pus accumulates in the maxillary sinuses, but in advanced cases, pus can enter the throat and even the lungs and brain. Sometimes after sinusitis a sore throat appears as a complication of this disease.

Treatment purulent diseases nasopharynx is prescribed by an ENT specialist; self-medication is extremely dangerous. If pharyngitis is allergic, then rinsing everything in a row can only intensify the reaction.

Tonsillitis is usually treated with lavage, which is carried out in a clinic. Sometimes washing is replaced by squeezing out purulent formations cotton swab, moistened with Lugol. This procedure is also performed by an ENT doctor, but not at home. If both are not possible, it is necessary to actively gargle with Lugol (diluted).

Pharyngitis is also treated by rinsing outpatient setting. An important part of treatment is nutrition. All irritating foods must be excluded. This concerns spicy food, highly salted, hot or too cold, and sour with vinegar. You need to gargle with a solution of furacillin or iodinol. You can use throat sprays such as Kameton or Ingalipt, which relieve inflammation and painful sensations. It is necessary to stop smoking and alcohol, as this will only weaken the immune system.

Most of these diseases are treated with antibiotics if their origin is bacterial.

More information about pharyngitis can be found in the video.

Typically, treatment is aimed at eliminating symptoms, reducing inflammation, and also eliminating the cause of inflammation itself, that is, fighting infection. Various physiotherapy procedures aimed at improving blood supply to tissues are widely used to treat sinusitis. They also use vasoconstrictor drops to ease breathing, antiseptic drugs and drugs aimed at strengthening the immune system.

Nasopharyngitis usually lasts about a week. There are no medications yet that can shorten this period, so treatment is aimed at relieving symptoms. This includes rest, rinsing with warm salted water, drinking large quantity liquids.

At elevated temperatures, antipyretics such as paracetamol or aspirin are prescribed (children are prescribed special syrups).

Treatment of purulent inflammatory diseases of the nasopharynx exclusively with folk remedies will not give results. They are usually prescribed in parallel with drug treatment. For example, if you have tonsillitis, yoga is helpful because it increases blood flow to the head and neck.

One of these exercises is the “birch tree”. However, these exercises can only be performed with washed tonsils, otherwise headaches and fever may occur.

What folk remedies exist to combat pus in the nasopharynx:

Herbal tea is indicated for many purulent inflammations of the nasopharynx, but you need to be careful not to overdo it with the amount of herbs and avoid allergies.
You can simply gargle with herbal infusions: chamomile, sage, peppermint, calendula, plantain, raspberry.
An infusion of cloves will cleanse the lymphatic system. But you need to use it with caution if you have ulcers.
Inhalation of fresh onion vapor has an antibacterial effect.
For sinusitis, inhalations with propolis tincture are often used.
A traditional folk remedy for fighting colds and any other inflammatory diseases of the throat and nose is inhalation of steam from boiled potatoes. Potatoes should be boiled in their skins.
For pharyngitis, it is recommended to drink drinks rich in vitamins, such as berry juice or rose hip decoction. Just remember that drinks should not be cold.
Purulent pharyngitis is also treated with a solution of soda and glycerin. Glycerin is needed to alleviate the feeling of dryness in the nose and throat that sometimes occurs with pharyngitis.
Since ancient times, colds, as well as sore throats, have been treated Kalanchoe juice. You can drop it into your nose and gargle, but be sure to dilute it with water before doing so.
Chewing small slices of lemon is also beneficial. Before doing this, you should consult your doctor. In some cases citric acid provides irritant effect on the mucous membrane and can worsen the situation.

In order not to suffer from purulent inflammation of the nasopharynx, first of all it is necessary to avoid viral and bacterial infections and strengthen the immune system in every possible way.

The best way to strengthen the immune system is considered to be hardening a healthy body (if a person is already sick, hardening must be stopped). The essence of this procedure is to help the vessels quickly adapt to sudden temperature changes. Under no circumstances should you immediately dive into ice water. To be beneficial, hardening must be gradual and very careful. In the beginning, you can generally wipe cold water only some parts of the body: arms, shoulders, face. After this, you must immediately wipe yourself dry with a towel.

An important part of prevention is disinfection of the home. To prevent pathogenic microbes from accumulating in your home, regularly ventilate the room and carry out wet cleaning with special products.

It is necessary to remember about your own hygiene. After working day and traveling on public transport, it is useful to take a cool shower. Of course, everyone knows that you need to wash your hands every time you come home and before eating, and also brush your teeth and tongue at least twice a day.

During epidemics, try to avoid crowded places. Working people cannot avoid public transport, so if you are shy about special masks, you can lubricate your nasal passages oxolinic ointment and also carry with you sea water(sprays like Aquamaris) to regularly rinse your nose from bacteria and germs.

Avoid hypothermia, and if staying in the cold is unavoidable, then you need to dress warmly. It is especially important to protect the throat area, legs, and back.

There should be an air space between the body and clothing, which will serve as a heat insulator, so woolen fabrics are especially effective in cold weather.

There are many multivitamin complexes, strengthening the immune system. Besides proper nutrition, which includes foods containing vitamin C, during epidemics, especially in the winter-spring period, it is useful to take additional vitamins.

Consequences of purulent inflammation of the nasopharynx

Wrong and untimely treatment may lead to some unwanted complications.

Sinusitis can lead to pharyngitis, tonsillitis and laryngitis. Untreated tonsillitis, in turn, is dangerous because it can lead to rheumatism and heart disease.
Tonsillitis should not be viewed as a harmless disease. Of course, this is not fatal, but the consequences can be very serious. For example, kidney disease, dermatoses and various diseases eye. An advanced form of tonsillitis can provoke complications in the functioning of the female reproductive system, as well as diseases of the biliary system.

In people who have been ill chronic tonsillitis(in severe form), the risk of developing lupus erythematosus and rheumatism increases.

Sinusitis is also dangerous because it can develop into meningitis or sore throat. Maxillary sinuses located close to the brain, so when chronic sinusitis and if not treated correctly, bacteria can enter the brain. This is perhaps the most terrible consequence of sinusitis, which does not exclude death.

There are statistics indicating that young women with a history of repeated purulent sore throats are more likely to experience the problem of miscarriages.

Pharyngitis itself is not so dangerous. If you treat it in time, it will go away harmlessly. However, if the disease is neglected, it can lead to such purulent complications like abscesses. Kidneys and joints are also at risk.
Diphtheria sore throat is especially dangerous for children from one to 5 years of age, as they are susceptible to such a contagious disease as diphtheria. Diphtheria bacillus has a destructive effect on the kidneys, heart, nervous system. One of the most dire consequences The disease is paralysis of the respiratory muscles.

ABSCESS(Latin abscessus- abscess; synonym: abscess, aposteme) - a limited accumulation of pus in various tissues and organs. An abscess should be distinguished from empyema (see) - accumulation of pus in body cavities and hollow organs - and phlegmon (see) - diffuse purulent inflammation of tissues.

Etiology and pathogenesis

The main causative agent of purulent infection is staphylococcus in the form of a monoculture or in association with other microbes ( coli, Proteus, Streptococcus, etc.).

Most often, the infectious agent enters from the outside ( exogenous infection), although there are also cases endogenous infection. Infection from neighboring or distant organs is possible: odontogenic ABSCESSES; para- and peritonsillar ABSCESSES; subdiaphragmatic ABSCESSES - in the presence of foci of purulent inflammation in the organs of the chest cavity; metastatic ABSCESSES of the lungs, brain, kidneys and a number of others. The penetration of certain chemicals (for example, kerosene) into tissues leads to the development of so-called aseptic ABSCESSES, if an infection does not penetrate into the area of necrosis that has occurred. The cause of ABSCESS may be the introduction into tissues of concentrated solutions of medicinal substances - 25% solution of magnesium sulfate, cordiamine, etc.

There are known cases of the development of Abscess in children after the administration of diphtheria, scarlet fever toxoids, polio vaccine and even antibiotics. The pathogenetic factor in the development of ABSCESSES of various localizations, as a rule, is purulent inflammation (see), which leads to tissue melting and sometimes to necrosis and rejection of dead tissue - sequestration. The resulting tissue sequesters are located in the A. cavity and can subsequently be subjected to enzymatic melting (see Sequestration, sequestration).

A feature of an abscess as a delimited purulent process is the presence of a pyogenic membrane - the inner wall of the abscess, lined with granulation tissue. The pyogenic membrane delimits the purulent-necrotic process and produces exudate. The ability of surrounding tissues to create a granulation membrane is a manifestation of the body’s normal protective reaction, aimed at isolating the purulent process. This is a manifestation of nonspecific reactivity, which is determined by the normal state physiological systems healthy body. Subject to availability serious illnesses(nutritional dystrophy, vitamin deficiency, diabetes mellitus, malignant tumors, etc.) the body’s ability to limit purulent inflammation by creating a granulation shaft is disrupted and the pyogenic membrane is intermittent or does not form at all (I.V. Davydovsky, 1969). In these cases, complete delimitation of the process does not occur, and it takes on a diffuse character.

Pathological anatomy

An abscess always occurs either in already dead tissues, in which microbial-chemical processes of autolysis increase (for example, during injury), or in living tissues that are exposed to strong microbial influence (for example, during infections). According to the nature of the course, ABSCESS can be acute or chronic.

In the initial period of formation of an abscess, a limited area of tissue is infiltrated with inflammatory exudate and leukocytes. Gradually, under the influence of leukocyte enzymes, the tissue undergoes melting, and a cavity is formed filled with purulent exudate. The shape of the cavity can be either simple round or complex, with numerous pockets.

Rice. 1. Acute abscess. An area of tissue infiltrated with purulent exudate. Accumulation of leukocytes along the periphery of the abscess (1).

Rice. 2. Chronic lung abscess. The wall of the cavity is formed by a pyogenic membrane, consisting of two layers: 1 - inner layer (granulations and scraps of necrotic tissue); 2 - outer layer (mature connective tissue).

Abscess walls early stage its formations are covered with purulent-fibrinous deposits and scraps of necrotic tissue. Subsequently, a zone of demarcation inflammation develops along the periphery of the Abscess; its constituent infiltrate serves as the basis for the formation of a pyogenic membrane that forms the wall of the cavity (Fig. 1). The pyogenic membrane is a vascular-rich layer of granulation tissue. Gradually, in that part of it that faces the tissues surrounding the Abscess, granulations mature. Thus, if the Abscess becomes chronic course, two layers are formed in the pyogenic membrane: the inner one, facing the cavity and consisting of granulations, and the outer one, formed by mature connective tissue(Fig. 2).

Abscesses in various organs have certain features that reflect the unique structure and function of these organs. So, with ABSCESS of the liver, its contents contain an admixture of bile; areas of epithelization of the pyogenic membrane appear.

If the communication of the ABSCESS with the surface of the body is insufficient or there are other reasons that prevent the collapse of the walls of the ABSCESS cavity, then after its emptying a fistula (see) is formed - a narrow channel lined with granulation tissue or epithelium that connects the cavity A. with the surface of the body or with the lumen hollow organ. A fistula often occurs in cases where the Abscess cavity contains foreign bodies or sequestra.

In some diseases, due to the characteristics of the pus, it can actively melt the surrounding tissues, spread through intertissue cracks and accumulate in places remote from the primary localization of the ABSCESS, for example, the so-called cold ABSCESSES (leaks), characteristic of tuberculosis, which can also be emptied through the fistulous tracts.

Clinical picture

Abscesses formed as a result of purulent or aseptic inflammation have a different outcome: spontaneous opening with a breakthrough outward (ABSCESS subcutaneous tissue, muscle ABSCESS, mastitis, paraproctitis, etc.); breakthrough and emptying into closed cavities (abdominal, pleural, joint cavities, etc.); breakthrough of the abscess into the cavity of organs communicating with the external environment (into the cavity of the intestine, stomach, bladder, bronchi, etc.). The emptied Abscess cavity, under favorable conditions, decreases in size, collapses and, due to active proliferative phenomena, undergoes scarring. At incomplete emptying and poor drainage of the ABSCESS cavity. the process can become chronic with the formation of a long-term non-healing fistula at the site of the ABSCESS breakthrough. The breakthrough of pus into closed cavities leads to the development of widespread purulent processes(peritonitis, pleurisy, pericarditis, meningitis, arthritis, etc.) with a severe course and prognosis.

In case of superficially located acute abscesses, local manifestations are characterized by classic signs of inflammation (redness, swelling, pain, local increase in temperature, dysfunction), and swell can be determined (see). Inflammatory phenomena can occupy different areas and depths depending on the size of the Abscess and its location. The nature of the pus (see) contained in the A. cavity (consistency, color, smell) is determined by the type of infection: the foul odor and dirty gray color of pus are characteristic of putrefactive flora; thick yellow-green pus - for staphylococcus; blue-green color and sweetish smell- for sticks of blue-green pus, etc. For chronic abscesses, general and local symptoms little expressed. Abscess of tuberculous etiology is characterized by effacement common manifestations and low severity of local tissue reaction (cold abscesses). With abscesses of tuberculous origin, pus often spreads along interstitial crevices far from the site of initial occurrence (for example, to the retroperitoneal tissue and to the medial surface of the thigh in tuberculous spondylitis), forming an abscess (see Abscess).

General clinical manifestations of an abscess do not have specific signs and are typical for purulent-inflammatory processes of any localization. Expressiveness common symptoms determined by the state of the macroorganism, the virulence of the microflora, the extent of local inflammatory phenomena, depth and prevalence necrotic changes at the site of inflammation. They boil down to an increase in body temperature from subfebrile levels to 41° in severe cases, general malaise, weakness, loss of appetite, and headache.

Leukocytosis is observed in peripheral blood - up to 20,000 or more with neutrophilia and shift leukocyte formula to the left. ROE, as a rule, is accelerated. The degree of these changes depends on the severity of the pathological process.

In severe cases of ABSCESS with a predominance of intoxication, difficulties sometimes arise in determining the reasons that determine the severity of the patient’s condition. This condition can be caused by both the absorption of toxic products from the lesion (see Purulent-resorptive fever) and the generalization of infection. The issue is usually resolved by comparing local and general phenomena. The correspondence of the temperature reaction and hematological changes in the severity of the local purulent-necrotic process indicates purulent-resorptive fever; in these cases, general disorders disappear with the elimination of the source of infection. In sepsis, severe intoxication and changes in internal organs are usually not adequate to local changes, and the symptoms of severe intoxication do not disappear with the elimination of the focus.

Clinical manifestations of abscesses of various organs have their own specific signs, determined by localization (abscess of the lung, liver, retropharyngeal, subdiaphragmatic, interintestinal, etc.). An abscess must be differentiated from a hematoma (see), cyst (see), disintegrating tumors. Diagnostic puncture is of great importance. Obtaining pus during puncture, in addition to establishing a diagnosis in doubtful cases, allows for a bacteriological study - isolating the pathogen and determining its sensitivity to antibiotics. This is especially important in modern conditions with a high frequency of antibiotic-resistant forms of microflora, since rational etiotropic therapy is impossible without knowledge of the type of pathogen and its sensitivity to antibiotics.

In the presence of gas-forming flora, gas can form and accumulate in the Abscess cavity - gas ABSCESS. The presence of gas facilitates both clinical diagnosis - the appearance of a tympanic sound during percussion over the area of the Abscess (tympanitis apostematica), and radiological; on photographs in the Abscess cavity, a gas bubble and a horizontal level of pus under it are determined (most often in A. around foreign bodies and in gunshot wounds complicated by putrefactive infection). Other radiological signs Abscess is a pathological darkening and displacement or deformation of adjacent anatomical formations.

Treatment

The diagnosis of ABSCESS is an indication for surgical intervention, the purpose of which, regardless of the location of the process, is to open the abscess, empty and drain its cavity.

Cold A. of tuberculous etiology cannot be opened due to the inevitable superinfection with pyogenic flora. The previously used puncture method for treating a number of superficially located Abscesses (for example, mastitis) did not justify itself, since this method leads to massive development of scar tissue and encapsulation of infected contents.

Puncture of the Abscess with aspiration of pus and subsequent injection of antibiotics into the Abscess cavity, enzyme preparations can be used only according to strict indications, for certain localizations of the Abscess. (for example, transparietal punctures of a lung that is not dropped through the bronchus of the ABSCESS).

Resection of an organ (for example, a lung) together with an abscess as a radical treatment method is used only for chronic abscesses.

In case of formed Brain Abscesses with a well-defined capsule, removal of the Abscess along with its capsule can be used.

The operation of opening a superficial abscess is performed under local infiltration anesthesia with a 0.25% or 0.5% novocaine solution or short-term intravenous anesthesia (sombrevin, epontol, sodium thiopental). Freezing with chlorethylene should not generally be used. When opening an abscess of internal organs, endotracheal anesthesia is indicated.

To open the Abscess, choose the shortest quick access taking into account anatomical features and topography of the organ. For this purpose, the method of opening an ABSCESS using a needle is often used. Initially, the ABSCESS is punctured, then the tissue is cut through the needle. When opening an abscess, if possible, approach its lower pole to create good conditions for drainage.

In order to reduce infection of the surgical field, carefully isolate the area of the organ where the abscess is supposed to be opened with gauze wipes, and, having made a small hole in the wall of the Abscess, remove the pus with an electric suction. After aspirating the pus, the incision is widened, and the remaining pus and necrotic tissue are removed. If the Abscess cavity is large, it is examined with a finger, separating the existing bridges, and tissue sequesters are removed. Rough manipulations that disrupt the pyogenic membrane should be avoided; the Abscess cavity is washed antiseptic solution. As a rule, there is no need to stop bleeding, since the vessels located in the area of inflammation are thrombosed. The Abscess cavity is drained with one or more rubber or polyethylene tubes and inserted into it gauze swabs, moistened with a solution of proteolytic enzymes, solutions of targeted antibiotics. If there is insufficient emptying, a counter-aperture is made through the main incision (see). Technique for opening abscesses of internal organs - see articles on the relevant organs.

Treatment of Abscesses after their opening is carried out according to the principle of treatment purulent wounds taking into account the phase nature of the wound process (see Wounds, wounds). As soon as the wound is cleared of pus and necrotic tissue and granulation appears, they switch to ointment dressings that are rarely changed.

Local use of antibiotics for postoperative treatment of abscesses is inappropriate; their effectiveness is significantly reduced by the presence of necrotic tissue and pus in the wound.

The use of physical antiseptics only helps to remove melted necrotic tissue and liquefied pus, while the melting itself occurs under the influence of proteolytic enzymes formed in the wound. Therefore, the use of proteolytic enzymes in the postoperative treatment of abscesses various localizations or in the treatment of Abscesses drained through natural ways(eg acute lung ABSCESS drained through the bronchus) is effective. The use of enzymatic necrolysis according to developed methods (V.I. Struchkov, A.V. Grigoryan et al., 1970) reduces the treatment time for patients by 1.5-2 times, and for chronic lung abscesses increases the effectiveness preoperative preparation. Enzyme therapy creates favorable conditions for the use of early secondary sutures on granulating wounds, including those formed after opening an abscess.

General treatment includes strengthening therapy, blood transfusions, plasma, etc., the use of antibiotics taking into account the sensitivity of the microbial flora, the use of specific therapy(immunization staphylococcal toxoid, the use of specific gamma globulin). For abscesses that have developed against the background diabetes mellitus, correction of impaired metabolism is necessary. Treatment of Abscesses of the viscera and Abscesses of various areas of the body - see the relevant articles (for example, Brain, Douglas abscess, Retropharyngeal abscess, Subphrenic abscess, Kidneys, etc.).

Bibliography: Davydovsky I. V. General pathology Cheloveka, M., 1969, bibliogr.; Strukov A.I. and Kodolova I.M. Chronic nonspecific lung diseases. M.. 1970; Struchkov V.I. Purulent surgery, M., 1067; Struchkov V.I. id. Proteolytic enzymes in purulent surgery, M., 1970, bibliogr.; Uglov F. G., Pugleeva V. P. and Yakovleva A. M. Complications during intrathoracic operations, L., 1966, bibliogr.; General pathology. ed. by L. Florey, p. 151, L., 1970; Handbuch der speziellen pathologlechcn Anatomie und Histologic, hrsg. v. F. Henke u. O. Lubarach, Bd 3, T. 1. S. 67 u. a., B., 1928.

V.K.Goetshtsev; B.C. Spiders (pat. an.)

An accumulation of pus in tissues or organs, separated from healthy areas of tissue or organ by a granulation shaft or pyogenic connective tissue membrane. IN initial stage under the influence of the inflammatory process caused by the activity of pyogenic bacteria, tissue infiltration occurs. Subsequently, necrosis and purulent melting occurs, and a cavity containing pus is formed.

Symptoms and course. Quite varied depending on the nature of the infection, the characteristics of the tissue in which the abscess develops, its location and the general condition of the patient. Characteristic features superficially located abscess are: pain, sharply increasing with palpation, swelling and tension of the tissue, redness of the skin, local, and sometimes general increase temperature. First, a compaction forms ( inflammatory infiltrate), and subsequently softening (fluctuation) in the central part of the swelling. If microbes are highly virulent, then intoxication phenomena develop: malaise, weakness, headache, a febrile state with an evening rise and a morning decrease in temperature. With a deep location of the abscess, as well as with abscesses in internal organs (liver, kidneys, etc.), their recognition is possible only on the basis of general clinical manifestations diseases and special studies: changes in the blood, fluoroscopy, radiography.

Treatment. When the first clinical signs superficially located abscess, it is necessary first of all to provide complete rest to the affected area of the body. At the very beginning of the disease (infiltration stage), when there is only pain, hyperemia and swelling, the use of cold is useful, and then, if the pain does not subside and other local symptoms (lymphangitis) appear, you should proceed to the use of heat - heating pads, warming compresses, physiotherapy (UHF). The use of antibiotics (penicillin - from 600,000 to 1,000,000 units), sulfonamides (streptocide - 0.5-1 g 3-4 times a day), antipyretics (acetylsalicylic acid, amidopyrine, etc.) is recommended. ).

If there is a fluctuation, surgical intervention is necessary: an incision followed by treatment of the wound according to the general rules.

Prevention. It is necessary to strictly observe the rules of personal hygiene and carefully treat every, even the smallest, damage to the skin: lubricating with iodine tincture, applying an adhesive plaster, colloid, cleol bandage.

Abscess appendicular. Sometimes, in acute appendicitis, the inflammatory process moves from the appendix to the surrounding tissues (parietal peritoneum, greater omentum, cecum). In these cases, an inflammatory infiltrate forms in the right iliac fossa with a vermiform appendix located in the center, in which purulent inflammation develops. When the inflammatory process subsides (on its own or under the influence of treatment), this infiltrate can gradually resolve. However, more often it undergoes purulent melting with the formation of an appendiceal abscess. Melting of the infiltrate begins in its depth and gradually spreads to the periphery. At the same time, a granulation shaft is formed in the peripheral areas of the infiltrate, and around it adhesions arise between the adjacent intestinal loops, the omentum and the parietal peritoneum. As a result, a cavity with pus is formed in the right iliac fossa, delimited from the free abdominal cavity.

Symptoms and course. A few days after the onset of the attack, the abdominal pain intensifies, the temperature rises even more and takes on an intermittent nature with evening increases and morning decreases. On palpation of the right iliac region the patient experiences sharp pain, in the center of the infiltrate, more or less clearly expressed softening is sometimes determined, the general condition of the patient worsens, leukocytosis increases. IN in rare cases appendicular abscess is opened into the adjacent intestinal loop or outward and a successful outcome occurs. Usually, if surgery is not performed, pus breaks into the free abdominal cavity and peritonitis develops. Therefore, at the slightest suspicion of an appendiceal abscess, the paramedic is obliged to immediately organize transportation of the patient to the nearest surgical department. The patient must be transported in a supine position. If impossible urgent hospitalization it is necessary to provide the patient with strict bed rest. Antibiotics are administered intramuscularly (penicillin - 200,000-800,000 units, streptomycin - 0.5-1 g per day), sulfonamide drugs (orally 0.5-1 g 6 times a day), ice on the stomach. Diet: tea with lots of sugar, broth, jelly. At the same time, the nearest air ambulance station is immediately informed about the patient’s situation. Before examining the patient by a surgeon, the use of laxatives and analgesics is contraindicated.

Prevention - early diagnosis acute appendicitis and early surgery.

Lung abscess, see section “Internal diseases”.

A brain abscess develops as a result of the transfer of pyogenic microbes into the brain from a purulent focus existing in the patient. The most common sources of infection are inflammation of the middle ear, boil upper lip, inflammatory processes in the frontal and maxillary adnexa sinuses, open fractures And gunshot wounds skulls Sometimes pyogenic microbes are introduced into the brain matter from distant purulent foci.

Symptoms and course. The clinical picture of brain abscesses is very diverse. It consists of general cerebral phenomena and symptoms, depending on the location of the abscess (dysfunction of a particular brain center). The most common symptoms are headache, restlessness or, conversely, depressed mood, apathy, nausea and vomiting that appear regardless of food intake, slow heart rate, especially during a headache attack, high blood pressure cerebrospinal fluid. The temperature is uncertain, often subfebrile, but sometimes rises significantly. Symptoms depending on the location of the abscess are also varied.

When the abscess is localized in the motor zone of the brain, convulsions, paresis and paralysis appear; when located in the cerebellum, there are severe dizziness* impaired coordination of movements, in temporal lobe- auditory and visual hallucinations, speech disorders

Treatment. Trepanation of the skull, opening the abscess or removing it along with the capsule. Sometimes only puncture of the abscess is performed, followed by suction of pus and injection of antibiotics into the cavity. Patients with brain abscess require very careful care and constant monitoring, especially during delirium. For anxiety, analgesics are prescribed. The patient is provided with complete rest, he is placed in bed in a horizontal position with his head slightly elevated. An ice pack is placed on your head. Diuretics and antibiotics are prescribed. Bowel and bladder function should be closely monitored. For constipation, laxatives are given or enemas are given, for urinary retention, bladder catheterization is prescribed, for urinary incontinence and involuntary defecation- thorough toileting of the body, insertion of a permanent catheter into the bladder.

Liver abscess. Primary liver abscesses are rare. Usually, secondary abscesses develop in it due to the transfer of pyogenic microbes from inflammatory foci located in other organs of the abdominal cavity. Most common reasons liver abscess - amoebic dysentery, inflammation of the gallbladder and cholangitis, typhoid intestinal ulcers, acute appendicitis, septic and infectious diseases. Both single and multiple liver abscesses are observed.

Symptoms and course. The clinical picture is characterized by significant polymorphism. Symptoms are often masked by manifestations of the underlying disease. In typical cases, they complain of pain in the liver area, radiating to the right shoulder blade and shoulder, nausea, vomiting, discomfort when lying on the left side (usually they lie on the right side with their knees brought to the stomach). Upon examination, a peculiar color of the skin with an earthy, slightly yellowish tint is noted. Upon palpation and percussion in the liver area, sharp pain is determined, the boundaries liver dullness increased. On radiography, the movement of the diaphragm on the right is limited, and there is effusion in the pleural sinus. There is high leukocytosis in the blood. Feverish state with chills. In diagnostics; liver abscesses, liver scanning is becoming increasingly important, allowing one to determine the location of the abscess, which facilitates the surgeon’s tactics when opening the abscess.

Treatment. Without timely surgical intervention, liver abscess usually leads to death. For abscesses of amoebic origin beneficial influence uses emetine.

Prevention - timely and correct treatment diseases of the abdominal organs

Subphrenic abscess. Pus accumulates in the space between top surface liver and lower surface of the diaphragm. The reason is the transfer of pyogenic microbes from inflammatory foci located in the organs of the upper floor of the abdominal cavity (liver, stomach, duodenum, gallbladder and bile ducts). Sometimes a subphrenic abscess develops in other inflammatory diseases(inflammation of the uterine appendages, acute appendicitis).

Symptoms and course. In some cases they are quite characteristic, while in others they are unclear, masked by the underlying disease. The complaints are not typical and varied. Some patients complain of pain, a feeling of heaviness and pressure in the right hypochondrium, others - of hiccups, nausea, vomiting, and shortness of breath. During examination, attention is often drawn to a lag in respiratory movements on the right, smoothness and slight swelling of the intercostal spaces. Palpation reveals pain with pressure on the lower ribs and intercostal spaces* with percussion - an increase in the boundaries of hepatic dullness, high location upper limit. An X-ray examination reveals a high position of the diaphragm, as well as the absence or limitation of respiratory movements; sometimes an accumulation of gas under the diaphragm is detected on the right, and in the lower areas pleural cavity- accumulation of fluid. The temperature shows sharp fluctuations, leukocytosis is high (10,000-20,000).

Surgical treatment: opening the abscess and draining the subdiaphragmatic space. Antibiotics in large doses (penicillin - up to 1,000,000 units, streptomycin - 1-2 g, biomycin - up to 2 g per day), cardiac medications.

Prevention. Timely and correct treatment of diseases of the abdominal organs.

Pus is a universal reaction of the body to the proliferation of harmful microbes. Bacteria, most often streptococci and staphylococci, are to blame for the occurrence and development of diseases in which pus appears in the throat.

Photo: Sources of purulent infection - staphylococcus and streptococcus

A number of diseases of the upper respiratory tract lead to the appearance of pus in the back wall throat. Due to the lack of sufficient outflow, inflammation spreads further into the surrounding tissues.

Reasons

A suppuration in the throat can occur when bacteria enters there immediately before the disease.

Germs penetrate by airborne droplets through close contact with an infected person through inhalation. In a dormitory, office, school, kindergarten, or home there are all conditions for the transmission of infection due to close contact between people.

Also, microbes can live indefinitely in the body and become activated due to reduced immunity. Reduced protection occurs due to hypothermia, drafts, allergic diseases, hits harmful substances along with the inhaled air, during fatigue and stress.

The appearance of pus also occurs when inflammatory processes in the nose. The natural outlets from the sinuses are located in such a way that the pus flows into the throat on its own or the sick person “sucks” it and coughs it up.

Diseases that can be detected this disease divided into:

purulent inflammation of the paranasal sinuses or sinusitis:
- sinusitis (maxillary sinusitis);
- sinusitis of other sinuses (frontal, main, ethmoidal labyrinth);
purulent throat diseases:
- purulent pharyngitis;
- purulent laryngitis;
- angina;
- tonsillitis;
- adenoiditis;
- abscess.

Inflammation can progress to a purulent stage with severe injuries to the bones of the facial skeleton or prolonged residence of foreign bodies in the nose and paranasal sinuses. Buttons, seeds, and pebbles are inhaled by children due to pranks and the habit of putting objects up their noses.

Sinusitis

In acute sinusitis, inflammation occurs in the right or left maxillary sinus. Pus flows from the affected side and collects in the throat.

Photo: Unilateral (left) and bilateral (right) sinusitis

If the discharge occurs through the posterior outlet or while lying down, then the pus flows into the pharynx. A sick person may complain of a pus-like taste in the mouth.

There is irritation and a feeling of something foreign, interfering. Upon examination, you can see pus flowing down the throat. A sick person may spit out pus. A similar picture occurs with purulent inflammation of other paranasal sinuses.

Video: sinusitis

Abscess

An abscess is a collection of pus in soft tissues, which has its limits.

It occurs when the natural openings of the tonsils become blocked or difficult to empty. This may be due to scar adhesions after previous purulent throat diseases.

Arises severe pain, it is difficult to open your mouth, your voice takes on a nasal tone. The pain in the throat is sometimes so severe that the patient cannot sleep.

Bright inflammatory redness appears in the area of the abscess. Severe swelling and bulging of the side wall lead to an asymmetrical arrangement of the arches and tongue.

If the suppuration is superficial, you may see clearing and discoloration at the site of pus formation. The appearance of a yellow spot indicates the formation of an abscess; in this place, opening and emptying of pus can occur.

In a weakened state of the body typical symptoms do not arise.

The picture of the disease will not be pronounced. Sore throat does not interfere with swallowing. Redness, swelling and protrusion can only be detected by careful examination of the throat. Pus in the throat without fever should alert you.

Video: retropharyngeal abscess

Purulent pharyngitis and laryngitis

Pharyngitis is an inflammation of the pharynx.

This disease causes a sore throat, which may get worse when swallowing and be accompanied by a cough due to irritation. There is a feeling of something foreign in the throat, but coughing does not lead to relief.

When examined in the throat, redness and swelling of the walls of the pharynx and palate are visible. Enlarged lymphoid granules, similar to large grains or grains, can be seen on the back of the throat, as well as white pus in the throat.

Laryngitis is an inflammation of the soft tissues of the larynx.

A hoarse voice and a dry, barking cough are common manifestations of laryngitis. With swelling in the area of inflammation, breathing difficulties occur. The penetration of microbes and suppuration form pieces of pus, which the patient can cough up and the pus comes out of the throat.

Video: symptoms and treatment of pharyngitis

Associated symptoms

Except local changes in the throat, patients experience a general reaction. It is associated with the spread of toxic microbial products and the response of the immune system.

Intoxication appears in the form of:

high temperature above 38 0 C;
fever;
chills;
general weakness;
headache.

If there is pus in the throat, inflammation may occur lymph nodes, located in the source zone.

Those closest to the source of infection swell first. Regional filters for the throat are the lymph nodes near the angle lower jaw and along the side of the neck.

How to treat

If pus appears in the throat, you should seek medical help.

Pus does not appear in the first days of the disease. He witnesses that the disease is out of control of the immune system and has been lasting for more than three to four days. Simple treatments and self-administration medications may worsen the condition.

Treatment is divided into several areas:

influence on the causative agent of the disease;
elimination of the focus of pus;
fight against local inflammation;
relief of general condition.
High temperature for more than 24 hours, difficulty breathing and opening the mouth require immediate appeal see a doctor.

Medical assistance

After examination, the doctor will confirm the cause of the appearance and prescribe the necessary treatment.

Bed rest is required, plenty of warm drink to alleviate the condition.

The choice of medications depends on the cause of the pus and the severity of the disease. To determine the type of microbe and its sensitivity to antibiotics, a study of pus may be necessary.

Treatment of pus in the throat consists of conservative and surgical methods.

Conservative method

For treatment, modern antibiotics are used that cause the death of microbes, for example semi-synthetic penicillins, for example Amoxicillin, or cephalosporins. Those drugs are prescribed to which the microorganisms that cause the disease are most sensitive.

If swallowing is difficult due to severe pain, then injections of medication are used.

The duration of the course of therapy is at least 5–7 days, it can be extended to 10. If the treatment is adequate, then on the 2–3rd day of taking the drug you will feel much better. This may make it tempting to stop taking the antibiotic.

Particular care should be taken during antibiotic therapy during pregnancy due to side effect medicines.

Non-steroidal anti-inflammatory drugs (containing paracetamol, ibuprofen) are given to reduce fever, reduce sore throat and fight inflammation.

It is better not to use aspirin for these diseases. It can increase vascular permeability and lead to bruising and rash.

For purulent sinusitis or purulent sinusitis Vasoconstrictor drops are used in the nose to relieve swelling and remove the block from the sinus outlet. With the action of these remedies, the natural openings of the sinuses expand, and the outflow of pus from them improves.

Local warming procedures in the form of compresses, heating pads and physiotherapy can be used when there is a good outflow of pus.

Surgical method

For purulent sinusitis, the doctor can puncture the paranasal sinus with rinsing and administration medicinal solution. If necessary, a catheter is inserted for subsequent rinses.

Treatment of abscesses is carried out according to the principle of early surgical opening. Waiting in anticipation of resorption or spontaneous emptying is dangerous due to the risk of spread of pus.

It is possible to develop a dangerous complication - laryngeal edema. In no case should you wait until the tissues soften, since extensive suppuration may already be developing in the depths.

The operation is performed under local anesthesia to maintain the pus expectoration reflex. The doctor uses an aerosol anesthetic and an injection in the area of inflammation.

Photo: Opening a retropharyngeal abscess

After opening the abscess, the patient must quickly tilt his head face down so that pus with blood does not get further into the respiratory tract. Surgical method treatment is always combined with antibacterial therapy.

Video: how to make a puncture for sinusitis

How to remove pus from the throat at home

You can get rid of the discomfort of pus in your throat using home remedies.

Gargling with warm salt water or herbal infusions (chamomile, thyme). They will get rid of pus. The use of iodine and Lugol's solution is undesirable due to the cauterizing effect.

Warm drinks (tea, milk, compote) will reduce intoxication and chills, warm the throat, and help reduce fever.

Sucking on lozenges and wrapping a scarf around your throat will relieve a sore throat.
Before starting home treatment, you need to consult a doctor to begin basic treatment.

Prevention

Microbes are transmitted from a sick person by airborne droplets.

Therefore, compliance simple rules safety will help avoid illness.

Need to:

wash your hands often with soap;
use a disposable mask to protect your mouth and nose;
use personal cutlery and glass;
avoid close contact with the patient;
have your own toothbrush and towel;
ventilate the premises.

For warning re-development infection, you need to eat right, increase the body's defenses and keep your living quarters clean. Walking on fresh air, vitamins and hardening the body will help prevent diseases.

Frequently Asked Questions

How long does it take to be treated?

Average treatment time similar diseases is 7–10 days. If after 2 weeks there are no signs of complete recovery, then you can think about complications or a protracted course of the disease.

When can I start doing fitness or physical education after illness?

To exclude the development of complications, for example, heart disease, joints, after past illness Doctors recommend resuming exercise no earlier than 10–14 days after complete recovery.

How to get rid of pus on the back of a child’s throat?

See your doctor immediately if:

child under 1 year old;
fever and high temperature lasts more than 24 hours;
there is lethargy and drowsiness;
difficulty breathing or swallowing;
the disease is accompanied by a rash or bruises;
it is impossible to open your mouth, there is no voice.

If a child can gargle on his own, then with frequent gargling, the throat will be freed from pus faster. If it is not possible to rinse, then use lollipops or give warm tea or milk to drink. In this case, swallowing occurs, which is acceptable for small children.

Photo: Gargling helps a child get rid of pus in the throat

When pus flows into the throat from the nose and the baby cannot blow his nose on his own, it is necessary to use a small rubber medical bulb or a special nasal aspirator.

Photo: Momert and NoseFrida nasal aspirators

After removing the discharge from the nose, you need to instill drops to reduce the amount of mucus, swelling and improve the outflow of pus.

Video: how to look at a child’s throat

Correct treatment presupposes the main thing - knowledge of the cause of the disease. You should not choose medications on your own, as many drugs have their own contraindications.