One of the most frequent complaints encountered in the practice of medicine involve bacterial infections of the skin and underlying soft tissues. The most common infections among these include cellulitis, folliculitis and furunculous. Traumatic injuries that involve the skin can lead to infection. Infections of surgical wounds are also common. Fortunately, the majority of uncomplicated skin and soft tissue infections respond to oral antibiotic therapy. However, several types of bacteria can cause life-threatening infections. Most uncomplicated skin and soft tissue infections respond predictably and favorably to local measures or antibiotics. However, serious skin infections can be fulminant, and the mortality rate can be as high as 75%. To produce optimal outcomes in these patients, the emergency physician must have a thorough understanding of the various etiologies, syndromes, and presentation patterns associated with a wide range of skin infections.
Causes of Soft Tissue Infections Of The Neck
There are a variety of infections that involve the skin and its underlying structures. Impetigo is a slowly progressive, indolent superficial infection of the skin. It can be caused by either Staphylococcus aureus or Steptococcus. Folliculitis is a superficial infection of the skin that is varcharacterized by reddened papules or pustules. They occur in proximity to the hair follicles. They range in size from 2-5 mm in diameter. Common sites for folliculitis include the beard, upper back, chest, buttocks, and forearms. At times, infection of the follicle will spread below the surface of the skin into the subcutaneous tissue. This results in the development of a furuncle. Furuncles or boils are deep-seated painful nodules, or abscesses, that develop adjacent to the hair follicle. Confluence of several furuncles and further extension can create a carbuncle with interconnecting sinus tracts and fibrosis. Furuncles can occur in any hair-bearing area including the face and auditory canal, but the lesions usually occur on the posterior portion of the neck, the back, or the thighs. Furuncles often rapidly enlarge and are red, swollen and painful. The lump may appear soft or mushy. Carbuncles are frequently associated with severe systemic symptoms. These may include fever, malaise, and enlarged lymph nodes. People with chronic diseases, impaired immune systems or malnutrition may suffer from recurrent furunclulosis. Occlusive clothing and poor hygiene contribute to the problem. Cellulitis is a deep infection of the skin that involves the layer of connective tissue underneath the skin, the subcutaneous tissue. It begins as a painful, tender, red and warm area that spreads rapidly and produces indistinct borders. Fever, chills and sweats are frequent. The infection frequently begins at the site of previous trauma, which may be minor or major. It may also occur as a result of infection associated with closure of non-sterile wounds and at the site of sutures. Cellulitis frequently extends via the lymphatic system. This system transfers fluids from the tissues though the lymph glands back towards the vascular system. Infection can gain access to the blood stream through this process leading to severe illness. Erysipelas, known in the Middle Ages as St. Anthony’s fire or Ignis Sacer, is varcharacterized by a rapidly progressing, reddened, firm, painful, and sharply demarcated area of superficial skin infection caused by Staphylococcus pyogenes. On rare occasions, erysipelas can be cased by other bacteria. Patients suffering from erysipelas present with a rash that gradually expands. The center of the rash remains red as it enlarges. The initial site of entry for the infection is often not apparent. Erysipelas is much more common in the very young and the elderly. Systemic symptoms such as chills, fever and sweats are frequent. About 5% of patients with erysipelas will have bacteria spread to the blood stream, resulting in bacteremia. It may lead to cellulitis, abscess formation, or even fasciitis. Animal Bites from dogs, cats, and humans are common problems encountered in emergency practice. It is estimated that dogs bite 1-1.5 million people each year in the United States. In locations where animal bites are a reportable condition, dogs account for 90% of all bites, cats for about 5%, and humans and rodents for about 2-3% each; all other animal species produce less than 1% of all bites. It is estimated that animal and human bite wounds account for about 1-2% of all emergency department visits annually.
Signs and Symptoms of Soft Tissue Infections Of The Neck
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Medical Content Last Updated on 07/12/2008
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