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Hyphalic abscess: causes, symptoms, diagnosis and treatment methods

Zagotny abscess (ICD-10 code J39.0) in childhood begins to develop after the appearance of infection in the body. At first, it can manifest itself in the form of rhinitis and does not present much discomfort. Then it infects the surrounding lymph nodes and enters with them into the respiratory space, where it causes an abscess.

Causes

An abscess can develop in children with the following infectious diseases:

ARVI;
measles;
scarlet fever;
diphtheria;
flu.

У взрослых заглоточный абсцесс чаще всего it forms on the background of a nasopharyngeal injury, for example, when a bone injects into the nasopharynx, during examination of the internal organs through the mouth or during its burn. Also, this condition can be caused in adults by a complication of angina. The causes of a pharyngeal throat abscess in adults can be tuberculosis or syphilis. This is due to the violation of the nasopharyngeal microflora and the organism as a whole.

According to statistics, patients with chronicinfectious diseases suffer from a pharyngeal abscess more often than with a simple course of the disease. Reduced immunity, diabetes, tumor or HIV can also cause this pathology.

Symptoms

Symptoms of abscess are listed below:

acute manifestations of sore throat;
increase in body temperature to 39-40 ° C;
violation of the general condition.

Compared to other infectious diseases that a patient has, the symptoms of a pharyngeal abscess in adults are manifested by a sharp deterioration in health status.

Children have an inexplicable feeling of anxiety, which leads to sleep problems and anorexia.

In newborns, the disease can cause sleep disturbance.

The very first symptom of a pharyngeal abscess inadults is the appearance of a sore throat, which is aggravated by swallowing water or food. This pain is sometimes so pronounced that patients are forced to refrain from frequent meals. There is a change in voice, most often it becomes hoarse. If the abscess is in the upper or lower part of the nasopharynx, then the patient has nasal congestion.

If the abscess is large, then the patient maymanifest asthma attacks. These attacks appear most often while standing, since in this state the pus begins to flow down and begins to interfere with the passage of air. When the abscess is detected swelling of the lymph nodes. If the pharyngeal abscess in children caused swelling of the surrounding tissues, then the neck may swell.

Location

The occipital abscess can be classified according to the following types, depending on where it is located:

Эпифарингеальный вид абсцесса —это нагноение fiber, which is localized above the palatal arch. This type of abscess is characterized by unilateral painful sensation in the throat, pain in the masticatory muscles and lymph nodes on the side of the development of an abscess.
Mesopharyngeal abscess. This abscess is located between the root of the tongue and the edge of the palatine arch.
Hypopharyngeal abscess. This abscess is located below the root zone of the tongue.
Mixed type of abscess - occupying the backdoor space and other several anatomical zones.

Forms of flow

Depending on the form of the flow, the occipital abscess is classified into the following types:

Initial form. At this stage, swelling and redness appear. This form is recommended to be treated with a medical method.
Acute form. Most often develops as a result of suppuration of the lymph nodes during infection with streptococci and staphylococci. This form is treated surgically.
Chronic. This stage develops after inadequate treatment of the acute form of the disease. This form is treated surgically.

Complications

Complications of the pharyngeal abscess occur due to the spread of infection. Especially dangerous is the movement of the upper respiratory tract.

If the infection has spread and settled on the bronchi, this is the cause of the appearance of bronchopneumonia.

During the spread of infection there is a violation of the lungs, which causes the development of pneumonia in them.

Also, the infection can spread to the cranial cavity, which leads to the development of an abscess of the brain or meningitis.

A serious complication is choking.It occurs due to the overlap of the airways due to the presence of pronounced swelling of the larynx at the site of an abscess rupture. During the manifestation of such attacks, the work of the heart may be reflexively disturbed, up to a cessation of cardiac activity.

Severe complication is abscess rupture, soas at this time the pus flows down the pharyngeal walls. It can affect large vessels, which can cause bleeding or blood clots. This pus can leak into the region of the mediastinum, where it can cause the development of purulent mediastinitis, which is the cause of sepsis.

Diagnostics

Diagnosis of the swallow abscess is carried out.otolaryngologist (Laura) by interviewing the patient and a comprehensive clinical examination. The purpose of the survey is to study the nature and duration of complaints, and on the basis of this - clarify the underlying disease, find out what caused the formation of an abscess. For diagnosis in children information about the nature of the first symptoms and the general state of immunity is specified in the parents.

After that, the doctor goes to the complexClinical research, which consists of examining a patient in order to identify specific signs of an inflammatory process of an infectious nature, such as redness of the pharynx mucosa, painful palpation of the site, and an increase in lymph nodes.

For visual examination of the posterior mucosapharyngoscopy is used for pharyngeal walls and detection of abscesses of the lower and upper sections General and biochemical analysis of blood will help determine the severity of inflammation and on the basis of this form an objective treatment.

Identify pathogenic microflora in the mucous will helpbacterioscopy and bacteriological examination, a biomaterial for which is a smear from the pharyngeal mucosa. To identify the presence and localization of an abscess, as well as the extent of the spread of the purulent process, use of modern research methods such as CT and MRI.

Autopsy

Autopsy of the pharyngeal (retro-pharyngeal) abscess is performed in several ways.

With the help of a surgical knife.The instrument should be wrapped with cotton or adhesive tape. At the same time, the cutting part remains free, approximately 0.05-0.06 cm. The incision is performed starting from the bottom, from the place where the mucous membrane begins to stick out. Depth is 0.5 cm. The incision should be completed at the most convex point of the abscess. To avoid pus flowing into the larynx, it is necessary immediately after the dissection to tilt the patient's head down.
Pointed scissors.Scissors inject into the highest point of suppuration. To avoid aspiration, first make a small dissection. Then open the tool to widen the edges of the cut. Using this method, in parallel, you can take a test sample for the purpose of diagnosis and treatment.
Pus can flow to the neck if the pharyngealThe abscess is low. Then the opening of the abscess is preferable to do an external surgical cut. Leading the line in this case is recommended along the anterior margin of the Musculus sternocleidomastoideus (sternocleidomastoid muscle). If a large section is made, there is a chance of damage to the accessory nerve.

When purulent clusters associated with the ear, in addition to opening, surgical treatment of the ear.

Pharmacology

Drug treatment of a pharyngeal abscess is the use of antibiotics. Currently used below listed groups:

Cephalosporins (Ceftriaxone, Cefepime).
Macrolides ("Erythromycin", "Clarithromycin").
Lincosamides (Lincomycin, Clindamycin).

The mechanism of cephalosporins blocks the renewal of the microbial cell structure, which completely destroys them. Depending on the representative, they can be injected intravenously or intramuscularly.

Cephalosporins are prescribed to children of any age. But their safety in children under 6 months is not proven.

Macrolides block the ribosomes in bacteria, which inhibits their growth. Macrolides are most often taken orally.

Lincosamides block protein renewalstructures in bacteria, which slows down their division and growth. Depending on the representative, lincosamides can be injected intravenously or intramuscularly. Some of these drugs can reduce the bioavailability of food taken.

Paired with antibiotics can be used.anti-inflammatory and antipyretic drugs. But they should be used only as a last resort, as they can cause depression and so weakened immunity.

Folk treatment

Treatment of folk remedies most oftenIt is performed to reduce the symptoms of throat abscess and arrest the development of inflammation. It is not possible to cure the pharyngeal abscess with folk remedies. This is due to the fact that this disease has an infectious nature of occurrence.

Folk remedies include gargling with the following solutions and decoctions:

A solution of salt and soda can significantlyreduce the number of bacteria around the swallowing process. To make it, you need to take one tablespoon of salt or soda and dissolve it in a glass of warm water. The resulting solution to gargle, during the day to repeat at least five times. The number of rinses can be increased by diluting the solution with water.
Infusion of herbs for rinsing a goal.The preparation of such an infusion begins with the drying and grinding of various herbs, then the resulting dust is poured with boiling water and allowed to infuse for several hours. Rinse repeated several times a day.
Reception of Kalanchoe juice will allow locally to remove inflammation and reduce the symptoms of abscess development by removing purulent plaque.

Forecast

Timely diagnosis and detectionan occipital abscess will allow to cure it without any problems. According to statistics, if you do not allow complications, the timely opening of the abscess in most cases allows you to completely get rid of it without the appearance of dangerous consequences. If treatment was not taken immediately and as a result of this, complications emerged, then in this case the prognosis is rather negative up to a fatal outcome.