Yaajde Sellulitis, Ɓoornugol Limfangitis Boɗewol, e Emergency Absces Laral¶

Infections bakteriiji ɓuuɓɗi e ɓalndu e ƴiye softuɗe (SSTI) ina ummoo e mooftugol ɓuuɓri nokkuuji (ɓuuɓri ɓalndu, ɓuuɓri, e karbunkule) haa e ñawuuji ɓalndu e les ɓalndu (erisipelas, sellulitis, e limfangitis ɓuuɓɗo ƴeeŋoowo). Hay so tawii ñawuuji keewɗi e ɓalndu ina njaaboo e antibiyotikuuji gonɗi e nder safrirde walla e ɓuuɓri ƴiiƴam, ñawu nguu ina yaawi saabaade waktu e waktu, ina nelda ƴiye boɗeeje dow junngo walla koyngal feewde e ŋoral walla e ŋoral, ina nannga e hakkunde yeeso walla e ŋoral gite, walla ina addana ɓalndu nduu ɓuuɓde, ɓuuɓde walla ɓuuɓtude, ina waawi kadi ɓuuɓnude ñawu nguu ina waawi warde nguurndam (sepsis e ɓuuɓri septik) walla ñaamoowo teewu fasiitis nekrotik. So tawii won e ɗee maale kulɓiniiɗe peeñi, noddu nokku maa limooje caɗtuɗe walla yahde to suudu safrirdu ɓurndu ɓadaade ɗoon e ɗoon. Kadi ƴeewto-ɗee njilluuji men e... sellulit orbital e mborosaaji kulɓiniiɗi-taƴre yeeso e ɓuuɓri ƴiiƴam luggiɗndi (DVT).

Golle maa ko yaawi e nder galle ko rewde keeri yaajɗi boɗeeji ɗii e binndol tinta e winndude waktu waktu oo e dow ɓalndu, toownude tergal ɓuuɓngal ngal dow tolno ɓernde ngam ustude ɓuuɓri ɓuuɓndi, **woto meeɗ ɓuuɓnude, pop, walla ɓuuɓnude ƴiiƴam-lance a boil walla abscess intravenek e nder galle ƴiye limfanjitik walla maale sepsis sistemik ina ƴellitoo.

Waɗde ɗum jooni¶

1. Ƴeewto ɗoon e ɗoon ngam yiytude Sepsis walla Necrotizing Fasciitis baawɗo warde nguurndam maa, noddude limoore emergency nokku maa so ina woodi. Noddu 911 e nder leyɗeele dentuɗe Amerik e Kanadaa, 112 e nder Dental Orop, 999 e nder leydi Angalteer, 000 e nder Ostarali, walla ƴeewto regginorde amen e limooje caɗtuɗe so tawii neɗɗo oo ina ƴellitoo nafoore ladde nde yahdaani e no ɓalndu nduu wayi, ɓuuɓri ɓaleeri-boɗeeri (bullae), ɓalndu nduu ina nanndi e ɓuuɓri no ɓuuɓri nii (crepitus) walla ina yahra e ɓuuɓri haa laaɓi, jiiɓru walla ɗanngal, foofaango yaawngo (ko ɓuri 22 fooftere e hojomaaji), ɓuuɓri pressure walla chills .
2. Hutoro pentol ballal walla maande seppo ngam reende ŋorol yaajngol ngol e ɓalndu boɗeeru nduu, winndu heen waktuuji waktuuji ɗii e sara doggol ngol. Siftor e nofru doggol ŋorol ŋorol walla ŋorol tiiɗngol to bannge ŋorol ɗo ɓalndu boɗeeru, ngulndu hawrata e ɓalndu no woorunoo, winndu waktu oo (yeru, 14:30). So aan walla cafroowo oo ƴeewtindiima ɓalndu nduu waktuuji 1 haa 2 caggal ɗuum, kala ɓuuɓri yahrundi yeeso e laylaytol tinndi maa ina hollita wonde ñawu nguu ina yaaji no feewi, ina wallita kadi e fooɗtude no ngu yahrata.
3. Ƴeewto laabi boɗeeji (lymphangitis streaks) jahrooji dow tergal ngal e ƴeewde so tawii ko ɓuuɓɗi, ɓuuɓɗi e nder reedu, e nder ŋoral, walla e nder ŋoral. Ƴeewto no feewi e dow bannge nder junngo, junngo dow, nagge, e running nder ɓanndu gila b red, faint walla faint. Limfangitis ƴeeŋtuɗo firti ko bakteriiji bonɗi (ko ɓuri heewde e Streptococcus pyogenes) naatii e ƴiye limfatik, ina ndoga feewde e ƴiiƴam ƴiye hakkundeeje ; ɗum ina ɗaɓɓi ƴeewndo safaara yaawngo, tee ina heewi waɗde antibiotik e nder ƴiiƴam.
4. WOTO MEƊƊU ɓuuɓnude, ɓuuɓnude, ɓuuɓnude, walla ɓuuɓnude ƴiyal sewnde walla ƴulɓe e nder ɓuuɓri, ɓuuɓri, walla ɓuuɓri ɓalndu. Ɓuuɓnude ɓuuɓri ina addana ɓuuɓri mekanik mawndi e dow ɓalndu ɓuuɓndu (membrane pyogenic) taariiɗo poos pus e**ta ɓuuɓri, ta rupturing the vecuback andta laabi limfatik, baawɗi aawde Stafilokokkus (MRSA) mo metisilin waawataa haɓtaade, feewde e ƴiiƴam (bakteriiji, endokarditis, walla trombose sinus kavernous).
5. Toownude tergal gonngal e sellulit mo alaa ko saɗti dow tolno ɓernde (so wonaa tawa ko ñawu arterial walla sindrom compartiment tuumaama). Softinde koyngal walla junngo e sellulit dow e dow pillooji dow tolno ɓernde ina huutoroo semmbe ngam ittude ndiyam ɓuuɓɗam (edema) ɓuuɓɗam hakkunde ɓalndu (edema). leeso.
6. Waɗde ɓuuɓri laaɓndi, ɓuuɓndi e ɓuuɓri udditiindi (walla ɓuuɓri ɓuuɓndi e erysipelas/cellulitis) e ittude denndaangal cirƴe, waktuuji, e paɗe tiiɗɗe. Ƴettu kala cirƴam e junngo walla e koyngal ɓuuɓngal ɗoon e ɗoon hade ɓuuɓri nanngude njamndi ndii, ɓuuɓna digit. Ngam ɓuuɓri gonndi e nokku, ndi alaa ko woni e mum so wonaa ñawu nguu, fooftinde ɓuuɓri laaɓndi e dow ɓuuɓri ndii fotde hojomaaji 15 laabi 3 haa 4 ñalawma kala ina ɓeyda ƴiiƴam nokku oo haa nde safroowo waawa waɗde incision and drainage (I&D) sterile.

Lekki pellital : triaging ɓuuɓri ɓalndu ɓuuɓndi, ɓuuɓri boɗeeri, e ɓuuɓri ɓuuɓri¶

flowchart TD
    Start["Boɗeejo ɓuuɓɗo, ɓuuɓɗo, ɓuuɓɗo, walla ɓuuɓɗo (boɗeejo yaajɗo, ɓuuɓri toowndi, ɓuuɓri boɗeeri, walla ɓuuɓri ɓuuɓri)"] --> CheckDeadly{"Ɗatal 1: Ƴeewto Surgical & Sepsis Banngeeji boɗeeji: Naafigaagal gonngal e nder njuuteendi, ɓuuɓri ɓaleeri/ɓaleeri, ɓuuɓri, ɓuuɓri ƴiiƴam, jiiɓru, foofaango yaawngo, ɓuuɓri, walla ɓuuɓri gite/wuddu/perineal?"}

    CheckDeadly -->|"EEY to KALA Banndiraawo Boɗeejo"| Emergency911["ƊAƊƊI NGURNDAM WALLA ƊAƊƊI : Noddu 911 / 112 / 999 walla Yah to Departemaa Ɓooygol Opitaal ɗoon e ɗoon (Tuumaaɗo Fasciitis Nekrotisant, Sepsis, walla Cellulitis Orbital)"]

    CheckDeadly -->|"NO: Jeertinaango, vitals dartiiɗi, kalaace pink/boɗeeje no woorunoo"| PenMark["Ɗatal 2: Siftor Ink Pen Border Taariindi Yaasi Edge Redness e Winndu Exact Waktu Timestamp e dow Laral; Ittu Denndaangal Ringuuji e Waktuuji"]

    PenMark --> Classify{"Ɗatal 3: Hol sifaa ñawu nguu ina woodi?"}

    Classify -->|"Laabi boɗeeji (streaks) jahrooji dow junngo walla koyngal feewde e ɓuuɓri ɓuuɓri walla ɓuuɓri ƴiiƴam"| Lymphangitis["LIMFANGITIS ASCENDING ACUTE : Yah to Departemaa Emergency walla Urgent Care e nder waktuuji seeɗa ngam heɓde antibiyotikuuji gonɗi e nder ɓalndu (ko heewi IV) ko adii bakteriiji"]

    Classify -->|"Ɓoornugol boɗewol ɓuuɓngol ɓuuɓngol walla ɓuuɓngol (Sellulitis walla Erisipelas - Alaa poos pus)"| Cellulitis["CELLULITIS WALLA ERYSIPELAS : Ƴeewtaade tergal dow ɓernde, ƴeewde hakkunde koyɗe mbele ina woodi ɓuuɓri funeeɓe, ɗaɓɓude ƴeewndo safaara ñalnde heen ; yah to ED ɗoon e ɗoon so tawii boɗewol taƴii pen line e yaawre walla nguleeki fuɗɗiima"]

    Classify -->|"Buumre teddunde, nanndunde e dome walla poos ɓuuɓɗo (Absès Cutané, Furuncle, walla Carbuncle)"| Abscess["ABSCESS / BOIL CUTANÉE : WOTO MEƊƊI ɓuuɓde, pop, walla ɓuuɓnude ƴiiƴam e nder galle ; waɗde kompaas laaɓɗo ngulɗo e ƴeewde safroowo ngam ƴeewde so tawii ko steril Incision and Drainage (I&D) e antibiotik MRSA"]

Senngo safaara : sellulit e erisipelas e limfangitis e ɓuuɓri ɓalndu¶

E fawaade e Fedde Ñawuuji mborosaaji Amerik (IDSA) e Duɗal ngenndiwal toppitiingal cellal e toppitagol (NICE), kuule jowitiiɗe e ñawuuji ɓalndu e ƴiye softeende, safaara ɓuuɓɗo fawii ko e so tawii ñawu nguu ina waawi wonde non-purulent (ina yaaji e nder ɓalndu tawa ina yaaji e nder reedu e ɓuuɓri, ko ɓuri heewde e mum ko Streptococcus beta-hemolytique) walla purulent (mooftugol ɓuuɓri gonndi e nder ɓalndu walla e nder ɓalndu, ko ɓuri heewde e mum ko Staphylococcus aureus, ina heen MRSA keɓaaɗo e renndo).

Hol no e hol ko waɗi waɗde karallaagal "Pen Border e Timestamp".¶

So ñawɗo walla tergal galle ƴeewii koyngal walla junngo boɗeejo, ɓuuɓngo, siftorde neɗɗo waawaa hoolkisaade so tawii boɗewol ngol ina yaaji fotde santimeeteer gooto walla santimeeteeruuji 5 e nder waktuuji tati ɓennuɗi ɗii, haa teeŋti noon e les njiimaandi suudu mbaylaandi. Cafrooɓe, infirmiyee en, e safrooɓe ɓalli e nder winndere ndee kala ina kuutoroo Laawol Demarkaasiyoŋ Ink Pen:

1. Huftoraade pentol balɗe, marker duumotooɗo fine-tip, walla pentol ɓalndu surgical: Loot juuɗe maa e saabunde ko adii. Siftor e nofru limre daande juutnde walla doggol jokkondirngol e dow daande ɓurnde yaajde e ɓuuɓri yiyteende (eritema). So tawii won limce boɗeeje dogduɗe dow junngo walla koyngal, ƴettu limre juutnde e toɓɓere ɓurnde toowde limre boɗeere ndee.
2. Winndu waktu (e ñalngu) tigi-rigi to bannge ɓalndu cellundu sara doggol ngol: Yeru, winndu 10:00 AM walla 10:00.
3. No firtirtee waylooji e nder doggol pen:
4. Yaajde jaawnde HADDE fuɗɗaade antibiotik: So tawii ɓuuɓri ndii ina yahra yeeso ko ɓuri santimeeteeruuji 1 haa 2 e waktu ina rewi e laylaytol tinndi maa, walla so tawii ɓuuɓri limfangitik boɗeeri ina yahra e santimeeteeruuji keewɗi dow junngo walla koyngal e nder waktuuji 1 haa 2, ko ɓuuɓri bakteriiji ɗii ina njaawna walla ina moɓtoo; yah to suudu safrirdu too ɗoon e ɗoon.
5. "Paradoks antibiotik gadano e nder waktuuji 24 haa 48" (Flare inflammatoire-like Jarisch-Herxheimer): E fawaade e IDSA e NICE, so ñawɗo fuɗɗiima ƴettude antibiotik moƴƴo e nder hunuko walla e nder ƴiiƴam ngam ñawndude cellulitis, ɓuuɓri e ɓuuɓri ina ɓeydoo ɓuuɓde e nder waktuuji 24 haa 36 gadani ɗii**. Ɗum noon ina waɗi sabu no antibiotik oo warata miliyoŋaaji bakteriiji Streptococcal e nder ɓalndu nii, ɓuuɓri ƴiiƴam bakteriiji ɗii ina yaltina tooke ɓuuɓɗe e antigenuuji, ɗi njiylotoo ko e sahaa gooto ƴiiƴam ɓalejam e ndiyam ɓurɗam heewde haa e daande ɓalndu nduu. So tawii ñawɗo oo ina wondi e ɓuuɓri (alaa ɓuuɓri kesiri, ɓuuɓri, walla ɓuuɓri luggiɗndi), yaajde keeri tokoosi e nder waktuuji 24 gadani ɗii firtaani tan ko antibiotik oo ŋakki ; kono so tawii boɗewol ngol ina jokki e yaajde e nder waktuuji 48 haa 72 e nder safaara antibiotik, walla so tawii maale ñawu nguu ina ɓeydoo bonde e kala sahaa, ƴeewndo safrirde ko yaawi ina foti waɗeede.

Limfangitis ɓuuɓɗo : hol ko waɗi "streaking boɗeejo" feewde e wuttulo walla e wuttulo ko caɗeele safaara¶

E nder daartol yimɓe heewɓe, diidi boɗeeji gonɗi e junngo walla koyngal ummoraade e taƴre nde ñawu nguu heɓtii, ina heewi wiyeede ko "tooke ƴiiƴam". To bannge anatomi, ndeen doggol boɗewol ko limfangitis ascendant acute : ko bakteriiji kuutortooɗi laabi limfatik ɗi ɓuuɓnata ndiyam ƴiiƴam ummoraade e ɓalndu, ngarta e ɓernde.

No bakteriiji njahrata gila e ɓalndu tokoosru ina ɓuuɓtoo e nder ƴiiƴam¶

1. Portal naatgol: Heewi wonde ko gaañannde fuɗɗorde ndee ina famɗi no feewi : ɓuuɓri pusiyel walla ɓuuɓri punndi e junngo, ɓuuɓri ƴiye rose, ɓuuɓri e dow taƴre, ɓuuɓri gonndi e ɓuuɓri (paronychia), ɓuuɓri ɓowɗi walla ɓuuɓri gonndi e ƴiye koppi hakkunde toa't koyɗe).
2. Naatgol e ƴiye limfatik: Bakteriiji bonɗi (ɓuri anndeede ko Goomu A Streptococcus pyogenes, ko kañum ɓuuɓnata enzimuuji ɓuuɓnooji ƴiye ko wayi no hyaluronidase e streptokinase, walla kapilaaruuji Pasteurella multocida e nder waktuuji 12 haa 24 e nder mikroo-kapilaaruuji) ɓalndu nduu.
3. Baaɗe boɗeeje yiyteteeɗe e dow ƴiye limfatik: No bakteriiji ɗii keewirta e ɓuuɓde dow e nder ƴiye limfatik toowɗe dogduɗe e saraaji ƴiye junngo walla les koyngal, koɗorɗe ƴiye limfatik ɗee ina ɓuuɓna no feewi, ina ɓuuɓna kadi warlotender red overlying pallamal or der streaks** dow tergal ngal.
4. Barriyee limfatik diiwaan (Lymphadenitis): Ɓowɗi limfatik ina njahda e bakteriiji ɗii to nokkuuji filtirɗe diiwaan oo : ɓuuɓri epitrokleer to wuttulo ndernderiijo e ɓuuɓri aksilaari to wuttulo (ngam ɓuuɓri juuɗe/juuɗe), walla ɓuuɓri deiin the **i hind ɓuuɓri ɓalndu (ngam ɓuuɓri koyɗe/koyɗe). Ɗeeɗoo ƴiye limfatik ina ɓuuɓta haa mbaɗta ɓuuɓri ɓuuɓndi, ɓuuɓndi, nde tawnoo ƴiye reenngo ɓalndu ina kaɓa ngam nanngude bakteriiji ɗii.
5. Fuɗɗude e nder ƴiiƴam ɓalndu e vena cava (Bacteremia e Sepsis): So tawii ñawu nguu ina ɓuuɓna ƴiiƴam diiwaan oo tawa alaa ko safraa ɗum, ƴiiƴam ɗam ina yalta e nder ɓuuɓri ɓalndu (walla ƴiiƴam ñaamo) ina yalta e nder he**ve, ƴiiƴam gonɗam e bakteriiji guurɗi (bacteremia) e ustude ɓuuɓri septik e nder waktuuji seeɗa.

Abscess cutaneux e ɓuuɓri MRSA : hol ko waɗi ɓuuɓde walla lancing galle ina bonna¶

Abscess cutané ko ɓuuɓri gonndi e nokku gooto, ndi ɓuuɓri (ƴiiƴam ɓalejam maayɗam, ɓuuɓri ƴiiƴam, e bakteriiji guurɗi) taariiɓe ɓuuɓri ƴiiƴam fibrin ɓuuɓɗo e ƴiiƴam granulaasiyoŋ. furuncle (boil) ko ɓuuɓri ummortoondi e nder ɓuuɓri gaasa, carbuncle ko ɓuuɓri luggiɗndi, keewndi cuuɗi, jokkondirndi, ndi waɗata ko ɓuuɓri mawndi, tiiɗndi no alluuje nii, ɓuuɓri violaceous (ko ɓuri heewde ko e nape wuddu, ad ghults e yimɓe toowɓe, walla).

Ko waɗi a fotaani MEƊDE ɓuuɓnude walla ɓuuɓnude ɓuuɓri e nder galle¶

So ɓuuɓri ina ɓuuɓna, ina metti, ñawɓe ina keewi etaade ɓuuɓnude e ɓuuɓnude ɗum hakkunde koppi mum en no ɓuuɓri akne nii, walla ɓuuɓnude ɗum e ɓuuɓri sewnde walla laɓi hobby.

No safrooɓe safrirta ɓuuɓri e kisal : taƴre e ɓuuɓri (I&D) sterile¶

Antibiyotik tan waawaa safrude ɓuuɓri mawndi sabu ɓuuɓri avaskulaar ɓuuɓri asid alaa ƴiiƴam ngam nawde lekki kii e nder mum, tee pH mo ŋakkaani ina ustoo antibiyotik keewɗo. E nder safrirde toppitiinde ko yaawi walla e nder departemaa toppitiiɗo ko yaawi, safroowo ina waɗa Incision et Drainage (I&D) yaawɗo: - Caggal nde o laɓɓini ɓalndu nduu, o ɓuuɓni dome oo e lidocaine (e heewde ƴeewde poosi oo e ultrasound lelnde ngam hoolkisaade so tawii ko ɓuuɓri ndiyam wonaa ɓuuɓri tiiɗndi walla pseudoaneurysm dow ƴiiƴam), doktoor oo waɗata ko taƴre lineere e nder dome oo, tawa ina waɗi ɓuuɓri gonndi e sterile. - Doktoor oo ina ɓuuɓna e nofru hemostaat walla kuret steril e nder ɓuuɓri ndii ngam taƴde poosuuji fibrous nder (loculations) ɗo ɓuuɓri suuɗii, ina ɓuuɓna ɓuuɓri ndii no feewi e saline normal sterile, ina waɗa heen wick light walla loop drain so ina haani mbele ƴiye ɓalndu nduu ina mbaasa uddude. - E nder kuulal IDSA, ɓeydude antibiotik MRSA-active (hono trimetoprim-sulfametoksazol [Bactrim/Septra] walla doksisiklin) fotde balɗe 5 haa 10 e sara I&D ina moƴƴina no feewi safaara, ina usta ɓuuɓri gonndi e ɓalndu so tawii ko ɓuuɓri gonndi e ɓalndu, kadi ina foti wonde ko ɓuri yaawde e cellulitis, tawa ina tawee e yeeso/juuɗe/ɓalndu, walla ina waɗa e ñawɗo mo nguleeki, jabet, walla ŋakkere reenngo ɓalndu.

Diagnostic différentiel critique : ngonkaaji nannduɗi e cellulitis (walla suuɗde les mum)¶

Ñalnde kala e nder safaara caɗtuɗo, paɗe ɗiɗi luurondirɗe ina mbaɗa : maa taw ko cakkital seppooji baawɗi warde (fasciitis nekrotisant walla trombose veineuse profonde) ina woppitee e "cellulitis simple," walla ngonka koyɗe ɓuuɓka ka alaa ko bonnata ɗum (**dermatitis stasis venous perg cellulaire up" misdiagnoses) ina safree tawa alaa ko nafata e ñawbuuli keewɗi.

Special high-risk portals of entry: animal bites, water exposure, and foot cracks¶

Kala nde njiyloto-ɗaa safaara ngam cellulitis walla abscess, waɗde sahaa kala haalan doktoor oo no ɓalndu nduu foti ɓuuɓde e hol nokku mo memi ñawu nguu, sibu ɓuuɓri keeriindi ina jogii bakteriiji ɗi keewaani, ɗi mbaawataa daɗde e antibiyotikaaji cellulitis gaadoraaɗi (hono cephalexin walla penicil) :

1. Cat e Dog Bites (Pasteurella multocida e Capnocytophaga): Niɓɓe pusiiji ina mbaɗa no ƴiye hipodermik nii, ina njuppa Pasteurella multocida haa juuta e nder ƴiye juuɗe e jokkondire, ina addana ɗum en ɓuuɓde cellal e limfangitis e nder waktuuji 12 haa 24 (ƴeew animal bites). Requires amoxicillin-clavulanate (Augmentin) rather than cephalexin. Capnocytophaga canimorsus from dog saliva can cause fulminant sepsis in patients without a spleen (splenic rupture and asplenia) or with liver disease.
2. (Gulf of Mexico)Vibrio vulnificus(Gulf of Mexico)
3. Freshwater Lakes, Rivers, Ponds, or Leeches (Aeromonas hydrophila): Lacerations in freshwater ponds or streams develop rapid cellulitis from Aeromonas hydrophila, requiring a fluoroquinolone (ciprofloxacin) or trimethoprim-sulfamethoxazole added to standard coverage.
4. Baaɗe ɓuuɓɗe, salonuuji ƴiye, walla punndi sneaker rewrude e sole kaɓirgal (Pseudomonas aeruginosa): Taƴde ƴiyal ɓuuɓngal rewrude e ŋoral paɗe tennis ina addana Pseudomonas aeruginosa e nder ƴiyal koyngal, tawi noon ɓulli ngulɗi ɗi ngalaa kuloor ina addana Pseudomonas follikulit.
5. Laral ɓuuɓngal hakkunde koyɗe (Koyngal Athlete / Tinea Pedis): E nder ko ina tolnoo e 50 e nder teemedere e ñawɓe sellulitis les koyɗe, bakteriiji ɗii naatata ko e ɓuuɓri ɓuuɓndi, macerated fungal hakkunde koyɗe nayaɓere e joyaɓere. Safrude ñawu nguu e nder ɓalndu (toe-web) e kiri topikal (antifungal) caggal nde cellulitis oo selli, ina haɗa cellulitis koyɗe ɗee ruttaade.

Doggol ƴeewndo yahrude yeeso sepsis : nde ñawu nguu wonti ñawu ɓanndu nduu fof¶

E wiyde Kampaañ Sepsis Wuurɗo e UK Sepsis Trust, kala mo sellulit, erisipela, limfangitis, walla ɓuuɓri ɓalndu, ina foti naweede to suudu safrirdu ɗoon e ɗoon so tawii o heɓi heen maale TIME / Red Flag Sepsis :

• T - Nguleeki ɓuuɓki: Ɓuuɓri toowndi ɓuuɓndi ɓurndi 38,3 degere Celsius (101 degere Fahrenheit), ɓuuɓri ɓuuɓndi ɓuuɓndi dente (rigors), walla nguleeki ɓanndu ɓuuɓki no feewi les **36,0 degere Celsius8h Fa.6s.
• I - Maandeeji ñawu nguu ina njaawna: Boɗeejo ina yaaji haa ɓurti maande pentol maa ko ɓuri 1 haa 2 cm e waktu kala, ɓuuɓri limfanji boɗeeri ina ƴetta e tergal ngal, walla ɓuuɓri kesiri ɓaleeri/ɓaleeri.
• M - Ɓooygol hakkille: Kala jiiɓru kesu, haala ɓuuɓka, ŋakkere hakkille, ŋoŋɗi ɗi ngalaa sifaa, walla caɗeele ummital.
• E - Ñawɗo no feewi / Ɓooygol ɓernde: Fooftere yaawnde (22 foofaango walla ko ɓuri ɗum e nder hojomaaji), ɓuuɓri ɓernde fooftere ko ɓuri 100 haa 110 ɓuuɓri e nder hojomaaji, ɓuuɓri so ummiima (tansiyoŋ sistolik les 100 mmHg), ɓuuɓri/ɓuuɓri ngam alaa ɓuuɓri walla ɓuuɓri ɓuuɓri 12+ waktuuji.

Limooje emergency diiwaan e porotokolle agence¶

• Leyɗeele dentuɗe Amerik e Kanadaa: Noddu 911 ngam kala ñawu nguu ina wondi e maale sepsis, banngeeji boɗeeji fasciitis nekrotisant, walla ɓuuɓri yeeso/orbital. So tawii ko ɓuuɓri ndi alaa ko bonnata walla cellulitis puɗɗorɗo tawa alaa maale mum, yah to nokku toppitiiɗo ko yaawi walla to departemaa toppitiiɗo ko yaawi ñalnde heen (ina njuɓɓinee e Kuule IDSA ngam haɓaade ñawu nguu e nder ɓalndu e ƴiye softuɗe).
• Dental Dowlaaji Dentuɗi: Noddu 999 walla yah ɗoon e ɗoon to A&E ngam heɓde kala maandeeji NICE NG153 / UK Sepsis Trust Banndiraawo Boɗeejo, sellulit orbital/yeru, walla limfanjitis jaawɗo saabaade. Noddu NHS 111 ngam ƴeewde GP walla Out-of-Hours ƴeewndo cellulitis walla ɓuuɓri nokkuure.
• Dental Orop: Noddu 112 e nder denndaangal leyɗeele jeyaaɗe e UE ngam heɓde caɗeele septik walla nekrosis.
• Ostraali e Nuwel Selannde: Noddu 000 to Ostarali walla 111 to Nuwel Selannde. Njuɓɓudi mum ko e les Laabi safaara: Antibiyotik (Ostarali) e ANZCOR porotokolle sepsis.
• Inndo e Asii-Pacifik: Noddu 112 (walla 108 to Inndo), 995 to Singapuur, 119 to Japon e Koree worgo, walla 999 to Malesi e Hong Kong. Jahde e safrirde jogiinde mbaawkaaji 24 hojom ngam seerndude antibiotik e nder ƴiiƴam.

Naamne keewɗe naamneede¶

Hol ko waɗi miɗo foti ƴettude doggol penndingol e saraaji ɓuuɓri ɓalndu boɗeeri?¶

Sifaade diidi e pentol walla marker to bannge keerol yaajngol boɗewol ngol e winndude waktuuji waktuuji laaɓtuɗi e dow ɓalndu nduu ina rokka on e safrooɓe emergency laamɗo yiytere ngam ƴeewde so tawii ñawu nguu ina yaaji e no ngu yaawiri. So tawii ɓuuɓri ndii ina yaaji haa ɓurti laabi tinndi maa e nder waktuuji 1 haa 2 garooji ɗii hade mum fuɗɗaade ƴettude antibiotik, walla ina jokki e yaajde haa waktuuji 48 caggal nde ñawndugol antibiotik oo fuɗɗotoo, ɗum ina hollita wonde ƴeewndo safrirde ko yaawi walla ƴeewndo ƴiiƴam ina haani.

Hol ko firti liggey boɗeejo walla streak ina diwa dow junngo am walla koyngal am gila e taƴre walla e ɓuuɓri mboros?¶

Laral boɗewal ummoraade e taƴre, ɓuuɓri, ɓuuɓri ɓowɗi, walla ɓuuɓri dow junngo walla les koyngal feewde e wuttulo walla e wuttulo, ko limfangitis ɓuuɓɗo, wonaa ɓuuɓri ƴiiƴam nder ƴiiƴam. Firti ko bakteriiji bonɗi (ko ɓuri heewde e Streptococcus Groupe A) naatii e ƴiye limfatik, ina njaha feewde e ƴiye limfatik diiwaan maa e ƴiiƴam hakkundeejam. Sabu limfangitis ina waawi yahrude yeeso haa wonta bakteriiji e sepsis e nder waktuuji seeɗa, aɗa foti ɗaɓɓude safaara ɓuuɓɗo ñalnde heen ngam heɓde antibiotikuuji gonɗi e nder ɓalndu.

Hol ko waɗi ina bonna ɓuuɓnude walla ɓuuɓnude ɓuuɓri walla ɓuuɓri ɓalndu MRSA e nder galle ?¶

Ina wayi no ɓuuɓri tokosiri, ɓuuɓri walla ɓuuɓri ɓalndu ko ɓuuɓri luggiɗndi, ndi taarotoo ko ɓuuɓri fibrin (fibrin) ɓuuɓndi, ndi haɗata bakteriiji ɗii yaltude e ƴiiƴam maa. So aɗa ɓuuɓna ɓuuɓri ndii, ina addana ɓuuɓri ndii ɓuuɓri ndiyam tiiɗndi, ina heewi ɓuuɓnude ɓalndu nduu e nder ɓalndu nduu, ina addana Staphylococcus aureus (MRSA) guurɗo oo naatde e ƴiye luggiɗe, e nder ƴiye, e nder ƴiye limfatik, ɗo ɗum waawi saabaade sepsis ƴiiƴam, walla ɓuuɓri ƴiye ɓernde, walla ɓuuɓri ɓalndu. E yeeso (nofru walla leppi toowɗi), ɓuuɓnude ɓuuɓri ina waawi ustude ɓuuɓri septik caggal e nder sinus cavernous ngaandi.

Hol no mbaawirmi anndude ko seerndi cellulitis ordinateer e fasciitis nekrotisant ñaamoowo kosam ?¶

E nder cellulitis gaadoraaɗo, ɓalndu nduu ina waɗi boɗeeji, ina ɓuuɓi, ina ɓuuɓi no feewi so neɗɗo memii ɗum, tee tolno nguleeki ina yahdi e no ɓalndu nduu wayi. E nder fasciitis nekrotisan, ñawu nguu ina doga e fascia luggiɗka les ɓalndu, ina addana ɗum mette luggiɗe 10/10 ɗe laddeeji mum en njahdaani e ɓuuɓri ɓalndu, rewi heen ko yaawi ɓuuɓri leɗɗe, ɓuuɓri gaas, nerves ɓuuɓɗi, ɓuuɓɗi ƴiiƴam ina njogii ɓuuɓri diskinb nguleeki mawki, jiiɓru, walla ɓuuɓri. Fasciitis nekrotisan ko ñawu nguu ina ɗaɓɓi ƴeewndo ko yaawi e nder suudu safrirdu.

Hol ko waɗi safrooɓe wiyde ina foti toownude koyngal e cellulitis?¶

Sellulit bakteriiji ina addana ɓuuɓri nokkuyankoori tiiɗndi, ndi waɗata kapilaaruuji mikroskopiiji ɗii ɓuuɓde, ina ɓuuɓna ɓalndu e ƴiye leslese ɗee e ndiyam ɓurɗam heewde (edema). So koyngal ngal fawii les, doole guubiliiji ina moofta oon ndiyam e nder calɗi e koyɗe, ina ɓuuɓna ɓalndu nduu haa tiiɗa, ina ɓuuɓna ƴiiƴam tokosam, ina ɓeyda mette, ina leeltina kadi dokkal antibiotik e ƴiiƴam ɓalejam. Softinde koyngal dow e dow pillooji dow tolno ɓernde ina ustoo ndiyam ɓurɗam heewde, ina yaawi cellal e balɗe.

Mbele neɗɗo ina waawi heɓde cellulitis e koyɗe ɗiɗi ɗee e sahaa gooto?¶

Sellulitis bakteriiji goongaaji ɓuuɓɗi, baɗɗi koyɗe ɗiɗi les ɗee e sahaa gooto, ina famɗi no feewi so wonaa tawa neɗɗo oo ina wondi e ɓuuɓri walla ɓuuɓri gonndi e koyɗe ɗiɗi ɗee sahaa gooto. E nder ko ɓuri 90 e nder teemedere, ɗo mawɗo ina wondi e ɓuuɓri, ɓuuɓri, e ɓuuɓri koyɗe ɗiɗi les ɗee gila e koyɗe haa e hakkunde calɗi tawa alaa ko ɓuuɓnata, ngonka goonga ka ko dermatitis stasis venous (circulation valve veineuse bonne), ko ɗum ɗaɓɓi ƴellitde koyɗe e ɓuuɓnude antibiotikuuji tawa ko e ɓuuɓri ɓuuɓri.

Fuɗɗoode e ardorde laawɗunde¶

• Fedde ñawuuji mborosaaji Amerik (IDSA, Amerik): Laabi gollorɗi ngam ƴeewde e ƴellitde ñawuuji ɓalndu e ƴiye softeende (Stevens et al., ñawbuuli mborosaaji kilinik, purulent vs triage).
• Duɗal ngenndiwal toppitiingal cellal e toppitagol (NICE, Royaume-Uni): Sellulitis e erisipelas: Ƴeewndorɗe antimikrobiyaal (Laabi NICE NG141) e Sepsis: Anndugol, ƴeewndo e njuɓɓudi ko yaawi (NG51).
• Fedde Adunaare toppitiinde ko feewti e seppooji (WSES) e Fedde winndereyankoore toppitiinde seppooji Orop (SIS-E): WSES/GAIS/SIS-E/WSIS/AAST Laabi seppooji winndereeji ngam ñawɓe wonduɓe e ñawuuji ɓalli e ƴiye softeende.
• Nokkuuji toppitiiɗi haɓaade ñawuuji (CDC, leyɗeele dentuɗe Amerik): Ardorde safaara ngam haɓaade mboros biyeteeɗo Staphylokoccus aureus (CA-MRSA) gonɗo e renndo, mo ñawu nguu heɓtotoo e mboros biyeteeɗo Vibrio vulnificus.
• Kampaañ sepsis wuurɗo (SCCM / ESICM, hakkunde leyɗeele): Laabi hakkunde leyɗeele ngam haɓaade sepsis e sepsis shock.

Ardiiɓe jokkondirɓe¶

• Fasciitis nekrotisant (ñawu ñaamoowo teewu) e sellulitis ina mbaɗi banngeeji boɗeeji
• Sepsis e septik shock anndinde e triage urgence
• Selilit orbital, trombose sinus kavernous, e ɓuuɓri gonndi e yeeso
• Emboli pulmonaire e trombose ƴiiƴam luggiɗɗam (DVT)
• Ɓoornugol daabaaji, ɓuuɓri pusi, e ɓuuɓri rabies