背景:蜂窝织炎是一种常见的临床疾病,如果治疗得当,发病率和死亡率较低。表现为红斑的蜂窝织炎的模拟物,水肿,温暖,如果误诊,疼痛可能与严重的发病率和死亡率有关。
目的:这篇综述调查了蜂窝织炎的体征和症状,模仿蜂窝织炎,以及管理蜂窝织炎及其模拟物的方法。
结论:目前急诊医学对蜂窝织炎的定义包括红斑,硬结,温暖,和肿胀。鉴于常见的病理生理途径,蜂窝织炎的模仿通常以类似的方式存在。这些病症包括化脓性囊炎,化粪池,深静脉血栓形成,痰斑蓝斑dolens,坏死性筋膜炎,屈肌腱鞘炎,战斗咬伤(闭合拳头受伤),眼眶蜂窝织炎,中毒性休克综合征,丹毒,脓肿,重罪犯,甲沟炎,痛风性关节炎.这些疾病中的许多如果被急诊医师错过则具有高发病率和死亡率。在快节奏的紧急情况下,很难将这些模拟物与蜂窝织炎区分开来。历史的结合,体检,和集中的诊断评估可能有助于正确确定潜在的病因。对于许多高死亡率蜂窝织炎的模仿,手术干预是必要的。
结论:由于对皮肤和软组织感染的相同生理反应,蜂窝织炎及其模拟物表现相似。历史的结合,体检,和诊断评估将帮助急诊医师区分蜂窝织炎和模拟蜂窝织炎。对于高发病率和高死亡率模拟物,经常需要手术干预。
BACKGROUND: Cellulitis is a common clinical condition with low rates of morbidity and mortality if treated appropriately. Mimics of cellulitis presenting with erythema, edema, warmth, and pain can be associated with grave morbidity and mortality if misdiagnosed.
OBJECTIVE: This
review investigates the signs and symptoms of cellulitis, mimics of cellulitis, and an approach to the management of both cellulitis and its mimics.
CONCLUSIONS: The current emergency medicine definition of cellulitis includes erythema, induration, warmth, and swelling. Given the common pathophysiologic pathways, cellulitis mimics often present in an analogous manner. These conditions include septic bursitis, septic joint, deep vein thrombosis, phlegmasia cerulea dolens, necrotizing fasciitis, flexor tenosynovitis, fight bite (closed fist injury), orbital cellulitis, toxic shock syndrome,
erysipelas, abscess, felon, paronychia, and gouty arthritis. Many of these diseases have high morbidity and mortality if missed by the emergency physician. Differentiating these mimics from cellulitis can be difficult in the fast-paced emergency setting. A combination of history, physical examination, and focused diagnostic assessment may assist in correctly identifying the underlying etiology. For many of the high mortality cellulitis mimics, surgical intervention is necessary.
CONCLUSIONS: Cellulitis and its mimics present similarly due to the same physiologic responses to skin and soft tissue infections. A combination of history, physical examination, and diagnostic assessment will help the emergency physician differentiate cellulitis from mimics. Surgical intervention is frequently needed for high morbidity and mortality mimics.