Contents
What is an infiltrate?
Infiltrate – this is a seal formed in the tissue area or organ (liver, muscle, subcutaneous tissue, lung), the occurrence of which is due to the accumulation of elements of cells, blood, lymph. There are several forms of infiltration. The inflammatory form is formed due to the rapid multiplication of tissue cells and is accompanied by the appearance of a significant number of leukocytes and lymphocytes, blood and lymph, which sweat from blood vessels.
The tumor infiltrate is made up of cells characteristic of different types of tumors (cancer, myoma, sarcoma). Its manifestation consists in infiltrated tumor growth. With such a formation, a change in the volume of tissue occurs, a change in color, its density and soreness increase. The surgical form of the infiltrate is a seal that occurs in the tissues when they are artificially saturated with an anesthetic, antibiotic, alcohol, and so on.
Causes of infiltration
The reasons why inflammatory infiltrates occur constitute a group with diverse etiological factors. Studies have identified 37% of patients with a traumatic source of the disease, 23% had an odontogenic infection, and in the remaining part of the patients, an inflammatory infiltrate developed due to various infectious processes. This form of the inflammatory process occurs with the same probability in any age category.
Infiltrates of the inflammatory form are often observed in the tissues of the maxillary location, in particular, in children with the occurrence of pulpitis and periodontitis, which can be confused with reactive processes. Diseases of periadenitis and serous periostitis are also a type of inflammatory infiltrate. In order to accurately assess the patient’s condition, it is required to recognize the non-purulent stage of the process. The group of odontogenic inflammations is of an inflammatory nature, affecting the jaw bones, tissues adjacent to the jaw, and regional lymph nodes.
Agents representing the microflora of the oral cavity (staphylococci, candida, streptococci, and others) are considered to be the causative agents of odontogenic inflammation. Along with them, the cause of the development of a negative process is the resistance of microorganisms, which is determined by specific and nonspecific protective factors, the reactivity of the organism of an immunological nature. Inflammatory infiltrate is manifested by infection of the contact type and by the lymphogenous pathway of its spread, followed by tissue infiltration.
The cause of the infiltrate may lie in the complicated state of acute appendicitis. This is an inflammatory type tumor, in its center there is a process of a vermiform form and an inflamed condition that occurs in the absence of timely surgical treatment. A variety of infiltrate can be post-injection type. It represents inflammation of the local type, which develops in the place where the intramuscular injection was performed, that is, its cause is incorrect medical manipulation, violated sanitary rules.
Infiltration symptoms
The development of an inflammatory infiltrate takes several days. The patient’s temperature during this period may be normal or subfebrile in nature (a slightly elevated temperature that does not normalize for a long time). Swelling and tissue compaction with a clearly visible contour appear in the affected area, the distribution area of uXNUMXbuXNUMXbwhich is distributed over one anatomical region or several. Palpation of the affected area may cause severe or mild pain.
It is not possible to determine the presence of fluid (fluctuation for pus, blood) in the resulting cavity. The skin of the lesion is slightly tense, has a red color or slight hyperemia. In this area, all soft tissues are affected – skin, mucous, subcutaneous fat and muscle tissue, several fascia with involvement of lymph nodes into the process of infiltration. Infiltrates with traumatic genesis have a zone of localization in the buccal, maxillofacial region and oral cavity.
The infiltrate, which is based on a complication of appendicitis in an acute form, develops up to 3 days from the onset of the disease. The inflammatory process is formed in the lower abdomen on the right side. Its symptoms are persistent aching pain, low temperature up to 37,5 ° C, there is a possibility of a reverse development of the process, during abscess formation, the temperature rises to 39 ° C, which is accompanied by chills, an abscess is formed and recovery is possible only after the intervention of the surgeon.
Diagnosis of infiltrate
Inflammatory infiltrate is diagnosed using a differential approach, which takes into account the factors of the cause and conditions under which the disease occurred, as well as the factor of its prescription. The accuracy of the diagnosis is confirmed by the following features: normal or subfebrile body temperature, clear contours of the infiltrate, sharp pain during palpation, the absence of pus in the closed cavity of the inflamed tissue.
Mild distinctive symptoms are: the absence of solid intoxication, slight hyperemia of the skin without detecting tension and a shiny effect of the skin. Difficulty diagnosing foci of a purulent type, the localization of which is in a space delimited by a group of muscles from the outside. In such cases, the build-up of signs of inflammation predetermines the prognosis of the disease. In doubtful cases, the diagnosis is made on the basis of the results of a puncture from the focus of inflammation.
By studying the histological structure of the material obtained from the infiltrate, that is, by conducting a morphological version of the biopsy study, it is possible to detect cells typical of the proliferative inflammatory phase with a complete absence or a small number of leukocytes of the segmented neutrophilic type. This indicator is typical for non-purulent inflammation. In infiltrates, as a rule, yeast and filamentous fungi are found in large clusters. This indicates the presence of dysbacteriosis.
Appendicular infiltrate is determined upon examination by a doctor. As a rule, special diagnostic methods are not used. In cases of suspected abscess formation, an echographic examination is performed. This method clearly shows the structure of the infiltrate and reveals cystic formations with a clear presence of capsules containing a heterogeneous fluid, which will be an indicator of the accumulation of purulent exudate.
Infiltrate treatment
Inflammatory infiltrate is treated with conservative methods that combine anti-inflammatory therapy and physiotherapeutic agents (laser irradiation, dressings using Vishnevsky ointment and alcohol). Suppuration of the infiltrate entails the occurrence of phlegmon, then surgical treatment cannot be avoided. Physiotherapy fulfills the main goal – the rehabilitation of infectious foci to eliminate inflammatory processes.
If there are no purulent manifestations in the infiltration or they have a small quantitative content without a bright fluctuation and a general reaction, physiotherapeutic methods perform resorption of the infiltrate (anti-inflammatory method), reduce swelling (anti-inflammatory method), and relieve pain (analgesic method). Anti-inflammatory therapy is prescribed for dense infiltrate without purulent fusions to increase blood flow in the local area, eliminate stagnation.
When using it, the intensity of exposure is important, but in the presence of purulent microflora, a high-intensity technique will provoke a purulent inflammatory form. Other methods with a thermal effect are prescribed in the absence of provocation on their part, preferably on the fourth day after UHF therapy or UV radiation. Electrophoresis of antibiotics performs an antibacterial role, and calcium electrophoresis is prescribed to delimit the focus of inflammation.
It is possible to treat appendicular infiltrate only in the stationary conditions of the clinic. It includes therapy with antibacterial drugs, dieting and limiting physical exertion. Within 14 days, the inflammatory process resolves and recovery occurs. In order to prevent such attacks after 90 days, an operation is recommended, as a result of which the appendix is removed.
Abscessing of the infiltrate (the formation of a cavity around the appendix filled with pus) requires an operation to open the abscess, the appendix is preserved in this case. The final recovery will come after the removal of the appendix six months after the abscess was opened.