A phlegmon is a disease of the soft tissue (fat, skin…) with diffuse suppuration and inflammation. This leads to a red discoloration of the skin as well as the underlying fatty and connective tissue, which also becomes painful and purulent. The cause of phlegmon is an inflammation with bacteria.
Causes of phlegmons
Phlegmons are caused by bacteria. In most cases, the bacteria are the pathogens beta-haemolytic streptococci, or more rarely staphylococci of the type Staphylococcus aureus. In very rare cases, however, other bacteria may also cause the phlegmons, for example the group of so-called anaerobes.
These are different bacteria that can only survive without oxygen (anaerobic) and therefore stay in the intestine, for example, where they are not exposed to oxygen that could damage them. Occasionally there are also so-called mixed infections, in which different bacteria are together responsible for the development of phlegmons. The reason why phlegmons can develop at all is usually due to a small injury to the skin and the underlying tissue.
In this case, it happens that pathogens that are actually on the skin (cutis) and cannot normally overcome it because the skin is a protective barrier, can penetrate through the cut or wound into the depth of the skin (subcutis). In some cases, even a prick with a small needle can cause the bacteria to spread to the depth of the tissue and cause a phlegmon. It is also possible that patients may suddenly notice pain and redness in the jaw area after dental (dental) treatment. By manipulating the oral cavity during the dental treatment, bacteria can penetrate through the opened gums into the depths of the tissue, which then leads to the formation of a phlegmon. It is important to remember that the cause does not always have to be an external injury, but that an iatrogenic injury unintentionally caused by the doctor can also lead to phlegmon.
Diagnosis
Once a phlegmon has progressed, a physician can diagnose it by looking at the skin and seeing that the skin is red and that the injury or the entry point of the bacteria is festered. Often the first black changes of the skin can already be seen. These are dead tissue, so-called necroses.
Often the phlegmons spread quickly within a very short time, so that muscles or large areas of the tissue are affected. In addition, the doctor can also take blood samples from the patient, since the signs of inflammation are increased (including the C-reactive protein, CRP for short, and the erythrocyte sedimentation rate, ESR for short). Since phlegmons usually require surgical treatment, a smear can also be taken from the wound secretion to diagnose the exact type of bacteria causing the infection.
