WHAT YOU SHOULD KNOW
Sometimes areas of swelling or masses in the body represent an infection. Infections can be of the acute pus producing type that will rapidly destroy tissue or of the slow chronic type that is hard to permanently eliminate. For the acute type, it is critical that the infection be recognized and treated surgically right away to avoid serious permanent tissue damage. For the chronic type, it is critical that the correct diagnosis be made in the laboratory so that the specific antibiotics needed to eradicate the infection can be administered.
MEDICAL HISTORY
All the circumstances surrounding when the patient first appreciated the mass should be reported. The exact symptoms of pain, swelling, redness, warmth, fluid drainage, and others should be described complete with the exact timing of each.
EXAMINATION
The area will be examined for size of the mass, consistency, tenderness, redness, warmth, and other features that reveal how the lesion is interacting with adjacent joint and tendon movements and the overlying skin.
ADDITIONAL TESTS
Occasionally blood cultures and other blood work will be obtained to track the infectious process. Plain x-rays will reveal any bone destruction from the infectious process.
TREATMENT OPTIONS
| NON-OPERATIVE | SURGICAL E DEBRIDEMENT | |
| CONSISTS OF | Antibiotics | Eliminating from the body all the visibly infected or damaged tissue |
| FEATURES | Intravenous or oral | Leave the wound open for acute type |
| ADVANTAGES | Avoids surgery | Absolutely essential step for any established infection |
| DISADVANTAGES | Only valid for the very earliest stages of the acute type | Damage from infection itself followed by the necessary surgery leaves behind substantial scarring |
RECOVERY
After a severe acute type infection, the patient will usually be hospitalized for a number of days until the wound is seen to be improving and the laboratory produces culture results. The patient is then discharged home on antibiotics and wound care. Dressings inside the wound are changed 2-3 times a day until the wound is healed. Spontaneous wound closure by the body requires weeks to complete depending on the wound size. The duration of antibiotic treatment will extend to around 6 weeks if there is bone and joint involvement. Surgery for the chronic type is outpatient, but antibiotic care is measured in months and often requires an intravenous line at home. Permanent elimination of the infection can be difficult for the chronic type or when there is bone involvement.
