Osteomyelitis - infectious inflammation of bone parts: directly bone, marrow and periosteum. When pathogens entered the bloodstream from distant foci of infection, developing hematogenous osteomyelitis. Traumatic osteomyelitis occurs when bacteria penetrate bone directly from the wound.

How does the formation of traumatic osteomyelitis

Traumatic osteomyelitis develops in open fractures, operations on them (including the application of skeletal traction, or the introduction of needles), gunshot wounds. The bacteria get into the bone directly from the wound channel.

Development of inflammatory processes contribute to damage to nerves and blood vessels. The soft tissues that are near the fracture, become unviable due to the effects of the injury and blood disorders. When they die, a large amount of pus. The decay products of damaged tissues cause spasm of the arteries and further damage the nerve fibers.

Bones of the dead, who have lost power, called primary sequestration. They are subject to putrefaction, which increases the toxicity. Later, an inflammation of the soft tissues with moves to viable bone. Since forming secondary and tertiary sequesters. If the bone is cracked, the inflammatory process extends them above or below the site of injury, and sometimes goes to the cavity adjacent joint.

Normally, the healing of the fracture at the site of violating the integrity of the bone callus is formed. But osteomyelitis Osteomyelitis: severe inflammatory disease   This structure is formed or not, or develops very slowly and is fragile. In the first case formed false joints False joints - when the mobility of broken bones And in the second - there are frequent secondary fractures.

Microorganisms that cause traumatic osteomyelitis are hemolytic streptococci, staphylococci, Pseudomonas aeruginosa, Escherichia coli. Most often, the inflammatory process is not one type of bacteria, and combinations thereof.

Signs

Depending on the symptoms of the disease distinguish several forms of the disease:

• Gunshot osteomyelitis .  It develops after a bad surgical treatment of the wound channel .  All manifestations of the disease in the first few weeks after injury associated with suppuration of soft tissue and bone are involved in the pathological process later .  The general condition of the patient depends on the severity and extent of damage to the inflammatory process .  Characteristically fever, signs of intoxication (weakness, malaise, headache) are expressed in varying degrees, .  There are swelling and redness of the edges of the wound, it stands out from the putrid contents and wound surface is covered with a dirty-gray patina .  Expressed in bone pain usually does not happen .  In most cases, gunshot osteomyelitis takes chronic, but may be complications of the disease .  These include ichorization bone marrow cavity formation of pus around the bone fragments, hyperostosis (overgrowth of bone) .
• Acute traumatic osteomyelitis. It is in its manifestations in many ways similar to the gunshot osteomyelitis. In the area of ​​bone lesions formed a deep, extensive wound, which rapidly abscesses. When the inflammation spreads to the bones, the person begins to experience pain beyond the wound surface. Intensity of intoxication may also be different.
• Chronic osteomyelitis. It develops after any form of acute osteomyelitis. The state of health of the patient improves, the pain becomes less pronounced. Sometimes impaired mobility adjacent joints, there is a bending or shortening. There are three features that are characteristic of chronic osteomyelitis: the presence of a fistula, bone sequesters and relapsing course (periods of improvement replaced exacerbations). Fistulas - are channels that connect the pathological lesions in the bone and surrounding tissues with the external environment. Around seizures formed capsule - sekvestralnaya box, which contains the bones of the dead skin and pus. Last through the fistulous passages excreted.

Diagnostics

Long flowing suppurative processes in the wound and pronounced signs of intoxication can be suspected acute osteomyelitis. The appearance of fistulas - a typical sign of the transition of the disease into a chronic form.

The main method of diagnosis of osteomyelitis - X-ray examination. The first signs are determined by only a month after the onset of the disease. In chronic osteomyelitis provides valuable information re-radiography, which is to be performed every three or four weeks.

Treatment and prevention

Treatment of osteomyelitis should combine conservative and operative methods. Antibiotics are appointed on a mandatory basis. This is determined by the sensitivity of pathogenic microflora to them to choose the most effective means.

Surgery - this is the main method of treatment of traumatic osteomyelitis. Necropsied burrowing pus, removal of free-lying bone fragments and dead tissue. If the bone at the fracture site for a long time does not grow together, then the economical resection (partial removal) of bone fragments. After that, the surface of the bone is compared and fixed plaster cast. In many cases, after the operation applied external fixation devices which allow to hold the bones in position and prevent their displacement.

Osteomyelitis prevention aims to prevent the emergence of purulent inflammation at the site of the fracture or a gunshot wound. Timely treatment to specialists, debridement and immobilization (the creation of stillness) of the damaged part of the body to significantly reduce the risk of traumatic osteomyelitis.

Chronic candidiasis phenomenon is not so rare, most often chronic recurrent candidiasis developing in the genital area in women is not uncommon as chronic intestinal candidiasis. It is usually the result of improper treatment of acute processes that resulted in complete inhibition of fungal infection.

Causes of

Chronic candidiasis can begin on the background of prolonged or uncontrolled use of antibiotics, while taking glucocorticoid drugs (in asthma, rheumatoid arthritis), due to lower immunity in cancer patients, patients with diabetes mellitus, primary and secondary immunodeficiencies. For example, if the primary (innate) immunodeficiency develops this kind of chronic candidiasis, as a chronic generalized (granulomatous) candidiasis.

Permanent focus of infection in adults are often the intestines and genitals. Usually, chronic recurrent processes develop on the background of immune disorders in combination with incorrect, incomplete treatment of acute processes.

How is chronic candidiasis of female genital mutilation

Acute candidiasis lasts no more than two months, and if he goes on and after that date, it is already considered chronic. For example, female genital mutilation candidiasis (thrush) begins acutely, with the appearance of burning and itching, which sometimes join frequent painful urination - a sign of the defeat of the urethra.

Too many women, having given the well-known television commercials, take one tablet of fluconazole Fluconazole - used with caution   and believe that candidiasis is finished. Imagine their surprise when, after a while signs of thrush appear again, and then come back again and again, despite the miracle pill. The reason for the formation of chronic candidiasis that were not originally addressed the causes of the disease, allowing the infection to penetrate deep into the mucosa and recur every time for this is favorable circumstances.

These favorable circumstances for infection is reduced immunity, so the recurrence of chronic yeast Chronic yeast infection - how to win illness   appear after colds, stress and other factors that reduce immunity. This exacerbation of symptoms of yeast infection are not as pronounced as the primary symptoms of the disease, which in itself speaks of the chronic process.

How is chronic intestinal candidiasis

A hotbed of fungal infection can be, and intestines. Especially often it happens in chronic infectious and inflammatory diseases, which are often used broad-spectrum antibiotics Broad-spectrum antibiotics - not only treat but also cripple That kill the normal microflora. It inhibits the growth of normal microflora of conditionally pathogenic microorganisms, including fungi of the genus Candida, causing candidiasis.

Chronic intestinal candidosis may take the form of dysbiosis, wherein the intestinal wall is not affected, but the digestive process is broken, which manifests itself in the form of abdominal distention, abdominal pain, constipation or diarrhea, as well as intoxication products to improper digestion.

But in some cases, chronic intestinal candidosis manifested as ulcer process that is already fraught complications such as perforation of the intestinal wall and internal bleeding.

How to diagnose

Yeast fungi of the genus Candida are natural inhabitants of the skin and mucous membranes, including hollow bodies having a connection with the external environment (such as the intestines). Therefore, their detection in feces or secretions of female genital mutilation is not yet a confirmed diagnosis. For this to be another sign of permanent and recurring candidiasis of an organ.

Therefore, the biological material are plated on nutrient medium with the identification of pathogen, its amount and sensitivity to antifungal drugs.

In addition, the immune system is tested, revealed the breach, as well as the causes of these disorders. The reasons may be latent diseases (eg, diabetes mellitus Diabetes - threatening and incurable disease Chronic infectious-inflammatory processes), tumors, receiving a variety of medications, alcohol, drugs.

Treatment

For the treatment of chronic candidiasis some antifungal drugs is not enough. It is necessary to restore the immune system, and this will take to identify and address (if possible) the reasons for the breach.

You should not try to cope alone with candidiasis, it is better to entrust his treatment doctor.

Galina Romanenko