Hot abscess due to myositis methicillin-resistant Staphylococcus aureus (MRSA) - Part 1

The article was written by Doctor of Laboratory - Microbiology, Department of Laboratory - Vinmec Da Nang International General Hospital.

A hot abscess is a localized foci following an acute infection, an inflammatory lesion leading to a striated muscle abscess produced by subcutaneous infiltration of staphylococcus aureus (Staphylococcus aureus), particularly methicillin-resistant Staphylococcus aureus is common. Occurs after an infected injury, boil, infected incision or an inflammation.

1.1 Definition of Hot Abscess The condition that causes inflammation of the muscle and creates an abscess, occurs only when two factors are present:
The presence of pathogenic bacteria There is an injury to the body such as an injury, an open wound or a boil The outside of the skin creates conditions for bacteria to penetrate, grow and cause disease

Patients are often subjective, paying little attention to pimples and small wounds on the body, although this is the way for bacteria to enter the body and cause disease. Progression of the disease often creates abscesses the size of a corn grain, an apple, a fingertip located just below the skin.

2.1. Common routes of bacterial transmission Boils: the most common of staph infections, which develop in hair follicles. Infected skin is usually red and swollen. Boils often appear under the arms, around the groin or buttocks. If the boil ruptures, pus may drain out. Cellulitis: an infection of the deeper layers of the skin, causing redness and swelling. Cellulitis occurs most often in the legs and feet; Impetigo: an infectious rash caused by Staphylococcus aureus. Impetigo mostly aggregates into large areas, draining pus, and forming a honey-colored crust. Staphylococcal scalded skin syndrome, common in infants and children, is characterized by fever, rash and sometimes blisters. When the blisters burst, they leave behind a rough red surface that looks like a burn. The toxin produced by Staphylococcus aureus can lead to this syndrome.. 2.2. Some related factors Many patients with boils often:
Squeeze pus at an early stage In the process of squeezing and squeezing, it is not sterile Not taking good care of the wound In addition, medical procedures are not guaranteed to be sterile. bacteria such as injections, acupuncture, infected incisions after surgery, creating favorable conditions for the penetration of bacteria into the patient's body.

2.3. Location of lesion Can be found at any location
Clinical symptoms:
Hot abscess progresses through 2 stages
Diffuse stage (1 -2 weeks):
Muscle swelling, firm pressure, yes red body. Pain is usually mild or aching, sharp in one area of ​​the body. There are signs of systemic infection such as high fever, chills, lethargy, headache... Examination has 4 basic symptoms:
Tumor or hard lump in the center and crusting at the outer edge. The tumor feels hot to the touch. The surface of the tumor is red compared to the surrounding skin. Immediately pressing the tumor is very painful. When examining and asking the patient, it is possible to detect the penetration lines under the skin of bacteria
Stage of pus accumulation (weeks 2 - 4):
Muscles are red, swollen, very painful, feeling swollen when pressed Sharp, sharp pain disappears, giving way to aching sensation Purulent aspiration of pus More severe systemic signs: fluctuating fever, elevated white blood cell count (increased polymorphonuclear leukocyte count) Examination reveals pericardial crusting of tumor Now palpation is softer than the center, when the two fingers are placed a few centimeters apart at the poles of the pus pocket, when pressed on one side the other finger is pushed (sign of wave).

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