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Abscess of the perineum muscle has many causes, usually in the summer due to excessive sweating, gradually progressing to an abscess. The disease can cause sepsis and death if not diagnosed and treated early.1. Causes of pelvic muscle abscess
A perineal muscle abscess is a pus-filled lesion in the striated muscle (perineal muscle), which often occurs after untreated perineal myositis. Because bacteria penetrate through the skin to form an infection, the most common bacteria is Staphylococcus aureus. In addition, other bacteria such as streptococci, gonorrhea, pneumococcus, meningococcus, gram-negative bacteria such as blue pus bacilli, and other anaerobic bacteria are also encountered.The way to enter is mainly through the local route through a skin infection such as: boils, trauma causing muscle tearing, myositis, infection of the genitals, urinary system... Injection techniques are not ensure sterility, acupuncture, intramuscular injection... In addition, it can penetrate through the bloodstream to form an abscess located in the perineal muscle, seen in the case of sepsis, polymyositis, inflammation of the membranes.
2. Risk factors
There are many risk factors leading to pelvic floor muscle abscess, including:Immunodeficiency, easy infection such as: diabetes; people with systemic lupus erythematosus, autoimmune polymyositis, scleroderma, prolonged corticosteroid use, HIV infection, malignancy; People with poor nutrition, the body is exhausted; The elderly and children are at risk of disease; Children sweat a lot, have many pimples; People with infected skin wounds; People who are suffering from genital and urinary tract infections.
Người mắc bệnh tiểu đường có nguy cơ bị áp xe đáy chậu cao hơn người bình thường
3. Clinical symptoms of perineal muscle abscess
Local symptoms. Swollen, hot, red, painful pelvic floor muscles. Muscle swelling, the skin over the abscess is red and painful. After about 2 - 4 weeks, the muscle is swollen, red, very painful, can be palpated, feels swollen when pressed, pus is aspirated.Systemic symptoms: Intoxication syndrome such as high fever 39-40 oC, continuous fever, fluctuating with dry lips, dirty tongue, bad breath, fatigue, weight loss. Many cases have no systemic manifestations.
Subclinical symptoms:
Increased infection markers such as: increased white blood cell count, increased neutrophil percentage; increased erythrocyte sedimentation rate, increased CRP, increased procalcitonin; Blood culture or pus culture of the patient detects pathogenic bacteria; Ultrasound of the perineum muscle can show damage: increased muscle volume, loss of muscle fiber structure; have clearly demarcated acoustic drums; Aspiration of the abscess: see pus pouring out; Purulent examination may show many degenerated neutrophils, may find pathogenic bacteria by direct examination or culture of pus; Magnetic resonance imaging when having an abscess of the perineum muscle shows the lesion of the abscess.
4. Treatment of perineal muscle abscess
It is necessary to combine treatment measures to be effective, including:Use antibiotics early, strong, high doses, preferably antibiotics based on the antibiogram. However, if there are no results of the antibiogram, treatment should be empiric; Injecting the abscess or aspirating to drain the pus ensures the principle of sterility, leaving it open, and changing the dressing daily; Improve physical health with a diet rich in protein, supplementing with vitamins C, group B, minerals,...; Symptomatic treatment: reduce fever and pain with paracetamol, aspirin... can be combined with anti-inflammatory drugs.
Bệnh nhân cần sử dụng kháng sinh sớm, mạnh, liều cao, tốt nhất là dùng kháng sinh dựa theo kháng sinh đồ
5. How dangerous is perineal muscle abscess?
Because the anatomical position of the perineal muscles is close to the genital organs, the abscess can spread to nearby sites, leading to vaginitis, salpingitis, and ovarian cysts affecting reproductive function such as: infertility, inflammation uterine cavity, ectopic pregnancy ...; The location is difficult to see if not cleaned, not treated early with antibiotics, it is easy to get infected. The most dangerous situation is sepsis, septic shock, multi-organ failure, the patient can die quickly; If the abscess is not injected, the pus may burst into the pelvic area, causing infection in the pelvic area; In case the abscess has not completely turned into pus, but the incision is extremely dangerous, causing the bacteria to quickly penetrate the surrounding tissues and enter the blood quickly; In case of non-sterile incision, improper incision technique, not leaving an incision after the incision, leads to more severe infection.6. Prevention
Children and the elderly in heat waves should avoid going out in the sun, stay in a cool room, eat in moderation, bathe daily to keep their skin clean to avoid developing boils; For those who are suffering from boils, wounds on the skin, people who are suffering from genital and urinary tract infections, diabetes, exhausted bodies... should be actively treated according to the instructions of the doctor. doctor; Increase nutrition, fruits of all kinds to improve health, prevent muscle abscesses that can develop on the main disease background; People who treat diseases by acupuncture method..., need to ensure good sterility to avoid infection and muscle abscess through injection or acupuncture.
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