Phlegmon within the jaw – diffuse purulent inflammation of the subcutaneous, submucosal and interfascial tissue of the maxillofacial region.
The reasons
The causative agents are traditionally staphylococci and streptococci, but other pyogenic microbes that penetrate into the cellular spaces through accidental damage to the skin, mucous membranes or hematogenously can also cause phlegmon. The disease occurs when an infection enters the deep layers of soft tissues and the state of allergic and nonspecific reactivity of the body.
The development of phlegmon is often preceded by osteomyelitis of the jaw, acute apical diseases, lymphadenitis, etc.
Symptoms
Severe pain when chewing, impaired jaw mobility (trismus), breathing, speech, difficulty swallowing, salivation, facial asymmetry. Spilled, dense, painful on palpation swelling of the face on the side of the lesion, the skin is shiny, does not gather into a fold. The phenomena of intoxication are expressed: weakness, sweating, chills, increased heart rate and respiration. The course can be complicated by asphyxia, facial vein thrombosis, meningitis, mediastinitis, sepsis, etc.
Diagnostics
In the blood, ESR is sharply increased. Body temperature 39-40 degrees Celsius.
Treatment
Patients with phlegmon are hospitalized. In the initial stage of phlegmon, conservative treatment is permissible: bed rest, rest for the affected limb, large intramuscular doses of antibiotics, heavy drinking, a milk-vegetarian diet, cardiac, painkillers are prescribed. Locally, in the circumference of the phlegmon, tissues are chipped with a solution of penicillin in novocaine, dry heat, UHF therapy are used. With the delimitation of the process and the formation of abscesses (limited phlegmon), conservative treatment ends with their opening and drainage.
With progressive phlegmon, a delay in surgical intervention is unacceptable.