DISEASES OF THE EAR : SEPSIS OTOGENOUS - etiology, pathogenesis, symptoms and course of, recognition, prediction and prevention
The infection of the ear lesion may occur:
Due to prolonged contact of the wall of the sinus with purulent molten cells of the mastoid process is formed of periferic, then phlebitis, endoplamic and a clot in the sinus sigmoideus. The formation of thrombus contribute to the slowing of blood flow, change its composition and damage of the vessel wall purulent infection. Sinistrality formed and after acute and after exacerbation of chronic processes in the middle ear. Infected thrombus is a septic focus. Broken-off pieces of a blood clot is recorded in the form of emboli in the blood in various organs.
Symptoms and recognition. In septicemia the temperature is raised, is in the nature of continua, the skin is dry, pale, sometimes with hemorrhagic rash, sclera, and sometimes skin jaundiced painted, tongue dry, pulse speeded up, headache, septic phenomena of the internal organs - endocarditis, hepatitis, enlarged spleen, bleeding in internal organs and under the skin. From the white blood - leukocytosis with a shift to the left of neutrophils. The frequent disappearance of eosinophils. If septicopyemia temperature is intermittent in nature with constant chills (when lifting) and heavy sweats (in the fall).
For. Distinguish septicemia occurring without metastases, and septicopyemia flowing with metastases. Metastases can occur in all organs.
The prediction of careful, considered to be less favourable metastases in the lungs. Dissociation between heart rate and temperature in sepsis prognostically unfavorable.
Penicillin therapy. Cleaning of the primary lesion, i.e. mastoidotomy, or obschepolostnaya trepanation, depending on the duration and the extent of involvement of the middle ear. When the modified wall of the sinus is proof puncture, opening or removal of the thrombus and, finally, depending on the further course of the process, the ligation of the jugular vein. Nutrition, skin care, heart (caffeine, camphor); sulfa drugs (sulfanilamide, sulfidine by 1.0 every 4 hours), symptomatic treatment; intravenous infusion of 40% of hexamine (after a day or two); blood transfusion (average doses of 200 - 250 ml).