最后审阅: 21 九月 2021
最后更新: 17 七月 2020

小结

定义

病史和体格检查

关键诊断因素

  • 突发皮肤红肿、疼痛、灼热、肿胀(蜂窝织炎
  • 边界清晰,皮肤凸起且色如涂丹(丹毒)

其他诊断因素

  • 橘皮样外观
  • 水疱生成
  • 出血
  • 淋巴管炎
  • 单侧
  • 发热
  • 不适感
  • 淋巴结肿大
  • 趾间隙异常
  • 危险因素
  • 其他全身症状
  • 感染源
  • 免疫功能受损
  • 近期旅行过
  • 蜂窝织炎深部出现波动
  • 皮肤坏死
  • 出现脓毒症体征
  • 坏死性筋膜炎征象
  • 眼眶和眶周蜂窝织炎征象

危险因素

  • 糖尿病
  • 静脉功能不全
  • 湿疹
  • 水肿和淋巴水肿
  • 肥胖
  • 既往蜂窝织炎发作
  • 趾间隙异常

诊断性检查

首要检查

  • 全血细胞计数
  • 红细胞沉降率 (ESR)
  • C 反应蛋白 (CRP)
  • 尿素和电解质
  • 血培养和药敏试验

需考虑的检查

  • 皮肤拭子
  • 皮肤抽吸物
  • 皮肤活组织检查
  • 分子诊断检验程序
  • X 线平片
  • 磁共振成像 (MRI)
  • 超声
  • 肝功能检测

治疗流程

撰稿人

专家顾问

Johann Grundlingh, MBChB, FCEM, FFICM, EDICM, DFMS, DipMedTox, MMedTox, MSB, ERT, MEWI, MBA

Emergency Medicine Consultant

Royal London Hospital

Barts Health NHS Trust

Honorary Senior Lecturer

Queen Mary University

London

UK

利益声明

JG declares that he has no competing interests.

Ram Narayanan, MBBS, MEM, MRCEM

ST5 in Emergency Medicine

Whipps Cross Hospital

Barts Health NHS Trust

London

UK

利益声明

RN declares that he has no competing interests.

鸣谢

BMJ Best Practice would like to gratefully acknowledge the previous expert contributor, whose work has been retained in parts of the content:

Matthew C. Robinson, MD

Infectious Disease Physician

Austin Infectious Disease Consultants

Austin

TX

Disclosures: MCR declares that he has no competing interests.

同行评议者

Susan Croft, MBChB, MRCP, FRCEM

Emergency Medicine Consultant

Sheffield Teaching Hospitals NHS Foundation Trust

Sheffield

UK

利益声明

SC declares that she delivered two paid presentations to local general practitioners on acute exacerbations of long-term conditions in March and April 2018 (supported by Astra-Zeneca).

编辑

Celia Pincus,

Section Editor, BMJ Best Practice

利益声明

CP declares that she has no competing interests.

Susan Mayor,

Lead Section Editor, BMJ Best Practice

利益声明

SM works as a freelance medical journalist and editor, video editorial director and presenter, and communications trainer. In this capacity, she has been paid, and continues to be paid, by a wide range of organisations for providing these skills on a professional basis. These include: NHS organisations, including the National Institute for Health and Care Excellence, NHS Choices, NHS Kidney Care, and others; publishers and medical education companies, including the BMJ Group, the Lancet group, Medscape, and others; professional organisations, including the British Thoracic Oncology Group, the European Society for Medical Oncology, the National Confidential Enquiry into Patient Outcome and Death, and others; charities and patients’ organisations, including the Roy Castle Lung Cancer Foundation and others; pharmaceutical companies, including Bayer, Boehringer Ingelheim, Novartis, and others; and communications agencies, including Publicis, Red Healthcare and others. She has no stock options or shares in any pharmaceutical or healthcare companies; however, she invests in a personal pension, which may invest in these types of companies. She is managing director of Susan Mayor Limited, the company name under which she provides medical writing and communications services.

Tannaz Aliabadi-Oglesby,

Lead Section Editor, BMJ Best Practice

利益声明

TAO declares that she has no competing interests.

Julie Costello,

Comorbidities Editor, BMJ Best Practice

利益声明

JC declares that she has no competing interests.

Adam Mitchell,

Drug Editor, BMJ Best Practice

利益声明

AM declares that he has no competing interests.

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