what are the causes of bacterial synergistic gangrene and what are the causes of bacterial synergistic gangrene
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The main etiology of bacterial synergistic gangrene is subcutaneous tissue infection caused by Streptococcus parvum and Staphylococcus aureus
First, the cause of the disease
Pathogenic bacteria are similar to necrotizing fasciitis, which is caused by many pathogenic bacteria. Microaerobic non-hemolytic streptococci are often found around the infection focus, while Staphylococcus aureus, Proteus, Enterobacter, Pseudomonas aeruginosa and Clostridium can be isolated in the central necrotic area.
This disease often occurs in the incision after abdominal or thoracic surgery, especially in the place of suture indwelling, the incision after abdominal abscess and empyema drainage, the colostomy or ileostomy, and minor trauma can also be complicated with this disease. This is closely related to the local contamination of the wound by pathogenic bacteria.
Second, the pathogenesis
Bacterial synergistic gangrene is a slow progressive infection, and the infection focus is only 1 ~ 2cm in 7 ~ 10 days. Histopathology showed chronic suppurative necrotizing inflammation with obvious eosinophilic leukocyte infiltration.
1. Extensive dissolution and coagulation necrosis of skin, subcutaneous, fascia and muscle. A large number of gram-positive cocci and various bacilli can be seen in the necrotic area. Necrosis develops from superficial to deep, and skin, subcutaneous, deep fascia, muscle, interosseous membrane and bone can all be necrotic.
2. The wall of some small vessels around the necrotic focus showed inflammatory cell infiltration, destruction, repair and proliferation, and some lumens were narrow or occluded. It can be seen that microvascular stasis and embolism in a wide range of tissues lead to blood circulation disorder.
3. There are dense lymphocytes, plasma cells and monocytes infiltrating around the necrotic focus of mixed inflammatory infiltration, and a large number of eosinophils can be seen, and inflammatory cells infiltrating in some areas can even be dominated by them.
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