Skin and soft tissue infection, five methods to diagnose

Skin and soft tissue infections mainly refer to common purulent infections of the skin and soft tissues, including folliculitis, carbuncle, acute cellulitis, abscess, erysipelas, acute lymphangitis, as well as rare diseases. So how should we diagnose and examine them?

1. Medical history

Ask whether the affected area is red, swollen, hot, or painful, as well as its occurrence and development, whether there is fever and its degree, and whether there has been any local trauma before the onset of the disease. In addition, you should also pay attention to asking whether the patient has tinea manuum and tinea pedis; whether the patient has varicose veins in the lower limbs and the extent of the varicose veins; and whether the patient has a history of tuberculosis and diabetes.

2. Physical examination

Check whether there is local redness, swelling, increased skin temperature, tenderness, nodules, lumps or red and painful strips that spread centripetally; check whether there is local fluctuation, necrosis, ulcers and functional disorders; pay attention to whether there is enlargement of regional lymph nodes. Are there similar lesions in other parts of the body? Whether there is active tinea manuum and tinea pedis.

3. Assay

Check blood routine and blood sugar if necessary, because diabetic patients are prone to skin and soft tissue infections.

4. Special inspection

When the diagnosis is difficult to make, ultrasound examination and/or diagnostic puncture can be performed. Deep abscesses must exclude tuberculous abscesses, aneurysms and tumors.

5. Bacteriological examination

When general treatment is ineffective, smear examination of wound secretions and abscess puncture fluid, bacterial culture and drug sensitivity test should be performed. Perform anaerobic bacterial culture when necessary. Blood cultures and drug sensitivity tests should be performed when sepsis is suspected.