Phlegmon

April 2017


Definition


A phlegmon is an inflammation of the connective tissue, which can be found just under the skin in the case of a superficial abscess, or near an organ in the case of deep cellulitis. The connective tissue, rich in fiber, supports and protects other tissues and organs of the body. Among the most frequent cases of superficial cellulitis are those of the fingers (cellulitis frequently involving tendon sheaths). As to phlegmons located near an organ, the tonsils are most frequently affected (peri-tonsillar abscess). The phlegmon is almost exclusively infectious, and can lead to tissue destruction and pus formation. Unlike an abscess, a phlegmon is not compartmentalized, it is limited in its extension, and it will tend to remain localized and not expand. It can sometimes develop into an abscess: a circumscribed abscess.

Symptoms


A phlegmon in the finger usually affects only one finger: it appears red, hot and very painful, rendering it almost impossible to touch or unfold. If it reaches a portion of the muscles whose function is flexion of the fingers, which is often the case, the latter will remain in a flexed position. A peri-tonsillar phlegmon is more disabling: inflammation of the tonsils contracts the muscles of the jaw, which prevents opening the mouth completely, and makes swallowing difficult. High fever (40° C) accompanies these symptoms.

Diagnosis


The medical diagnosis of finger cellulitis is often made from the clinical examination. It is most often made in the context of the evolution of an inflammation or in the aftermath of a plaque that had been neglected and has spread to neighboring structures. For cellulitis that affects the tonsils, it is often a complication due to bacterial tonsillitis. Generally, it appears as a red mass invading the amygdala, which is highly suggestive of the diagnosis in the context of the evolution of a sore throat over a few days.

Treatment


In both cases, surgical treatment is essential to prevent the infection from spreading. For the finger, surgery ablates the dead tissues and cleans the affected area. The finger is then often immobilized with a splint, and antibiotic therapy is prescribed for several days. The operation on a cellulitis affecting the tonsils, for its part, comprises of a surgical incision and drainage of the infection. It is also followed by antibiotics, while a tonsillectomy is necessary in the following months to prevent recurrence.

Related

Published by Jeff. Latest update on November 12, 2013 at 04:40 AM by Jeff.
This document, titled "Phlegmon," is available under the Creative Commons license. Any copy, reuse, or modification of the content should be sufficiently credited to CCM Health (health.ccm.net).