Pus

Pus (Latin pus, pus- forming pyogenic = ) is a typically yellowish exudate that arises in the context of a cellular inflammatory response in the body of vertebrates. Of the immune cells, especially neutrophils, polymorphonuclear leukocytes play a central role. Most of this form arises inflammation in response to bacterial infection. However, there are also non-infectious pus caused, for example, when as pustular psoriasis.

Nature

Pus has a different viscosity (from thin to thick) and different colors (from pale yellow to green, and - in the case of Pseudomonas Infections - blue-green). The smell depends on the type of bacteria concerned; in infections with E. coli, for example, smell the pus of feces.

An encapsulated collection of pus in the tissue is referred to as abscess, a collection of pus in body cavities as empyema. Upon the occurrence in the chest cavity is of a pleural empyema or pyothorax, spoken in the joints of a Pyarthros, in renal pelvis of a pyonephrosis. The slang term " boil " can ( suppurative hidradenitis, acne inversa a ) for both a fused lymph nodes, an abscess, but also for boils, carbuncles one, as well as for a Schweißdrüsenabszess stand.

Pathogenesis

The melting of the tissue takes place by the action of proteolytic enzymes from the leukocytes or - are formed by the pyogenic pathogens - in the case of an infectious cause.

Examples purulent diseases

• Superficial (skin): Impetigo, pyoderma
• Pustules
• Hair follicle: Boils, carbuncles

• Finger, finger tendons: whitlow
• Tissue columns: Cellulitis
• Joints: empyema, Pyarthros.

• Abscess

• Empyema and specific names, such as purulent peritonitis, purulent pleurisy

• Pyonephrosis ( purulent hydronephrosis )

• Blennorrhoea

Principles of the treatment

Almost always should be sought to relieve a collection of pus, so that the juices to flow. " Ubi pus, ibi evacua " - " Where is pus, there deflate him " - this motto of Hippocrates of Kos va in the jaw and face area of particular importance where the connection of the local veins with those of the brain is in danger of cerebral venous thrombosis ( cavernous sinus thrombosis); see boil.

In addition to the usual methods of septic surgery - columns of an abscess, inserting drainage easier - one uses irrigation-suction drains to clean a wound cavity. When abscessed bone ( osteomyelitis) were even brought chains of non-absorbable gentamicin - containing plastic beads into the cavity that had to be drawn at a later time.

The use of antibiotics in advanced boils or an abscess in the muscle or fat tissue, which is closed off by a Granulationswall from the body, usually has no healing effect and is considered useless. The drug does not penetrate into the suppuration. In other suppuration, however, such as cellulitis, empyema and other the situation is different; here you fear the septic side effects. With multiple small abscesses the sole long-term administration of effective antibiotics surgery is even preferable, because so many cases healing was observed. In the application, for example as a powder or as an ointment ( Zugsalbe ), and systemic administration of antibiotics is between local Applizierung to distinguish. With systemic administration admission into the bloodstream via the gastrointestinal tract or the infusion is meant. The drug works then throughout the body, including in the area of ​​the wound.

Pyogenic germs like all pathogens develop antibiotic resistance and pass it on to other germs. By concentration of the sick ( bacterial load ) on the one hand and the often generous and untargeted antibiotics ( development of resistance without prior Germinated Tung ) at the hospital fears here the selection of in-house multi-drug resistant problem bacteria that are resistant to almost all available antibiotics. This is called the " nosocomial infections ". The general strategy of combating it is simple, but understandably not always successful: Exemplary hygiene, small but meaningful (only indexed ) and constantly on the effectiveness checked antibiotics Regulation.

Historical

In medicine of the 19th century, there was the notion of pus bonum et laudabile, the good and laudable pus. He was referring here to the so-called pure, creamy - yellow staphylococcus pus, without a wound healing did not take place after former view.