Ropowica, czyli ostre bakteryjne zapalenie tkanki łącznej, może prowadzić do poważnych, zagrażających życiu powikłań. Jaka jest etiologia tego schorzenia i w jaki sposób się je leczy?
Co to jest ropowica?
Ropowica to zapalenie ropne, które rozwija się w tkance łącznej. Może obejmować zarówno tkankę podskórną, jak i tkanki położone głębiej.
Jakie są przyczyny ropowicy?
Czynnikiem etiologicznym ropowicy najczęściej jest zakażenie paciorkowcem lub gronkowcem, do którego dochodzi w wyniku urazu, pokąsania przez zwierzę, oparzenia lub powikłań po operacji chirurgicznej. Ropowica może także stanowić powikłanie innych schorzeń, np. w przypadku ropowicy jamy istnej przyczynę może stanowić ropień migdałka, angina lub próchnica.
Szczególnie narażeni na rozwój ropowicy są pacjenci z cukrzycą, otyli oraz cierpiący na zaburzenia układu odpornościowego o różnej etiologii (m.in. zakażenie wirusem HIV, zabiegi transplantacyjne, nowotwory). Czynnikami predysponującymi do rozwoju ropowicy są także alkoholizm i leczenie immunosupresyjne.
Jakie objawy wywołuje ropowica?
Ropowica wiąże się z objawami miejscowymi takimi jak bolesność, obrzęk, zaczerwienienie i ucieplenie obszaru objętego zakażeniem. Wraz z upływem czasu w miejscu zakażenia rozwijają się wypełnione ropną treścią pęcherze. Objawom miejscowym towarzyszą objawy ogólne – wysoka gorączka, dreszcze, osłabienie.
Jak odróżnić ropowicę od ropnia?
Zmiany spowodowane ropowicą w przeciwieństwie do ropnia nie są wyraźnie odgraniczone od zdrowej skóry. Ropień przyjmuje postać pojedynczej otoczonej ziarniną torebki, którą wypełnia treść ropna. Ropowica natomiast objawia się w postaci drobnych, rozlanych pęcherzy. Ponadto dla ropnia charakterystyczny jest objaw chełbotania, czyli przesuwania płynu w obrębie wykwitu pod naciskiem. Objaw chełbotania nie występuje w przypadku ropowicy.
Jak przebiega leczenie ropowicy?
W leczeniu ropowicy stosuje się antybiotykoterapię w skojarzeniu z leczeniem chirurgicznym polegającym na nacięciu i sączkowaniu lub drenażu ropnych zmian. Może także być konieczne opracowanie rany polegające na usunięciu zmienionych martwiczo tkanek.
Jakie mogą być powikłania ropowicy?
Nieleczona ropowica ulega rozprzestrzenieniu na sąsiednie tkanki i narządy. Może to doprowadzić do rozwoju nowych ognisk zapalnych, a w konsekwencji także do uogólnionego zakażenia, czyli sepsy. W przypadku ropowicy w obrębie kończyny niewdrożenie odpowiedniego leczenia może skutkować amputacją.
Źródła:
- M. J. Taraszkiewicz, S. M. Piotrowski, „Ropowica szyi – aktualny problem diagnostyczno-leczniczy. Opis przypadków”, „Forum Medycyny Rodzinnej” 2018, 12(4): 149-155.
- www.healthline.com
- profilaktyka.umed.lodz.pl
- dermatolog.pl
Przeczytaj także: Pierwsza pomoc przy oparzeniu chemicznym przełyku
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