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Ropowica – groźne zapalenie tkanki łącznej

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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:

  1. M. J. Taraszkiewicz, S. M. Piotrowski, „Ropowica szyi – aktualny problem diagnostyczno-leczniczy. Opis przypadków”, „Forum Medycyny Rodzinnej” 2018, 12(4): 149-155.
  2. www.healthline.com
  3. profilaktyka.umed.lodz.pl
  4. dermatolog.pl

Przeczytaj także: Pierwsza pomoc przy oparzeniu chemicznym przełyku

Przeczytaj bezpłatnie pokrewny artykuł w czasopiśmie „Pielęgniarstwo w Anestezjologii i Intensywnej Opiece”:

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