Systemic pyogenic infections include septicemia and pyemia. The former occurs when pathogenic bacteria from a suppurative lesion invade the bloodstream, persist for a prolonged period, and multiply extensively. The latter results from intermittent entry of bacterial emboli into the bloodstream. Although their clinical manifestations differ slightly, the treatment principles are essentially the same.

bubble_chart Diagnosis

1. Septicemia

(1) The onset is acute, with sudden shivering and high fever, with body temperature reaching 40-41°C, often presenting as a sustained type.

(2) It is often accompanied by toxic symptoms such as headache, dizziness, lack of strength, nausea, and vomiting. In severe cases, dysphoria, restlessness, delirium, unconsciousness, and shock may occur.

(3) Hemorrhagic spots or ecchymoses may appear on the skin and mucous membranes. Hepatosplenomegaly is common, and jaundice may even occur.

(4) Primary purulent foci are often present, and blood cultures are frequently positive.

2. Pyemia

(1) The onset is mostly subacute, with intense shivering, chills, and fever, presenting as a remittent type.

(2) Symptoms such as constitutional weakness, poor appetite, nausea, vomiting, and emaciation often occur.

(3) After two weeks, metastatic abscesses often continuously appear in the soft tissues of the lower back and limbs, making them difficult to detect.

(4) Blood cultures may be positive during episodes of high fever and shivering.

bubble_chart Treatment Measures

1. Local Treatment

Early incision to ensure unobstructed drainage, and in some cases, lesion excision may be required.

2. Systemic Treatment

(1) Antibiotics. Should be administered early and in sufficient doses, with adjustments based on bacterial culture results. (2) Supportive Therapy. Bed rest, high-calorie diet, multivitamins, and multiple small transfusions of fresh blood. (3) Symptomatic Management. Fever reduction, sedation, fluid replacement, correction of electrolyte and acid-base imbalances, and appropriate use of glucocorticoids. (4) Chinese medicine Chinese medicinals treatment. Options include Rhinoceros Horn and Rehmannia Decoction and Coptis Detoxification Decoction. For unconsciousness, Peaceful Palace Bovine Bezoar Pill or Purple Snow Bolus may be added.