What is purulent inflammation?

It is a combination of the words 'purulent' and 'inflammation'. It refers to inflammation that is accompanied by pus or white blood cells. In other words, it is a type of non-suppurative acute inflammation.

In order for purulent inflammation to occur infection must be present. The invading pathogens (e.g. bacteria, viruses, parasites) cause an inflammatory reaction within the invaded tissue; however no pus forms because the germs (bacteria) start destroying and digesting tissue and cellular debris which prevent clumping and accumulating into a large collection like we see in boils and abscesses. 


purulent inflammation
purulent inflammation

Yet there might still be coagulation necrosis due to damaged platelets from the invading organisms as well as fibrin deposition due to the acute inflammatory reaction. This produces a characteristic necrotizing inflammation with or without red blood cells showing hemorrhagic infarctions. The result will be a soft tissue mass of swollen and inflamed tissue which is reddened by increased capillary permeability because of increased microvascular pressure. 

Purulent inflammation can occur anywhere in the body, but it most often occurs in the lungs. In fact, pneumonia is an example of purulent inflammation that mainly affects the lungs. The other site where purulent inflammation may appear is on a person's skin. Examples include boils and carbuncles.


What are the symptoms associated with purulent inflammation? 

Usually, people who have purulent inflammation experience fever, chills, headaches, pain in their muscles and joints, loss of appetite, nausea/vomiting, diarrhea, or constipation. Some may also be sick to their stomachs or have trouble breathing. 

Other common signs include muscle aches and pains, red spots on the skin that are warm to the touch, confusion, fatigue, pale skin color, decreased urination, bleeding from natural openings or wounds (including coughing up blood), foul-smelling discharge from an open wound, inflamed areas on the skin that may be red, yellow and/or swollen, and seizures.


How can purulent inflammation affect a person? 

It depends on what type of infection is causing the inflammation. When an infection causes purulent inflammation in a person's lungs, resulting in pneumonia may be serious because it could become life-threatening if not treated.  

If pus from a boil or carbuncle blocks a vein or artery, it could lead to septic shock. In addition, people with these infections may have complications with their heart valves, bones, and joints. In some cases, one particular organ is infected by a particular germ and shows a purulent inflammation resulting in a different disease than pneumonia, for example, purulent arthritis.


How does a doctor diagnose purulent inflammation? 

When examining patients for signs of purulent inflammation, doctors first focus on the site(s) where the person's symptoms developed. Next, they consider other factors such as: whether or not the person has recently had an infection; if they have been exposed to someone with an infection; what kinds of germs might be causing their infection; how severe their symptoms are; and if enzymes normally found in blood cells are present. Then based on these observations and laboratory tests doctors make a diagnosis.


What are the different types of purulent inflammation? 

The following are general classifications for purulent inflammation. However, it is important to note that doctors may not use these terms when diagnosing specific cases; instead, they will classify them based on what caused the infection.

Proinflammatory Inflammation: 

This type of inflammation happens after an injury or trauma (e.g., surgery) and is usually localized in one area of the body. Examples include acute pancreatitis, subcutaneous tissue infections, ischiorectal abscesses, pyelonephritis, emphysematous cholecystitis, and perirectal abscesses.

Suppurative Inflammation: 

This type of inflammation is characterized by an accumulation of pus (i.e., the fluid, white blood cells, dead tissue, and bacteria that make up pus). Infections with staphylococci cause this type of inflammation. Examples include furuncles, carbuncles, skin abscesses, pyogenic osteomyelitis, pyogenic arthritis, pyogenic liver abscesses.

Bacterial Suppuration Endocarditis: 

Another form of purulent inflammation is bacterial endocarditis which happens when the bacterium Enterococcus faecalis enters a person's bloodstream and begins to multiply. This may result in pus-forming inflammation on the heart valves.


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How is purulent inflammation treated? 

In most cases, antibiotics will be prescribed to treat purulent inflammation. In severe cases of purulent infections caused by staphylococci, vancomycin or other types of powerful antibiotics may be necessary until symptoms improve. 

Some patients need surgery to drain their pustules or abscesses. To avoid potential problems associated with having several draining wounds, doctors may recommend a minor surgical procedure to collect pus from an area within the body (e.g., the abdomen), rather than several different areas (e.g., skin). If surgery is not required, then doctors may use a needle to collect the pus (i.e., aspiration) and give antibiotics.


How does purulent inflammation affect people? 

Some people who get infections with purulent inflammation will experience complications related to their heart valves, bones or joints, eyes, kidneys, or nervous system. Some conditions that cause purulent inflammation are life-threatening if left untreated because they could lead to septic shock.

Purulence can also be seen in stomach problems such as gastritis, parietal perforation after peptic ulcer disease, Mallory–Weiss tear, Meckel's diverticulum, gastropathy, and peritonitis.


Is there anything else I can do to prevent purulent inflammation? 

Simple steps that may lower your chances of developing an infection with purulent inflammation include: 

keeping hands clean by washing them before eating, after using the bathroom, after touching pets, or outdoor materials (e.g., dirt); 

clear away objects in areas where you live and work so your area is easier to clean; 

be sure the building's ventilation system is not obstructed by clothing or garbage; 

eat a well-balanced diet. 

Also, use caution when engaging in sexual contact because infections are often spread through sexual contact.