**17. Diagnosis of complicated abscess and soft tissues infections**

Often begins with a diagnosis of a comprehensive abscesses clinical history and physical examination results, which helps to assess the severity of infection, followed by the study of the living organisms that cause microbearing [84, 85].

Standard procedure is to increase the clinical assessment of laboratory investigations, especially for inpatient. In addition to the patient's history, should be taken into account relevant risk factors such as frequent entry in the hospital factors, diabetes, neutropenia, wounds sting and animal contact, which may indicate a potential junior responsible for the injury of living organisms [86].

Possible complications associated with cysts such as inflammation of the lymph glands and muscle inflammation and inflammation of the intestine and colon, gangrene, osteomyelitis, bacteremia, endocarditis, blood poisoning or poisoning should be taken into account during the diagnosis. It may indicate a significant increase in the number of white blood cells (or leukopenia) syndrome poisoning, while the levels of creatine kinase high may indicate the presence of muscles selflessly caused by inflammation of the fascia or inflammation of the bowel syndrome and colon [87].

Radiological examination and investigations aid imaging of deep tissue infections to assess the location and size of the infection and any involvement of blood vessels that can guide surgical drainage procedures. Tests must be performed culturing microbiological in all cases to distinguish between abscesses and MRSA infections, non-infectious MRSA, and therefore the revision of the final decision on the management of antibiotics to reduce the risk of treatment failure likely [88].

Diagnosis of skin abscess usually depends on the clinical manifestations. Abscess appears Oristepelas in areas of skin erythema, edema, and warmth. It is raised lesions Erysipelas higher than the surrounding skin with a clear delineation of the level of tissue between the concerned and involved. Skin abscess appears as a painful, volatile, erythematous node, with or without a surrounding abscess.

For laboratory tests are not required for patients with uncomplicated infection in the absence of associated diseases or complications. It must be subject to patients with disposable abscess incision and drainage. Routine culture of materials debrided is not necessary in healthy patients who are not receiving antibiotics [89].

There is no justification for the cultures of abandoned materials and cultures of blood (before the addition of antibiotic treatment) in the following cases [90, 91]:


Blood cultures are positive in less than 10% of cellulitis cases [92]. There may be a justification for skin biopsy if the diagnosis is uncertain; cultures from samples of skin biopsy result in pathogens in 20–30% of cases. Cultures of healthy skin wipes are not useful and should not be done [93].

It can be useful radiographic examination to determine whether the skin abscess is present (via ultrasound) and to distinguish between cellulitis and osteomyelitis (via magnetic resonance imaging). There may be a justification for radiological assessment in patients with immune suppression, diabetes, venous insufficiency, or lymphedema in patients with persistent symptoms of systemic. Radiological examination cannot reliably distinguish inflammation from Salil fasciitis or gas gangrene Grunt; if there is clinical doubt for these entities, the imaging should not delay surgical intervention [94].

In patients with recurrent cysts, serological tests for drugs Almnhllh blood beta may be a useful diagnostic tool. Assays include the reaction of an anti Alstrptullizin-O (ASO), or test an anti-desoxyribonuclease b (anti-DNA), or anti Alheialoronidaz test (AHT), or antibody test Alstrepettosem [95].
