infections



Overview

Definition

Infection is usually a local tissue and/or systemic inflammatory reaction caused by invasion of the body by pathogens such as bacteria, viruses, fungi, parasites, mycoplasma, chlamydia, spirochetes, etc., and is related to the body’s self-defense process. The clinical manifestations of patients with infections are diverse, often with localized redness, swelling, heat, and pain [1-2].

The clinical manifestations of patients with different infections often vary depending on the site of infection, for example, patients with pulmonary infections often present with fever, cough, sputum, shortness of breath, chest tightness, chest pain, etc., and in severe cases, symptoms such as respiratory distress may occur; patients with gastrointestinal infections are mainly characterized by fever, nausea, vomiting, abdominal pain, diarrhea, blood in the stools, etc., and in severe cases, symptoms such as cardiac distress and decreased blood pressure may occur.

Classification

Infections can be categorized in many ways, usually according to the type and source of the pathogen, the site of infection, the course of the disease, the condition, the nature and so on.

Types of pathogens

Depending on the type of pathogen involved in the infection, it can be broadly categorized as follows [3].

Bacterial infections: e.g. Mycobacterium tuberculosis infection, Streptococcus pneumoniae infection, Clostridium tetani, etc.

Viral infections: e.g. hepatitis B virus infection, human immunodeficiency virus (HIV) infection, etc.

Fungal infections: e.g. Trichophyton rubrum infection, Candida albicans infection, etc.

Parasitic infections: e.g. roundworm infection, duodenal hookworm infection, etc.

Mycoplasma infections: e.g. Mycoplasma pneumoniae infection.

Chlamydial infections: e.g. Chlamydia trachomatis, etc.

Spirochete infections: e.g. syphilis spirochete infection, etc.

Source of pathogens

Endogenous infection: the pathogen causing the infection usually comes from the patient’s own normal flora.

Exogenous infection: usually refers to infections caused by pathogens originating outside the organism.

Site of infection

Localized infection: refers to the situation where the pathogen invades the organism, grows and multiplies in a specific area and produces corresponding toxic products, resulting in infection, such as boils and carbuncles caused by infections such as Staphylococcus aureus [1,4].

Systemic infection: refers to the relevant manifestations of systemic inflammatory reaction caused by pathogens that enter the blood circulation after invading the organism and produce a large number of toxic products in the body, such as sepsis [2].

Course of infection

Acute infection: generally refers to infections with a course of less than 3 weeks.

Subacute infections: infections with a course between acute and chronic, and whose clinical manifestations are not as significant as those of acute infections, with a slightly milder course [5].

Chronic infection: usually refers to infections with a duration of more than 2 months.

Infection conditions

Opportunistic infections: generally refers to the situation in which pathogens with weak pathogenicity are unable to cause disease when the body’s immune function is normal, but can invade the body and cause disease when the immune function is reduced [6].

Secondary infection: also known as “repeated infection”, related to the long-term use of broad-spectrum antibiotics, so that the growth of sensitive bacteria is inhibited, while the rapid reproduction and growth of non-sensitive bacteria.

Hospital-acquired infections: Infections acquired by hospitalized patients in hospitals, including infections that occur during hospitalization, infections acquired in hospitals but occur after discharge, and infections acquired by newborns during the maternal birth canal [2,7].

Nature of infection

Specific infections: infections that differ from general pathogen infections and can present with a more distinctive pathologic process, such as those caused by Mycobacterium tuberculosis, Clostridium tetani, and Clostridium perfringens [8].

Nonspecific infections: e.g., infections caused by Staphylococcus aureus, hemolytic streptococci, and Escherichia coli.

Questions you may be concerned about

What are the main measures to prevent infection when injecting

The main measures to prevent infection when injecting are aseptic operation, strict sterilization, do not enter the needle in the inflamed area and so on.

1. Aseptic operation: wash your hands before injection, wear a mask, and keep your coat and hat tidy. The needle used in sterile syringe must be taken by sterile tweezers, and the piston, inner surface of syringe, nipple and needle tip and stem should be kept sterile.

2. Strict disinfection: use two percent tincture of iodine and seventy percent deiodination of ethanol for routine disinfection of the injection site, and disinfect the skin of the injection site with a diameter of more than 5 cm to avoid bacteria entering the body with the needle and causing infection.

3. Do not enter the needle in the inflammation site: patients who need long-term injections, the injection site should be used alternately, not in the pus infection, hard knots, inflammation or skin disease site into the needle.

After injection, the skin should be kept dry, the injection site should not be exposed to water within 24 hours, and timely observation should be made to prevent infection.

Difference between Ureaplasma Carrier and Infection

The difference between Ureaplasma urealyticum carrier and infection mainly lies in whether there are symptoms in the body.

1. Ureaplasma urealyticum carrier: it means that the body carries Ureaplasma urealyticum as a pathogenic bacterium, but there is no morbidity, the body does not have any uncomfortable symptoms and feelings, and does not affect the normal life and work. The ureaplasma urealyticum carries no special treatment, usually pay attention to hygiene and exercise, regular review can be.

2. Ureaplasma urealyticum infection: It is due to the presence of ureaplasma urealyticum in the body and causes uncomfortable symptoms, such as frequent urination, urinary urgency, urethral urethral urethral urethral urethral urethral exudate, plasma secretion, and so on. In women, it may cause cervical edema, erosion, and leukorrhea.

Ureaplasma urealyticum infection, you need to timely choose a sufficient amount of antibiotics standardized medication, anti-infection treatment.

What kind of infection is coughing up yellow pus and sputum

Coughing up yellow sputum may be a respiratory tract infection, such as bacterial infection of the respiratory tract. Common diseases, there are acute upper respiratory tract infection, pneumonia, chronic bronchitis, bronchodilatation, lung abscess and so on.

1. Acute upper respiratory tract infection: most of the early viral infections, if secondary bacterial infection may lead to coughing, spitting yellow sputum symptoms, often accompanied by swelling and pain in the throat and other discomforts.

2. Pneumonia: Pneumonia caused by Streptococcus pneumoniae, Staphylococcus aureus and other infections can lead to coughing, coughing up yellow sputum, chest pain, dyspnea, fever and other symptoms.

3. Chronic bronchitis: When chronic bronchitis is in acute attack, most of the symptoms will be coughing, producing a lot of pus sputum, yellow sputum, dyspnea, wheezing and so on.

4. Bronchial dilatation: The decrease in elasticity of the bronchial tubes can lead to repeated coughing, coughing up a lot of pus and yellow sputum, causing symptoms of coughing up yellow pus and sputum.

5. Lung abscess: most of the respiratory tract is infected by anaerobic bacteria, causing and symptoms of yellow pus and sputum.

Coughing up yellow pus and sputum, there may be other reasons, it is recommended to go to the hospital for examination, to clarify the cause of the disease, and active treatment.

Causes

Infections are usually caused by pathogens, but may also be induced by local factors, immunocompromise, lifestyle factors, poor hygiene and so on [2].

Causes of disease

Pathogens

The occurrence of infections is mainly associated with pathogens such as bacteria, viruses, fungi, parasites, and mycoplasma. Some of these pathogens are infectious, such as Mycobacterium tuberculosis, hepatitis B virus, HIV, syphilis spirochetes, etc., which can be transmitted through the respiratory tract, gastrointestinal tract, blood or body fluids, etc [2-3].

When the organism does not develop protective immunity, it is mostly susceptible to pathogens, especially in immunocompromised people. Pathogens can cause the body to develop an ego-defense response and local tissue and/or systemic inflammatory manifestations.

For example, Mycobacterium tuberculosis can avoid being killed directly after entering the human body, and release a large number of cytokines, causing a local immune response, so that more immune cells are recruited to the lesion, and gradually form structures such as tuberculosis granulomas and cause disease [2].

For example, HIV is a reverse transcription virus that can violate the body’s immune system, causing a constant decrease in the number of CD4+ T lymphocytes and other cells, which ultimately leads to defective cellular immune function, resulting in the occurrence of infection.

Such as syphilis spirochetes enter the body, can through mucopolysaccharidases, matrix metalloproteinases, flagella and other components of attachment, wandering and tissue invasion, and ultimately lead to the occurrence of infection [2].

Predisposing factors

Local factors

Factors such as breakage of skin and mucous membranes, obstruction of cavity organs (e.g., intestines, bladder) and some ducts (e.g., bile ducts, ureters), etc., which make the contents stagnant, and ischemia of local tissues, can prompt invasion of pathogens and induce infections [1-2].

Low immunity

In the case of long-term illness such as diabetes, malnutrition, or long-term use of immunosuppressants and other drugs, can lead to the human body due to low immunity can not defend Mycobacterium tuberculosis, Trichophyton rubrum and other pathogens invasion, and ultimately lead to the occurrence of infection [9].

Lifestyle factors

Lifestyle factors such as engaging in unprotected sex, intravenous drug use, etc. may induce the occurrence of infections including HIV and syphilis [2,10].

Poor hygiene

Poor sanitary conditions are also prone to induce the occurrence of infections, such as eating raw unwashed vegetables or fruits, etc., which can easily induce ascariasis, and tuberculosis may be induced by prolonged poorly ventilated environments.

Predisposing factors

The following factors are all closely associated with an increased risk of developing infections and are predisposing factors for infections.

People who have broken skin or mucous membranes, or who have obstructions in the intestines or bile ducts.

People who have had unprotected sex or intravenous drug use.

Questions you may be concerned about

Are pseudo warts caused by HPV infection?

HPV is the human papilloma virus. Pseudo warts often occur on the inside of the labia minora and the vaginal vestibule of women, and are clusters of white or reddish caviar-sized smooth pimples, with no self-awareness of symptoms and a negative acetic acid white test. Pseudo condyloma is not associated with human papillomavirus infection.

The cause and pathogenesis of pseudo condyloma is not completely clear, but part of pseudo condyloma may be a normal physiological anomaly, belonging to the abnormal proliferation of the vulvar mucosa, and the other part of pseudo condyloma may be associated with vaginal candida, trichomonas infections, chronic inflammation long-term stimulation and other factors, and has nothing to do with human papillomavirus infection.

Pseudo condyloma is a kind of similar to the acrodermatitis acuminata rash only seen in the female labia minora, vaginal vestibule, is a kind of benign pseudo-papillomatous tumor-like lesions, mainly manifested as caviar-like, reddish pimples, usually without special treatment, symptoms are obvious can be used to medication and physical treatment treatment treatment.

The patient with pseudo-papilloma should go to the hospital in time, under the guidance of the doctor to do choose the appropriate treatment method.

Cervical biopsy can cause infection

Cervical biopsy does not usually cause infection.

A cervical biopsy is usually performed when the patient is not suffering from inflammation of the cervix or vagina. Before the procedure, the doctor will disinfect the patient’s vulva with an antiseptic solution such as povidone-iodine and then spread a sterile towel. During the operation, the doctor will wear sterile gloves and use strictly sterilized or sterile disposable vaginal speculums, biopsy forceps and other instruments to extract the cervical tissue.

After the operation, the doctor will also let the patient take oral or intravenous antibiotics according to the situation during the operation to prevent infection. Therefore, cervical biopsy generally does not cause infection.

Cervical biopsy is usually performed within 3 to 7 days after menstruation, and patients must choose regular hospitals for consultation to avoid adverse consequences.

Cytomegalovirus and rubella virus herpes simplex infection at the same time will cause night sweats?

Cytomegalovirus and rubella virus herpes simplex infection at the same time may cause night sweats.

Patients with cytomegalovirus infection usually do not have obvious clinical symptoms, and children present with asymptomatic infection while adults present with latent infection. A small number of infected individuals may develop a fever, mainly high. In contrast, common symptoms of rubella virus include fever, rash, and swollen lymph nodes behind the ears and occiput.

Rubella is primarily a skin disease caused by human herpesvirus infection, which is characterized by changes in the skin and mucous membranes, and usually manifests as localized lesions, such as pain, itching, and fever. When the virus multiplies in the body it causes inflammation, at which point night sweats are produced.

This suggests that cytomegalovirus and rubella virus herpes simplex infection at the same time may cause night sweats.

If you have cytomegalovirus and rubella virus herpes simplex infection at the same time, you should go to the hospital in time for targeted examination and treatment to avoid delaying your condition.

Symptoms

Infections are diverse, often involving multiple organs and tissues, and the clinical manifestations of patients with different infections often vary depending on the site of infection.

Common infections such as lung infection, gastrointestinal infection, urinary tract infection, wound infection, neurological infection, systemic infection, etc., the following is only for the above parts of the infection is introduced.

Main Symptoms

Lung infections

Patients with lung infections may often present with fever, cough, sputum, shortness of breath, chest tightness, chest pain, and in severe cases, dyspnea may occur [11].

Gastrointestinal infections

Patients with gastrointestinal infections mainly present with fever, nausea, vomiting, abdominal pain, diarrhea, and blood in stool, and in severe cases, they may present with panic and decreased blood pressure [11-12].

Urinary tract infection

Some patients with urinary tract infection may have no obvious symptoms, or they may have intermittent fever and dysuria.

If recurrent, patients may present with urinary frequency, urgency, urinary pain, dysuria, lumbar pain, abdominal pain, and percussion pain in the renal region [13].

Wound infection

The site of wound infection may present with persistent non-healing, redness of the skin, swelling, elevated skin temperature, and pain, which may be accompanied by localized pressure pain [8,14].

Some patients with severe wound infections may also present with fever, chills, and panic.

Nervous system infection

Patients with neurological infections may present with headache, dizziness, vomiting, convulsions, and other symptoms, and in severe cases, there may be impaired consciousness, paralysis, and other manifestations [15].

Systemic infection

Patients with systemic infections have a rapid onset of illness and may present with high fever (temperature >39°C), chills, malaise, panic, shortness of breath, nausea, vomiting, abdominal pain, and in severe cases, respiratory distress and impaired consciousness.

Complications

Complications such as pleurisy, infectious shock and sepsis may occur in infected patients.

Pleurisy

Infected patients, especially when the lungs are infected, the pleura can often be involved and manifestations of pleurisy, such as chest pain and dyspnea, can occur [11].

Infectious shock

Infectious shock may complicate some infected patients, especially in elderly patients, and may manifest as impaired consciousness, cold extremities, excessive sweating, tachycardia (heart rate >100 beats/min), decreased blood pressure, and cardiac arrhythmia.

Sepsis

Patients with severe infections can be complicated by sepsis, and patients may present with chills, fever or hypothermia (body temperature <36°C), tachycardia (heart rate >100 beats/min), accelerated respiration (respiratory rate >20 breaths/min), oliguria, and low blood pressure (blood pressure <90/60 mmHg) [8,15].

Seek medical attention

Different patients have different sites of infection, and the corresponding consultation departments are different, the following are the common clinical consultation departments.

Department of medicine

Department of Infection Medicine

Patients with symptoms such as high fever, chills, cough and sputum are advised to consult the department of Infectious Diseases.

Department of Dermatology and Venereology

If you have symptoms such as redness, swelling, elevated skin temperature, or pain, it is recommended that you consult the Department of Dermatology and Venereology.

Emergency Medicine

If you have symptoms such as high fever (body temperature >39℃), hypothermia (body temperature <36℃), hypotension (blood pressure <90/60mmHg), dyspnea, or impaired consciousness, it is recommended that you consult the Department of Emergency Medicine in a timely manner.

Preparation for medical treatment

Preparing for a visit to the emergency department: registration, preparation of documents, and frequently asked questions.

Tips for medical treatment

It is recommended to wear loose clothing to facilitate physical examination.

If you have a combination of symptoms such as redness and swelling of the skin, avoid using cosmetics before the visit to avoid masking the condition.

Record the changes and characteristics of your condition for your doctor’s reference.

Preparation List

Symptom list

Particular attention should be paid to the time of onset of symptoms, special manifestations, etc.

What are the symptoms of discomfort? How long have they lasted?

Were there any obvious triggers at the time of onset?

Any aggravating or relieving factors?

Medical history checklist

Have there been any infections with pathogens such as Mycobacterium tuberculosis, Human Immunodeficiency Virus, Trichophyton rubrum, Ascaris lumbricoides, etc.?

Are there any breaks in the skin and mucous membranes, or obstructions in the intestines, bile ducts, etc.?

Are there any chronic medical conditions (e.g., diabetes, malnutrition), or long-term use of medications such as immunosuppressants?

Has there been unprotected sex, intravenous drug use, etc.?

Checklist

Test results for the last six months, which can be brought to the doctor’s office

Laboratory tests: routine blood test, routine urine test, routine stool test, blood sedimentation, C-reactive protein, lymphocyte subgroup test, infectious disease screening, condensation set test, etc.

Imaging examination: ultrasonography, X-ray examination, CT examination, etc.

Other tests: bronchoscopy, pathogenetic tests, etc.

Medication list

Medications used in the last 3 months, if available in boxes or packages, bring with you to the doctor’s office

Anti-tuberculosis drugs: isoniazid, ethambutol, rifampicin, etc.

Antiviral drugs: tenofovir, abacavir, entecavir, etc.

Antifungal drugs: ketoconazole, terbinafine, amorolfine, etc.

Antiparasitic drugs: mebendazole, ivermectin, albendazole, etc.

Antibiotics: penicillin, azithromycin, tetracycline, etc.

Diagnosis

Because of the different pathogens and pathogenesis, infections have their own special clinical manifestations and diagnostic criteria. At present, the diagnosis of infection is mainly based on medical history, clinical manifestations, laboratory examination, imaging examination and so on.

Diagnosis

Medical history

The following conditions are not necessary for the diagnosis of infection, but if there are the following conditions, they can provide some reference significance for the diagnosis of the disease.

Previous infection with pathogens such as Mycobacterium tuberculosis, human immunodeficiency virus, Trichophyton rubrum, and roundworms.

There are breaks in the skin and mucous membranes, or obstructions in the intestines or bile ducts.

Patients with long-term illnesses (e.g., diabetes, malnutrition) or long-term use of medications such as immunosuppressants.

People who have had unprotected sex, intravenous drug use, etc.

Clinical manifestations

Patients may present with fever, chills, cough, sputum, shortness of breath, chest pain, dyspnea and other symptoms.

Symptoms such as nausea, abdominal pain, diarrhea, urinary urgency and pain, lowered blood pressure, and difficulty in urination.

Symptoms such as skin redness, swelling, elevated skin temperature, pain, or headache, dizziness, convulsions, and impaired consciousness.

Symptoms such as high or low body temperature, tachycardia, arrhythmia, cold sweat on the extremities, rapid breathing, and low blood pressure.

Laboratory Tests

Blood tests

It can clarify whether there are abnormal changes in white blood cells, neutrophils, red blood cells, hemoglobin, etc. in the patient’s body.

If there is an increase in the count of white blood cells and neutrophils, there may be bacterial infection; if there is a decrease in the level of white blood cells, red blood cells and hemoglobin, there may be viral infection; if there is an increase in the number of eosinophilic granulocytes, there may be parasitic infections such as Ascaris lumbricoides, which is of guiding significance in the diagnosis and differentiation of the disease [13].

Urine routine

It can be used to clarify the condition of leukocytes and bacterial count in urine, and the presence or absence of proteinuria.

If the results of urine routine suggest that the white blood cell and bacterial count are significantly increased, it often suggests the presence of urinary tract infection, which is helpful for the diagnosis of infection and the judgment of the degree of infection [13].

Stool routine

It is mainly used to detect the presence of leukocytes, pus cells and other components of feces.

If there is a significant increase in the number of leukocytes and pus cells in the feces, it suggests that the patient may have gastrointestinal infections, which is helpful in diagnosing the disease and guiding the treatment.

Blood Sedimentation

Hematocrit, or erythrocyte sedimentation rate, is one of the commonly used indicators of inflammation in the acute phase.

If the blood sedimentation rate increases significantly, it suggests that the body may be infected with bacteria and other pathogens, which can assist in the diagnosis of the disease.

C-Reactive Protein

C-reactive protein is an acute-phase reactive protein, and its elevated level is commonly seen in infections.

If C-reactive protein is significantly elevated, it suggests that there is a possibility of infection such as bacteria and the patient is in the acute phase of inflammation, which can assist in the diagnosis of the disease and judgment of the condition [13].

Lymphocyte subsets

It can be used to clarify the body’s immune cells and their subtypes, such as T cells, B cells, CD4+ T lymphocytes and so on.

If the number of CD4+ T-lymphocytes is significantly reduced, it suggests the possibility of viral infections such as HIV and can assist in the diagnosis of the disease [2,14].

Infectious disease screening

Infectious disease screening mainly includes screening for hepatitis B virus, hepatitis C virus, HIV, and syphilis spirochetes.

A positive test result for hepatitis B virus, hepatitis C virus, HIV, or spirochetes suggests the possibility of infection with the respective pathogens, which is important for the diagnosis of the disease.

Cold agglutination test

Cold agglutination test is used to detect autoantibody levels in human red blood cells at 4℃, and is often used to detect pathogen infections such as Mycoplasma pneumoniae.

If the result of the agglutination test is positive, or the agglutination potency is >1:32, it suggests that there is the possibility of infections such as Mycoplasma pneumoniae, and can be used to assist in the diagnosis of the disease [15].

Imaging

Ultrasonography

It mainly includes abdominal and urinary system ultrasound, which can be used to clarify the presence of infection in the abdomen.

If the abdominal ultrasound shows double-line strong echoes, “parallel tube” sign, etc., it suggests that there may be parasitic infections; if the ultrasound of the urinary system suggests that urinary tract obstruction, stones, pus accumulation, etc., it suggests that there may be urinary tract infections, and it can be used to assist in the diagnosis and differentiation of the disease [13,16].

X-ray examination

X-rays are commonly used to assess the presence of lung infection in patients.

If X-ray examination of the lungs shows patchy shadows, diffuse corn-like nodules in both lungs, and bronchial congestion signs, tuberculosis may exist; if there are low-density flaky shadows with a segmental distribution, it suggests that Mycoplasma pneumoniae infection may exist. It is instructive for the diagnosis of infection and evaluation of the condition [16].

CT examination

CT examination is often used to clarify whether the patient has lung infection, neurological infection and other conditions.

If lung CT shows patchy solid lesions, increased lung texture, grid-like or patchy shadows, lung cavities, etc., it suggests the possible existence of tuberculosis, mycoplasma pneumonia, etc.; if brain CT shows the disappearance of the normal morphology of the cerebral sulcus, enlarged cerebral ventricles, meningeal enhancement and other manifestations, neurological infections may exist, which is an important guide to the diagnosis and differentiation of infections [15-16].

Other examinations

Bronchoscopy

Bronchoscopy can visualize the lesions in the bronchial tubes and collect specimens from the lesions for testing, which can be used to clarify the presence of infection and other conditions.

If bronchoscopy shows mucosal congestion, ulceration, erosion, scar formation, bronchial stenosis and other manifestations, or if pathogens such as Mycobacterium tuberculosis are detected in tissue specimens, it is important for the diagnosis of lung infection [2].

Pathogenetic examination

Pathogenologic examination includes sputum smear examination, bacterial culture, fungal microscopy, etc., which can be performed on samples from different sources.

If antacid bacilli are found in sputum smear or Mycobacterium tuberculosis is present in sputum bacterial culture, it suggests the possibility of tuberculosis; if Ascaris lumbricoides eggs, larvae, or adult worms are detected in fecal smear, it suggests the presence of ascariasis, which is important in the diagnosis of different parts of the infection, and the differential diagnosis [2].

If the samples are examined by fungal microscopy and mycelium, spores and other special structures are found, it suggests the presence of fungal infections, which is of great significance in defining the etiology and assisting in the treatment [14].

Differential diagnosis

Due to the wide variety of pathogens that cause infection, the clinical manifestations are diverse. Here, only infectious diseases caused by common pathogens such as bacteria, parasites, and fungi (e.g., tuberculosis, ascariasis, tinea pedis) are differentiated from related diseases.

Lung cancer

Similarities: Both lung cancer and tuberculosis patients may present with cough, sputum, blood in sputum, recurrent fever, and weight loss.

Differences: Lung cancer is mostly seen in middle-aged and old-aged patients, accompanied by irritating cough and chest pain. Imaging examination of lung cancer shows hilar shadows, spherical or lobular shadows, and the edges of the lesions often have cuttings and burrs, which are quite different from the imaging manifestations of tuberculosis; the results of tuberculin test are mostly negative [2,11].

Peptic ulcer

Similarities: Patients with peptic ulcer and ascariasis may present with nausea, vomiting, abdominal pain, and loss of appetite.

Differences: peptic ulcers have a longer history, symptoms often come on periodically, and may present with regular pain associated with meals, such as hunger pain and postprandial pain. Pathologic examination of peptic ulcers does not usually reveal pathogens [11,15].

Eczema

Similarities: Patients with eczema and tinea pedis may both present with small skin blisters, itching, thickened skin, and dryness.

Differences: eczema lesions tend to be polymorphic, ill-defined, with exudation, and symmetrical in distribution, while patients with tinea pedis tend to have deeper blisters with more distinct boundaries. Fungal microscopy of eczema tissue is usually negative [14].

Treatment

Treatment purpose: eliminate pathogens, relieve symptoms, prevent and reduce internal organ function damage, etc.

Treatment principle: clinically, different kinds of anti-infective drugs are mainly adopted for the infectious pathogens, together with general treatment, surgical treatment and so on.

General treatment

Infected patients should pay attention to rest.

For patients with body temperature over 39℃, the symptoms can be relieved by physical cooling and other general treatments as prescribed by doctors, such as ice packs, warm water baths, ice caps, etc.

Medication

There are many types of infections with various clinical manifestations, and drug treatment can help patients eliminate pathogens and relieve symptoms. Here is a brief introduction to drug therapy for infections caused by some pathogens.

Anti-tuberculosis drugs

Commonly used drugs such as isoniazid, ethambutol, rifampicin.

These drugs have bactericidal and bacteriostatic effects on Mycobacterium, can interfere with the synthesis of RNA in the body of bacteria, inhibit bacterial reproduction, and are commonly used in the treatment of infections caused by pathogens such as Mycobacterium tuberculosis.

Adverse effects of anti-tuberculosis drugs include numbness of the extremities, pain in the hands and feet, blurred vision, granulocyte deficiency, and skin rash [17].

Antiviral drugs

Commonly used drugs such as tenofovir, abacavir, and entecavir.

This class of drugs includes nucleoside reverse transcriptase inhibitors, protease inhibitors, integrase inhibitors, etc., which can play a role in blocking the reverse transcription and replication of viruses, and are often used in the treatment of patients with viral infections such as HIV, hepatitis B virus, and other viral infections.

Common adverse effects of antiviral drugs include rash, nausea, vomiting, diarrhea, and sensory abnormalities [17].

Antifungal drugs

Commonly used drugs such as ketoconazole, terbinafine, and amorolfine.

These drugs can usually be used externally or orally, and play the role of inhibiting and killing fungi by inhibiting the synthesis of ergosterol, the main component of fungal cell membranes, etc. They can often be used in the treatment of patients with fungal infections such as Trichophyton rubrum, Candida albicans, and so on [17].

Common adverse effects of antifungal drugs include liver function impairment, nausea, vomiting, diarrhea, and rash.

Antiparasitic drugs

Commonly used drugs such as mebendazole, ivermectin, and albendazole.

These drugs can play the role of killing parasites by inhibiting the intake of glucose by the worms, paralyzing the larvae, and slowing down the reproduction rate, thus they are widely used for the treatment of patients with parasitic infections in the clinic [17].

Adverse effects of antiparasitic drugs include gastrointestinal reactions (e.g., nausea, abdominal pain), dry mouth, and drowsiness.

Antibiotics.

Commonly used drugs such as penicillin, azithromycin, and tetracycline.

Penicillin belongs to the penicillin class of antibiotics, azithromycin belongs to the macrolide class of antibiotics, and tetracycline is a tetracycline class of antibiotics, which can play a role in inhibiting the synthesis of the bacterial cell wall and so on, and usually has a good killing effect on a variety of bacterial infections.

Common adverse reactions to antibiotics include allergic reactions, gastrointestinal reactions such as abdominal pain, diarrhea, and nausea, and dry mouth, lingual inflammation, and liver function abnormalities [17].

Surgical treatment

Due to the diverse presentations of patients with different infections, surgical treatment can help remove pathogens and relieve symptoms when necessary.

Surgical treatment is feasible for pulmonary infections with critical conditions such as unilateral lung tissue destruction and uncontrollable hemoptysis [2,8,11].

When abscesses appear in localized wound infections, they can be incised and drained by means of surgical treatment to remove pus and necrotic symptoms in time [8].

When parasitic infection causes intestinal obstruction, bile duct blockage, etc., choledochotomy and worm removal, gastrointestinal decompression and other treatments can be carried out early to effectively remove the lesions and relieve symptoms [1,8].

Prognosis

Cure

Infections caused by different pathogens have different clinical manifestations, so there is a large difference between different prognoses.

Most patients with infections can effectively control symptoms and clear pathogens through active, standardized and timely drug treatment, and generally have a good prognosis.

Some patients with viral infections, such as acquired immunodeficiency syndrome, cannot be completely cured at present, and standardized treatment can usually help to slow down the progression of the disease and reduce the emergence of serious complications.

The prognosis is relatively poor for some patients with poor drug therapy, severe immune deficiency or multiple organ involvement such as heart, lung and kidney.

Prognostic factors

The prognosis of infections due to different pathogens varies and is often influenced by a number of factors. The following factors may be associated with a poor prognosis for infection.

Patients with recurrent infections that are poorly treated with medications.

Patients who present with severe immune deficiency or multiple organ impairment.

Daily

Daily management

Dietary management

Daily diet should be balanced and nutritious, with more water, high quality protein such as eggs and milk, and vitamin-rich foods such as carrots and animal liver.

Avoid eating raw and cold food, unwashed vegetables and fruits, etc. to avoid digestive tract infection; avoid drinking alcoholic beverages and wine; and avoid spicy and irritating food such as chili peppers and mace.

Life management

Pay attention to personal hygiene, clean and disinfect the living environment regularly, open windows more often for ventilation, and actively prevent infection.

Pay attention to regular work and rest, avoid over-exertion, and exercise according to individual conditions.

Patients with tuberculosis, mycoplasma pneumonia and other lung infections should pay attention to reducing or avoiding close contact with others due to the contagious nature of the pathogens they are infected with, refrain from spitting, and avoid others and cover their mouths and noses when coughing or sneezing.

Acquired immunodeficiency syndrome, syphilis and other viral infections, need to pay attention to avoid unprotected sex with others, avoid contact with other infectious diseases.

Patients with tinea pedis and other fungal infections should avoid sharing shoes, socks, towels, bathtubs and other daily necessities with others, and should wash and dry their feet in a timely manner and change shoes and socks frequently.

Psychological support

The course of some pathogen-induced infections may be long or the symptoms may be recurrent, and patients may suffer from anxiety, depression and other adverse emotions. If the patient shows signs of emotional instability and psychological depression, relatives and friends may increase companionship and provide psychological intervention if necessary.

Disease monitoring

Monitor temperature and blood pressure daily and record them.

Observe whether cough, sputum, diarrhea, abdominal pain, painful urination, frequent urination, etc. occur.

Observe whether there is any change in the degree of illness, such as whether chest tightness, shortness of breath, panic worsens, whether there is headache, decrease in urine output, and so on. Seek medical attention if dyspnea, impaired consciousness, hypotension, hypothermia, etc. occur.

In case of intolerable adverse reactions (e.g. severe allergic reactions, blurred vision, etc.), timely follow-up is required.

Follow-up examination

As the condition and progression of infections due to different pathogens vary, and involvement of internal organ function may occur, regular review may help prevent or delay the onset of injury.

Patients with different infections have different clinical manifestations and need to be followed up regularly according to the doctor’s instructions, and the follow-up period is usually 1 to 2 months.

Patients should be reviewed regularly according to their condition, and routine blood tests, urine tests, fecal tests, blood sedimentation, C-reactive protein, ultrasound, X-rays, and CT scans may be needed.

Prevention

There are numerous pathogens that cause infections and it is generally difficult to prevent them effectively, but the following healthy lifestyles or behaviors, etc. can help reduce the risk of developing the disease.

Strict attention to personal hygiene, dietary hygiene, and maintaining a regular routine.

Actively treating diseases such as diabetes, malnutrition, anemia, etc. to strengthen the body’s immunity.

Wear a mask when going to closed, airless public places or crowded places, and avoid going barefoot in public bathrooms and other places.

Use condoms correctly and have safe sex; refuse drugs and do not share needles.