Freiberg Jeffrey A
School of Medicine, University of Maryland, Baltimore, MD, USA.
J Community Hosp Intern Med Perspect. 2017 Jul 13;7(3):196-198. doi: 10.1080/20009666.2017.1343077. eCollection 2017 Jul.
The presence of pus is one of the most easily recognizable signs of an infection. However, for several centuries suppuration, known as 'laudable pus,' was believed to be a sign of a healthy, healing wound. This historical misconception can be explained by the difference in the presentation of a necrotizing soft tissue infection versus other more common skin and soft tissue infections. Chronic wound infections, due to pyogenic bacteria, typically produce large amounts of thick, whitish-yellow pus. On the other hand, necrotizing soft tissue infections, despite their severe mortality and morbidity, are devoid of pus in the traditional sense. What the ancient medical observers recognized was the fact that pus is not characteristic of this subset of incredibly severe infections. This is an important distinction to remember when evaluating an infection, even today.
脓液的存在是感染最容易识别的迹象之一。然而,在几个世纪里,被称为“值得称赞的脓液”的化脓被认为是伤口健康愈合的标志。这种历史误解可以通过坏死性软组织感染与其他更常见的皮肤和软组织感染的表现差异来解释。由化脓性细菌引起的慢性伤口感染通常会产生大量浓稠的黄白色脓液。另一方面,坏死性软组织感染尽管死亡率和发病率很高,但传统意义上却没有脓液。古代医学观察家所认识到的是,脓液并非这类极其严重感染的特征。即使在今天,这也是在评估感染时需要记住的一个重要区别。