Acute vulvar cellulitis

　　In severe cases of acute vulvar cellulitis, blisters may occur on the surface or dark red ischemic necrosis may occur due to local swelling affecting blood circulation. It often accompanies chills, fever, enlargement of peripheral lymph nodes, an increase in white blood cells, and even sepsis. Concurrent with urethritis, vaginitis. White blood cell count increases in blood routine examination, and vaginal secretion examination.

　　Acute vulvar cellulitis is characterized by the initial appearance of a locally red, diffuse infiltrative patch with unclear boundaries, which is not easily localized, spreads rapidly, and has no obvious boundary with normal tissue. The affected area is red, swollen, hot, and extremely painful, with a firm sensation in the swollen area. Pressing it can cause indentation. In severe cases, blisters may occur on the surface or dark red ischemic necrosis due to swelling affecting blood circulation. It often accompanies chills, fever, enlargement of peripheral lymph nodes, an increase in white blood cells, and even sepsis. Afterward, the tissue gradually softens and becomes fluctuant, ulcerating and forming an ulcer, which heals after scabbing for about two weeks. Chronic cellulitis often presents as a hardening, erythema, burning sensation, and hyperpigmentation, with mild pain and skin showing signs of hardening and atrophy similar to systemic sclerosis, also known as hardening cellulitis. If the cellulitis is located in the deep central part of the lesion, the local swelling may not be obvious, only local edema and deep tenderness, and the pain is relatively mild. Pressing the local area produces a crunching sound, but the condition is more serious at this point, with high fever, chills, headache, general weakness, an elevated white blood cell count, and progressive necrosis of the cellulitis and fascia, with the pus having a foul odor.

　　1, Pay attention to personal hygiene, actively treat small skin infection foci and other parts of infection foci, pay strict attention to aseptic technique during injection operations, and actively treat open wounds, which is meaningful for preventing the occurrence of this disease.

　　2, Commonly used drugs: Vitamin B1, cefametin, azithromycin.

　　3, Prognosis: Complete treatment with no adverse prognosis, some lesions may recur, leading to recurrent cellulitis.

　　Bacterial culture and drug sensitivity test of pus for diagnosis and treatment.

　　First, dietary therapy for acute vulvar cellulitis

　　1, Early stage of acute cellulitis

　　(1) Clinical manifestations: At the beginning, sudden swelling and discomfort between the skin and flesh of the affected area, shiny without a head, quickly forming a mass, the skin becomes red (some skin color is not red), burning pain, gradually expanding, becoming high and firm. Generally, mild cases have no systemic symptoms, while severe cases may have chills, fever, headache, and nausea. It is advisable to choose food therapy formulas that clear heat, disperse wind, and remove blood stasis.

　　(2) Diet therapy

　　(2) Ficus pumila fruit powder: 30 grams of Ficus pumila fruit, wash and dry, grind into powder. Take twice a month, 5 grams each time, for 3 consecutive days, take with warm water. Suitable for the early stage of boils.

　　(1) Jasmine flower braised bean curd: 2 pieces of water bean curd (about 200 grams) cut into small pieces, 15 jasmine flowers. Heat the wok over medium heat, add oil, heat to 70% heat, add clear soup, boil, add scallions, ginger, yellow wine, salt, and water bean curd, cook until flavored, thicken with cornstarch, sprinkle with jasmine flowers and monosodium glutamate, mix well. Take 1-2 times while hot. Suitable for boils and abscesses.

　　2, Middle stage of acute cellulitis

　　(1) Clinical manifestations: After 7-8 days of the disease course, when the pus heads first form, the local swelling is prominent, the pain intensifies, the body temperature remains high, and if the local area is pressed and feels soft, it indicates that pus has formed. It can be incised to drain pus or allowed to溃破 naturally. It is advisable to choose food therapy formulas that promote pus drainage.

　　(2) Diet therapy

　　Buddleja sinensis and Jinyinhua tea: 5 grams of dried wood rose flowers, 5 grams of Jinyinhua. Boil 200 milliliters of water, soak for 15 minutes. Drink as tea. Suitable for various boils and abscesses.

　　Jinyinhua wine: 40 grams of Jinyinhua, 10 grams of licorice root, add 500 milliliters of white wine and clear water, boil to 500 milliliters, remove the residue and take the juice, drink frequently at a warm temperature, and apply the medicine residue to the sore. Suitable for boils with persistent swelling and pain.

　　Squash porridge: 50 grams of glutinous rice, 800 milliliters of water, boil with high heat, then peel and wash 1 squash, cut into pieces and add to the pot, simmer with low heat to make porridge, add salt, monosodium glutamate, and sesame oil, mix well. Take 1-2 times on an empty stomach. Suitable for boils, carbuncles with severe heat and not yet ulcerated, or those that have ulcerated but the heat toxin has not been cleared, as an auxiliary treatment.

　　Squash bean curd soup: 2 pieces of water bean curd, 300 milliliters of water, boil with high heat, wait until the water bean curd becomes honeycomb-like, then add 250 grams of squash slices, cook until the squash is fully cooked, add salt and monosodium glutamate, pour sesame oil. Can be eaten alone or as a side dish. Suitable for boils, carbuncles, boils, intestinal wind piles, and children's heat boils.

　　3. Late stage of acute cellulitis

　　(1) Clinical manifestations: After ulceration, there is often a yellow, thick, purulent discharge, or mixed with purple blood clots. If the pus is discharged smoothly, the local swelling and pain will subside, and the systemic symptoms will be alleviated or disappear. After 8-9 days, the wound will heal. If the pus is discharged after ulceration and the surrounding area is firm, or the pus is thin and the discharge is not smooth, or the body is weak, affecting the growth of new flesh, leading to inability to heal, it is advisable to choose food therapy formulas that tonify Qi and promote pus discharge.

　　(2) Diet therapy

　　① Yangya Ji Li Soup: One white wild duck (about 1500g in weight), killed, cleaned, and cut into pieces. 50g of dried mushrooms, remove the stems, clean, and slice. 120g of white Ji Li, clean, and put into a gauze bag, tie the bag tightly. Clean ginger, crack, and clean. Put them all in a pot, add 600ml of water, bring to a boil, skim off the foam, add salt, and simmer over low heat until tender. Remove the medicine bag, add味精, and pour sesame oil. Eat the duck meat and mushrooms 2-3 times, and drink the soup while hot. Suitable for boils that do not heal for a long time after ulceration.

　　② Husk powder: Clean 500g of loofah, slice it, and mix it with buckwheat flour to form a paste. Wrap it in the fire and burn it, then remove the buckwheat flour. Grind the loofah slices into powder. Take 20g three times a day, with warm water, for the treatment of boils and ulcers with pus and blood.

　　③ Braised shark meat with vinegar: Heat the wok over high heat, add oil, and heat to seven成热. First, add ginger slices to sizzle, then add 150g of shark meat slices, stir-fry until well combined. Add salt and vinegar, and stir-fry until cooked through. Serve hot as a meal or as a side dish. Suitable for boils and ulcers that do not heal for a long time.

　　Two. Foods that are good for the body in acute vulvar cellulitis

　　1. Eat more vegetables and fruits.

　　2. Drink more tea or light beverages.

　　3. Consume foods that cool the blood and detoxify. Foods such as mung beans, glutinous rice, cucumber, bitter melon, portulaca, green tea, etc.

　　Three. Foods that should not be eaten in acute vulvar cellulitis

　　1. Avoid smoking, alcohol, and spicy刺激性 foods.

　　2. Avoid greasy, fried, moldy, and salted foods.

　　3. Avoid foods that can cause boils, such as rooster and goose.

　　4. Avoid seafood and刺激性, allergenic foods when itching is severe.

　　5. Avoid warm and hot foods such as lamb, chive, ginger, pepper, cassia, etc., in cases of ulcers and bleeding.

　　Prevention should pay attention to personal hygiene, actively treat small skin infection foci and other parts of infection foci, and pay attention to strict aseptic technique during injection operations. Open wounds should be actively treated, which is meaningful for preventing the occurrence of this disease.

　　One. Traditional Chinese medicine treatment methods for acute vulvar cellulitis

　　1. Differential diagnosis and treatment:

　　This disease is characterized by实证, heat syndrome, and Yang syndrome.

　　(1) For wind-cold transforming into heat on the surface, treatment should be given to detoxify and disperse wind-cold, with Jingfang Baidu Decoction as the choice of formula, with modifications.

　　(2) For wind-heat transforming into fire, treatment should be given to disperse wind, clear heat, and detoxify, with Niuhuang Detoxification Decoction and Niuhuang Detoxification Tablets as the choice of formula, 3 tablets each time, twice a day; Lianqiao Baidu Decoction, 9g each time, twice a day, both are suitable for heat toxicity accumulation and heat excess muscle corruption syndrome. Alternatively, Puji Xiaodai Drink may be used.

　　(3) For damp-heat, treatment should be given to clear heat, promote diuresis, and detoxify, with Baijie Shen Shi Decoction as the choice of formula.

　　(4) For severe heat toxicity, treatment should be given to clear fire and detoxify, with Huanglian Detoxification Decoction as the choice of formula.

　　(5) For the invasion of heat evil into the interior, treatment should be given to clear the营and cool the blood, with Qingying Decoction as the choice of formula.

　　2. External treatment:

　　For those with significant redness and swelling, apply Zhu Yu ointment, Yang He Jie Ning ointment, Bi Yu ointment, etc., to the affected area.

　　3. Bed Rest

　　The patient should rest in bed to reduce local swelling and pain.

　　Second, Western Medical Treatment for Acute Vulvar Cellulitis

　　The principle of treatment is to reduce inflammation, relieve pain, strengthen supportive therapy, and rest in bed to control the condition.

　　1. Antimicrobial Treatment

　　The first choice of antibiotic is penicillin group, such as penicillin 800,000 to 1,600,000 units, twice a day, intramuscular injection; or penicillin 8,000,000 to 12,000,000 units per day, intravenous injection; ampicillin 4 to 6g per day, intravenous injection. For those allergic to penicillin, erythromycin 0.9 to 1.2g per day, intravenous injection; ethylsuccinate erythromycin (Lisilac) 0.2g, 4 times a day, oral. For suspected anaerobic bacterial infection, metronidazole (Metronidazole) 1 to 2g per day, intravenous injection should be given in combination with treatment. The initial dose of antibacterial drugs should be sufficient to quickly control the spread of infection. After the pus breaks through, antibiotics may not be used. Analgesics and antipyretics can be given according to circumstances, such as Somiton tablets (Analgin), Compound Acetylsalicylic Acid (Compound Aspirin), etc.

　　2、Strengthen Supportive Therapy

　　Increase fluid intake and supplement adequate amounts of vitamins: such as vitamin C, B1, and E, etc.

　　3. Topical Medication

　　For early stages before the pus forms, 50% magnesium sulfate wet敷 or 50% ichthyol ointment can be applied.

　　4. Incision and Drainage

　　If the drug cannot control the situation, the tissue swelling is severe, the local tension is too high to affect blood circulation, and the surface skin turns purple and red, it should be incised early to reduce tension, excise and drain necrotic tissue. The incision for drainage should be large enough to ensure adequate drainage, but not exceed the normal tissue. Consideration should be given to gas-producing bacteria infection or due to dense tissue and high tension, even if there is not much pus, it should be incised early for decompression to control the spread of infection. Early incision should also be considered for suspected anaerobic bacterial infection. After the operation, the wound should be flushed with 3% hydrogen peroxide solution and wet敷.

　　5. Puncture and Aspiration of Pus

　　For those with small and deep abscess cavities, a thick needle can be used to puncture the abscess cavity, remove the pus, and flush the abscess cavity with antibiotic solution once every other day.

　　6. Local Physiotherapy

　　For the initial stage of acute cellulitis, infrared or ultraviolet radiation can be used to promote local blood circulation, which is beneficial for controlling the development of inflammation and can also alleviate local symptoms.