Phlegmon - Symptoms, causes and treatment

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Phlegmon - Symptoms, causes and treatment
Phlegmon - Symptoms, causes and treatment

Phlegmon is inflammation of the tissue under the skin caused by an infection and produces pus. In addition to the skin, phlegmon can also occur in internal organs, such as the tonsils and the appendix

Phlegmon can spread quickly, so in some cases it causes life-threatening conditions, such as phlegmon that occurs in the floor of the mouth known as Ludwig's Angina.

cleaned abscess wound

The Cause of Phlegmon

Phlegmon is caused by a bacterial infection. The bacteria that most often cause this condition are Staphylococcus aureus and group A Streptococcus.

The following are some of the ways phlegmons occur:

  • Bacteria enter through scratches, insect bites, or cuts on the skin, causing phlegmon under the skin
  • Bacteria infect the mouth, for example due to dental surgery, and cause phlegmon or mouth abscess
  • Bacteria that enter the body stick to the walls of internal organs, such as the walls of the stomach and appendix, then cause phlegmon

Phlegmon Symptoms

The symptoms that accompany phlegmon vary, depending on the location and severity of the infection. Generally, symptoms of phlegmon can be recognized by the appearance of fever, headache, fatigue, and swollen lymph nodes.

In addition to these symptoms, phlegmon can also be accompanied by different symptoms. Phlegmon on the skin is usually accompanied by the following symptoms:

  • Skin is red
  • Swelling
  • It hurts so bad
  • Pus forms under the skin without clear boundaries

Meanwhile, if phlegmon occurs in internal organs, the symptoms can be:

  • Pain
  • organ dysfunction

When to see a doctor

Do an examination to the doctor if symptoms of phlegmon appear as mentioned above. Prompt and appropriate treatment plays a very important role in the healing of phlegmon.

Phlegmon Diagnosis

In some cases, phlegmon can resemble other soft tissue infections, such as cellulitis and abscesses, making it difficult to distinguish. However, there are several characteristics that can distinguish each condition.

Inflammation in patients with cellulitis occurs due to infection of the skin and underlying tissue. If not treated immediately, the area affected by cellulitis will form a walled cavity filled with pus, which is called an abscess.

Phlegmon is different from an abscess, because a phlegmon does not have a cavity with a wall, so the inflammation that occurs can be more extensive than an abscess.

To diagnose phlegmon, the doctor will start the examination by asking questions about the symptoms and complaints experienced by the patient, such as when, how, and how long the symptoms have occurred. The doctor will also ask about the patient's medical history and medications being used.

After that, the diagnosis is followed by a physical examination. Phlegmon on the skin is usually easily visible. As for phlegmon in internal organs, the doctor will usually feel the painful body part to detect the presence or absence of a lump.

Auxiliary examination can also be done to confirm the diagnosis, especially if phlegmon occurs in internal organs. The following are some additional tests that can be performed to diagnose phlegmon:

  • Blood and urine test
  • Scans, such as ultrasound, CT scan, X-ray, and MRI

Phlegmon Treatment

The treatment that can be used to treat phlegmon depends on the location of the phlegmon and the severity of the condition. However, in general, phlegmon can be treated with antibiotics and surgery. Here is the explanation:

Antibiotic Drugs

Some antibiotics that doctors can prescribe to treat phlegmon are penicillins and cephalosporins. Other treatments that can be done to relieve symptoms are giving fever relievers, cold or warm compresses on the sore area, and complete rest.


Sometimes, surgery is needed to prevent the spread of infection and prevent complications. Surgery is also needed for severe cases, such as phlegmon in the floor of the mouth and phlegmon in the lining of the joint covering tissue.

In phlegmon that occurs on the skin, surgery may be needed to remove dead skin tissue. Meanwhile, to treat phlegmon in internal organs, surgery aims to remove pus from the organs.

In severe enough cases, phlegmon can become a life-threatening condition. However, with proper treatment, phlegmon is generally curable. Therefore, it is very important to immediately consult a doctor when experiencing symptoms of phlegmon.

Phlegmon Complications

If left untreated, phlegmon can spread to deeper tissues, causing serious complications. The following are complications that can occur due to phlegmon:

  • Infection of lymph nodes and their ducts
  • Thrombophlebitis
  • Sepsis
  • Vomiting blood
  • Peritonitis
  • Esophagitis
  • Stenosis and perforation of the esophagus
  • Empiema
  • Mediastinitis
  • Paralysis of the infected body part

Phlegmon Prevention

There is no vaccine that can prevent infection with Staphylococcus aureus and group A Streptococcus bacteria that cause phlegmon. However, bacterial infections can be prevented by taking the following steps:

  • Use moisturizer on dry skin to prevent chapping.
  • Keep your body clean, for example by bathing regularly and washing your hands frequently.
  • Avoid sharing the use of personal items, such as toothbrushes and drinking glasses.
  • Cook the food until it is completely cooked.
  • Use the medicine as recommended by the doctor if you have a wound or infection on the skin.

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