Although infected tattoos They are not usually very common, it is important to identify them in time to avoid complications. A tattoo can become infected just like any clean wound; that is, carried out under controlled conditions, in an environment with minimal sanitary conditions and taking into account aseptic and antiseptic measures.
However, due to the particular characteristics of the tattoo, determining if it is infected or not can be a challenge, being this diagnosis much more complex than any other skin infection..
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The symptoms of a tattoo infection are usually the same as those of any infection: redness and pain in the affected area. On the surface, it should not represent a diagnostic challenge; however, the situation is not as simple as it seems.
First of all, tattoos are usually covered with a layer of transparent paper. This layer, although it allows you to see the skin, does not give access to fine details such as the characteristics of the follicles.
A freshly done tattoo cannot be felt. This makes it more difficult to identify areas of indurations and local temperature rise. During the first few days, while the tattoo is covered, it is very difficult to inspect the area for incipient signs of infection, which may go unnoticed..
Once the clear cover is removed, signs of infection may still go unnoticed; this is because they overlap with the symptoms that the person is expected to feel during the first days after having tattooed.
In this sense, it is very difficult for someone to differentiate if the pain they feel is due to the tattoo itself or to an infection, especially in extensive tattoos.
In these cases, the person usually realizes that there is a problem several days later, since the pain persists later than expected and even gets worse..
The redness of the area can go unnoticed due to it being camouflaged with the colors of the tattoo, especially those with very saturated or dark colors.
It is also possible that the person may not notice the local increase in temperature due to the coverage and because the tattoo itself causes some degree of inflammation of the skin, which is hotter than the surrounding integument. So, once again, it is difficult to detect the infection in the first days.
However, for the experienced eye it is possible to detect these incipient symptoms and be able to make the diagnosis, so that when the patient goes to the doctor, they usually have a diagnosis in a matter of minutes. This diagnosis is usually confirmed with a hematology that reveals elevated white blood cells..
Unfortunately, the more time that passes between the onset of symptoms and the moment when the affected person notices that they have a problem, the greater the chances of complications such as abscesses and sepsis..
When the infection is severe or treatment is started too late, there is a possibility that an abscess will develop in the area of infection. Known as abscess cellulitis, this condition is characterized by the accumulation of pus under the skin, creating cavities that must be drained in order to heal the abscess..
It is not a common condition, but when it occurs, immediate action must be taken in order to prevent it from evolving to sepsis, or the abscess from becoming so large that its treatment (usually surgical) causes disfigurement of the affected area..
It is known as sepsis to the generalized infection of the organism with risk of failure of multiple organs and even death. Sepsis occurs when an infection spreads from the starting point to the entire body through the bloodstream..
Although this is not frequent, it is not impossible either, so that in extensive infections, when treatment is delayed or ineffective, there is the possibility that the patient develops sepsis, requiring hospitalization to place intravenous antibiotic treatment and provide life support measures..
As with any other type of skin infection, the most frequent culprits are the microorganisms that colonize the skin, and of these the Staphylococcus aureus is the most common.
However, when the conditions of the tattoo area are not optimal and aseptic and antiseptic measures are not respected, contamination by other less common germs, such as gram negative bacilli and even pseudomonas, is possible.
Usually the causative agent is treated empirically. However, if there is no response to treatment or complications develop, it may be necessary to perform cultures to determine the bacteria involved in the infection, in order to establish a specific treatment based on the antibiogram..
Depending on the severity and extent of the infection, topical or oral treatments may be used..
If the infection is well localized, the patient does not have general symptoms and the problem is detected early, it is possible to control the infection with topical antibiotics in gel or cream form, the most effective being bacitracin and mupirocin..
When these do not have the desired effect or complications develop, then oral treatment should be started..
The first-line antibiotics most often used are first-generation cephalosporins (such as cefadroxil), semisynthetic penicillins (such as amoxicillin or ampicillin), or even quinolones (such as ciprofloxacin) in cases of penicillin allergy..
If none of these treatments work, cultures should be performed to identify the causative organism and be able to start therapy based on the antibiogram..
Likewise, if serious complications develop (such as sepsis), hospitalization may be necessary to administer intravenous treatments..
In exceptional cases of very extensive abscesses, it may be necessary to perform surgery to drain the purulent material, although these cases are not usually very frequent due to the success of antibiotic treatments..
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