The classic signs and symptoms of infection are redness, swelling, heat, and pain. Redness of the skin is due to intense hyperemia and is seen in infections which involve the skin or subcutaneous tissue and, in some patients, in the. skin overlying foci of suppurative thrombophlebitis hyperemia is responsible for the local increase in temperature. Fever and tachycardia are additional but nonspecific signs of infection. Rigors and chills are suggestive of septicemia.
Leukocytosis commonly accompanies acute bacterial infection.
Generally, the more severe the infection, the greater the leukocytosis. A Gram stain of the exudate should be performed immediately to facilitate prompt institution of appropriate antimicrobial therapy. A wound biopsy is a useful method of confirming the presence of infection in a wound, particularly in a burn wound or wounds of the subcutaneous and soft tissues. Areas of the wound that appear purulent or reveal new focal areas of discoloration should be biopsied. If the technical capability exists, a portion of the specimen should be sent to the microbiology laboratory for quantitative culture.