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How To Tell If A Burn Has Become Infected

Many people are not aware, but one of the most dangerous aspects of a burn is the risk of a subsequent bacterial infection.  Burns are generally slow to heal and diminish the integrity of the skin and its ability to form a protective barrier to keep out bacteria.  The most difficult aspect of determining if a burn has become infected is that the signs and symptoms of burns and skin infections are very similar.  These signs and symptoms for both burns and bacterial skin infections include pain, heat at the site of injury, swelling and redness.  It is also probable that the individual would have a fever.

Anything more serious than a minor third degree burn is not only painful but also dangerous, however, the risks escalate rapidly if the wound is infected with bacteria.  Burns themselves can present life-threatening complications due to a host of reasons including electrolyte imbalances and organ failure, for this reason it is vital to not also force the body´s immune system to fight against a bacterial infection.  For this reason, even with minor burns that do not demand a trip to the hospital, it is important to be able to determine if the burn has become infected.  Even for modest burns, it is important to know that if the wound becomes infected, it will greatly increase the amount of scar tissue that develops and it will also extend the length of time it takes for the wound to close and heal.

There are a few different ways to tell if a burn has become infected in which case you should immediately  consult with a doctor no matter how small the burn may appear.

Both burns and bacterial infection can and will usually cause a fever in the individual.  The difference between the two is the severity and the duration.  A burn, even a modest one, can result in a low-grade fever that normally stays below 100F and lasts less than a day.  If the fever is caused because the burn is infected, the fever can go above 100F and will spike after the first 24hrs as the bacterial infection ramps up.  If a fever lasts more than 24hrs or the fever exceeds 100F, it is important to see a doctor.

The second sign is the degree of redness around the actual burn.  In the hours after the initial injury, a red ring will appear around the burn site.  This redness is caused by the initial heat injury and also because additional cells around the burn site will die a few hours afterwards because of substances released from the burned cells.  The importance of this is that after an hour or two of the initial burn, this ring should stop expanding.  If the red area around the burn continues to expand a day or two after the initial injury, it is probable that a bacterial infection is what is causing it. In a clean burn, without significant infection, the redness should being retreating back to the initial burn site within a day or two.


Also, for burns that are located on the arms, legs, hands or feet, the lymph nodes can be an early indication of an infection.  The major lymph nodes for the legs are located on the inner thigh, and for the arms they are located under the armpit.  Normally, a burn will not cause inflammation or swelling of the lymph nodes, however, a bacterial infection does.  Slight pain, especially when the lymph nodes are pressed is a good indication that there is an infection.

Burns are often more serious then they appear, there are many internal risks that are much more threatening than the pain indicates.  This is drastically compounded if the burn becomes infected.  Make sure to pay attention to the red ring around the burn and see a doctor if the ring continues to grow.  Make sure you take your temperature at regular intervals and make sure the fever doesn´t go above 100F nor stay for more than a day.  Finally, pay attention to any odd pain under the armpits or on the inner thigh, they are in indication that a bacterial infection has cause the lymph nodes to become swollen.  Consult a doctor rapidly if any of these signs or symptoms occur as they indicate that the burn has become infected.

Reviewed:  Peter Sedesse, MD


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