Abscess

Definition

An abscess is a cavity containing pus and surrounded by inflamed tissue, formed as a result of a localized infection (characteristically, a staphylococcal infection).

Description

An abscess may develop, enlarge or subside, depending on whether microorganisms or leukocytes (white blood cells) gain the upper hand in any one of a number of locations in the body. Abscesses may develop in any organ and in the soft tissues beneath the skin in any area.

Common sites include the breast, gums and peri-rectal area. Rarer sites include the liver and the brain. Common sites for abscesses under the skin include the axilla (armpit) and the groin. These two areas have a large number of lymph glands that are responsible for fighting infection.

A collar-button abscess is one in which a small abscess cavity under the skin connects via a sinus to (channel) to a much larger one in deeper tissues.

Causes and Risk Factors

Common bacteria, such as staphylococci, are the most common cause, although the bacillus responsible for tuberculosis is an important abscess-forming type.

Fungal infections sometimes cause abscesses, while amebae (single-celled animal parasites) are an important cause of liver abscesses.

The infection usually reaches an organ via the bloodstream or penetrates tissues under the skin via an infected wound or bite.

Symptoms

Symptoms of discomfort or pain depend mainly on the site of the abscess, though most larger ones - since they are a source of infection within the body - cause fever (sometimes with chills), sweating, and malaise.

Abscesses close to the skin usually cause inflammation with redness, increased skin temperature and tenderness.

Tuberculous abscesses are the exception; hence their introduction as cold abscesses.

Diagnosis

An abscess is diagnosed clinically by means of the history and a physical exam, demonstrating a tender mass with overlying erythema (redness).

Treatment

The abscess cavity almost always requires draining. This is done by making a cut in the lining and providing an escape route for the pus, either through a drainage tube or by leaving the cavity open to the skin.

Without spontaneous or surgical drainage, an abscess occasionally resolves slowly after digestion of the pus produces a thin, sterile fluid that is reabsorbed into the bloodstream. Incomplete reabsorbtion leaves a cystic loculation (small pouches) within a fibrous wall where calcium salts sometimes accumulate to form a calcified mass.

Many abscesses subside after drainage alone; others subside after drainage and drug treatment. Occasionally, their presence within a vital organ, such as the liver or brain, damages enough surrounding tissue to cause some permanent loss of normal function.

Antibiotics are usually prescribed to treat a bacterial infection, antifungal drugs to treat fungi, and antiamebic drugs to treat amebiasis. However, the lining of the abscess cavity tends to reduce the amount of drug that can penetrate the source of infection from the bloodstream.

Questions to Ask Your Doctor

What medications are taken to relieve the pain?

How long before the pain subsides?

Will the abscess have to be drained?

Will the abscess reoccur?

What caused them to occur?

Could this be Pilonidal Disease?