Abscess

A skin abscess is a tender mass generally surrounded by a colored area from pink to deep red. Abscesses are often easy to feel by touching. The vast majority of them are caused by infections. Inside, they are full of pus, bacteria and debris.

abscess

Painful and warm to touch, abscesses can show up any place on your body. The most common sites on the skin in your armpits (axillae), areas around your anus and vagina (Bartholin gland abscess), the base of your spine (pilonidal abscess), around a tooth (dental abscess), and in your groin. Inflammation around a hair follicle can also lead to the formation of an abscess, which is called a boil (furuncle).

Unlike other infections, antibiotics alone will not usually cure an abscess. In general an abscess must open and drain in order for it to improve. Sometimes draining occurs on its own, but generally it must be opened with the help of a warm compress or by a doctor in a procedure called incision and drainage (I&D).

When our normal skin barrier is broken, even from minor trauma, or small tears, or inflammation, bacteria can enter the skin. An abscess can form as your body's defenses try to kill these germs with your inflammatory response (white blood cells = pus). Obstruction in a sweat or oil (sebaceous) gland, or a hair follicle or a pre-existing cyst can also trigger an abscess.

The middle of the abscess liquefies and contains dead cells, bacteria, and other debris. This area begins to grow, creating tension under the skin and further inflammation of the surrounding tissues. Pressure and inflammation cause the pain.

People with weakened immune systems get certain abscesses more often. Those with any of the following are all at risk for having more severe abscesses. This is because the body has a decreased ability to ward off infections.

The doctor will examine the abscess and surrounding areas. If it is near your anus, the doctor will perform a rectal exam. If an arm or leg is involved, the doctor will feel for a lymph gland either in your groin or under your arm.

An abscess is a pocket of pus. You can get an abscess almost anywhere in your body. When an area of your body becomes infected, your body's immune system tries to fight the infection. White blood cells go to the infected area, collect within the damaged tissue, and cause inflammation. During this process, pus forms. Pus is a mixture of living and dead white blood cells, germs, and dead tissue.

Bacteria, viruses, parasites and swallowed objects can all lead to abscesses. Skin abscesses are easy to detect. They are red, raised and painful. Abscesses inside your body may not be obvious and can damage organs, including the brain, lungs and others. Treatments include drainage and antibiotics.

A tooth abscess is a pocket of pus that's caused by a bacterial infection. The abscess can occur at different areas near the tooth for different reasons. A periapical (per-e-AP-ih-kul) abscess occurs at the tip of the root. A periodontal (per-e-o-DON-tul) abscess occurs in the gums at the side of a tooth root. The information here is about periapical abscesses.

A periapical tooth abscess usually occurs as a result of an untreated dental cavity, an injury or prior dental work. The resulting infection with irritation and swelling (inflammation) can cause an abscess at the tip of the root.

Dentists will treat a tooth abscess by draining it and getting rid of the infection. They may be able to save your tooth with a root canal treatment. But in some cases the tooth may need to be pulled. Leaving a tooth abscess untreated can lead to serious, even life-threatening, complications.

An abscess is a collection of pus that has built up within the tissue of the body.[1] Signs and symptoms of abscesses include redness, pain, warmth, and swelling.[1] The swelling may feel fluid-filled when pressed.[1] The area of redness often extends beyond the swelling.[6] Carbuncles and boils are types of abscess that often involve hair follicles, with carbuncles being larger.[7]

They are usually caused by a bacterial infection.[8] Often many different types of bacteria are involved in a single infection.[6] In many areas of the world, the most common bacteria present is methicillin-resistant Staphylococcus aureus.[1] Rarely, parasites can cause abscesses; this is more common in the developing world.[3] Diagnosis of a skin abscess is usually made based on what it looks like and is confirmed by cutting it open.[1] Ultrasound imaging may be useful in cases in which the diagnosis is not clear.[1] In abscesses around the anus, computer tomography (CT) may be important to look for deeper infection.[3]

Standard treatment for most skin or soft tissue abscesses is cutting it open and drainage.[4] There appears to be some benefit from also using antibiotics.[9] A small amount of evidence supports not packing the cavity that remains with gauze after drainage.[1] Closing this cavity right after draining it rather than leaving it open may speed healing without increasing the risk of the abscess returning.[10] Sucking out the pus with a needle is often not sufficient.[1]

Skin abscesses are common and have become more common in recent years.[1] Risk factors include intravenous drug use, with rates reported as high as 65% among users.[2] In 2005, in the United States, 3.2 million people went to the emergency department for an abscess.[5] In Australia, around 13,000 people were hospitalized in 2008 with the condition.[11]

Abscesses may occur in any kind of tissue but most frequently within the skin surface (where they may be superficial pustules known as boils or deep skin abscesses), in the lungs, brain, teeth, kidneys, and tonsils. Major complications may include spreading of the abscess material to adjacent or remote tissues, and extensive regional tissue death (gangrene).[citation needed]

The main symptoms and signs of a skin abscess are redness, heat, swelling, pain, and loss of function. There may also be high temperature (fever) and chills.[12] If superficial, abscesses may be fluctuant when palpated; this wave-like motion is caused by movement of the pus inside the abscess.[13]

An internal abscess is more difficult to identify, but signs include pain in the affected area, a high temperature, and generally feeling unwell.Internal abscesses rarely heal themselves, so prompt medical attention is indicated if such an abscess is suspected. An abscess can potentially be fatal depending on where it is located.[14][15]

Risk factors for abscess formation include intravenous drug use.[16] Another possible risk factor is a prior history of disc herniation or other spinal abnormality,[17] though this has not been proven.

Abscesses are caused by bacterial infection, parasites, or foreign substances.Bacterial infection is the most common cause, particularly Staphylococcus aureus. The more invasive methicillin-resistant Staphylococcus aureus (MRSA) may also be a source of infection, though is much rarer.[18] Among spinal subdural abscesses, methicillin-sensitive Staphylococcus aureus is the most common organism involved.[17]

Surgery of the anal fistula to drain an abscess treats the fistula and reduces likelihood of its recurrence and the need for repeated surgery.[19] There is no evidence that fecal incontinence is a consequence of this surgery for abscess drainage.[19]

Perianal abscesses can be seen in people with, for example, inflammatory bowel disease (such as Crohn's disease) or diabetes. Often the abscess will start as an internal wound caused by ulceration, hard stool, or penetrative objects with insufficient lubrication. This wound typically becomes infected as a result of the normal presence of feces in the rectal area, and then develops into an abscess. This often presents itself as a lump of tissue near the anus which grows larger and more painful with time. Like other abscesses, perianal abscesses may require prompt medical treatment, such as an incision and debridement or lancing.[citation needed]

An incisional abscess is one that develops as a complication secondary to a surgical incision. It presents as redness and warmth at the margins of the incision with purulent drainage from it.[20] If the diagnosis is uncertain, the wound should be aspirated with a needle, with aspiration of pus confirming the diagnosis and availing for Gram stain and bacterial culture.[20]

The final structure of the abscess is an abscess wall, or capsule, that is formed by the adjacent healthy cells in an attempt to keep the pus from infecting neighboring structures. However, such encapsulation tends to prevent immune cells from attacking bacteria in the pus, or from reaching the causative organism or foreign object.[citation needed]

An abscess is a localized collection of pus (purulent inflammatory tissue) caused by suppuration buried in a tissue, an organ, or a confined space, lined by the pyogenic membrane.[22] Ultrasound imaging can help in a diagnosis.[23]

Abscesses may be classified as either skin abscesses or internal abscesses. Skin abscesses are common; internal abscesses tend to be harder to diagnose, and more serious.[12] Skin abscesses are also called cutaneous or subcutaneous abscesses.[24]

The standard treatment for an uncomplicated skin or soft tissue abscess is the act of opening and draining.[4] There does not appear to be any benefit from also using antibiotics in most cases.[1] A small amount of evidence did not find a benefit from packing the abscess with gauze.[1]

The abscess should be inspected to identify if foreign objects are a cause, which may require their removal. If foreign objects are not the cause, incising and draining the abscess is standard treatment.[4][25]

In critical areas where surgery presents a high risk, it may be delayed or used as a last resort. The drainage of a lung abscess may be performed by positioning the affected individual in a way that enables the contents to be discharged via the respiratory tract. Warm compresses and elevation of the limb may be beneficial for a skin abscess.[citation needed] 041b061a72