An abscess is a localized collection of pus that generally develops in response to infection. An abscess is typically painful, and it appears as a swollen area that is warm to the touch. The skin surrounding an abscess typically appears pink or red.
Abscesses can develop in many parts of the body, but they usually involve the skin surface. Common sites affected include the armpits, groin, rectal area (perirectal abscess), the external vaginal area (Bartholin abscess), and along the tailbone (pilonidal abscess). Abscesses can also affect the brain, kidneys, liver ( hepatic abscess), lungs, teeth (dental abscess), and tonsils (peritonsillar abscess). Inflammation surrounding hair follicles can lead to the formation of abscesses. Skin abscesses are often referred to as boils.
Unlike other infections, antibiotics alone will not cure an abscess. In general, abscesses must open and drain to improve. Although sometimes an abscess will open and drain spontaneously, it generally needs to be opened and drained (incision and drainage) by a health care provider.
Symptoms of Abscess
Abscesses tend to get worse as time goes on. Symptoms include tenderness or pain and the site of the abscess being warm to the touch. Symptoms of discomfort or pain depend mainly on the site of the abscess, though larger ones - since they are a source of infection within the body – can cause fever, 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.
Call your doctor if you have a high fever, or if the abscess is larger than ½ inch across, is near your rectal area or groin, or if red streaks are radiating out from the abscess.
Individuals with any of the following conditions are at higher risk for developing abscesses:
- Chronic steroid therapy
- Dialysis for kidney failure
- Sickle cell disease
- Peripheral vascular disease
- Crohn's disease
- Ulcerative colitis
- Severe burns
- Severe trauma
Treatment of Abscess
Small abscesses may be helped by applying warm compresses to the area several times a day. This will sometimes promote spontaneous drainage of the abscess which is important since the primary treatment of abscesses is to drain them. However, it is also important to not attempt to drain an abscess yourself. This can lead to trauma of the surrounding tissue and potentially help spread the underlying infection.
Draining the abscess 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. The area around the abscess will be numbed before draining. Most people feel immediately better after the draining.
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.
Without spontaneous or surgical drainage, sometimes an abscess will be 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.
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