🔅 ABSCESSES (Collection of pus due to infection)
An abscess is a collection of pus that forms in or on the body due to an infection. Abscesses can be caused by bacteria, parasites, or other factors that affect blood clotting or increase the risk of bleeding. Abscesses can cause pain, swelling, redness, warmth, and fever.
They can occur in any part of the body, such as the skin, mouth, lungs, brain, teeth, kidneys, and tonsils. Abscesses can be diagnosed by physical examination, imaging tests, or laboratory tests. Treatment usually involves draining the pus and taking antibiotics. Some abscesses may require surgery or other procedures. Abscesses can be prevented by avoiding injuries, infections, and risk factors that can cause bleeding. Abscesses can have serious complications if left untreated, such as tissue death, infection spread, or organ damage.
Detailed below is a comprehensive overview of abscesses, based on the available clinical resources.
TYPES OF ABSCESSES
There are many different types of abscesses, depending on where they occur in the body. Some of the common types are:
1). Skin abscesses
These are abscesses that develop under the skin, usually due to a bacterial infection of a hair follicle, sweat gland, or wound. They are also called boils, furuncles, or carbuncles. They can appear anywhere on the body, but are more common on the face, neck, armpits, groin, and buttocks. They can vary in size and shape, and may be tender, warm, red, and swollen. They may also leak pus or blood. Some examples of skin abscesses are:
a). Armpit abscess: An abscess that forms in the armpit, often due to a condition called hidradenitis suppurativa, which causes inflammation of the sweat glands and hair follicles.
b). Breast abscess: An abscess that forms in the breast, often due to a breast infection (mastitis) that occurs in people who are breastfeeding (chestfeeding).
c). Anorectal abscess: An abscess that forms in or around the anus or rectum, often due to a blocked anal gland, an anal fissure, or a sexually transmitted infection. A perianal abscess is an abscess that forms on the skin around the anus. A pilonidal abscess is an abscess that forms in the crease of the buttocks, often due to ingrown hairs or friction.
2). Mouth abscesses
These are abscesses that form in the mouth, usually due to a bacterial infection of a tooth, gum, or throat. They can cause pain, swelling, difficulty swallowing, bad breath, and fever. They can also affect the surrounding tissues and bones, and may spread to the jaw, face, or neck. Some examples of mouth abscesses are:
a). Tooth abscess: An abscess that forms at the root or crown of a tooth, often due to tooth decay, injury, or gum disease. There are different types of tooth abscesses, such as: gingival abscess (gum abscess), periapical abscess (root abscess), and periodontal abscess (bone and tissue abscess).
b). Gum abscess: An abscess that forms in the gum, often due to a foreign object, such as a popcorn kernel, that gets stuck in the gum and causes irritation and infection.
c). Throat abscess: An abscess that forms in the throat, often due to a bacterial infection of the tonsils, adenoids, or pharynx. They are also called peritonsillar abscess, retropharyngeal abscess, or quinsy.
3). Internal abscesses
These are abscesses that form inside the body, usually due to a bacterial infection that spreads from another site, such as the skin, lungs, or abdomen. They can affect any organ or tissue, and may cause serious complications, such as: sepsis, organ failure, or death. They can be difficult to diagnose and treat, and may require imaging tests, such as ultrasound, CT scan, or MRI, to locate and evaluate them. They may also require surgery or other procedures, such as drainage or biopsy, to remove or sample them. Some examples of internal abscesses are:
a). Lung abscess: An abscess that forms in the lung, often due to a bacterial infection of the airways, such as: pneumonia, bronchitis, or tuberculosis. They can cause cough, chest pain, shortness of breath, and bloody sputum.
b). Brain abscess: An abscess that forms in the brain, often due to a bacterial infection that spreads from the sinuses, ears, teeth, or blood. They can cause headache, fever, confusion, seizures, and neurological deficits.
c). Abdominal abscess: An abscess that forms in the abdomen, often due to a bacterial infection that spreads from the intestines, appendix, gallbladder, pancreas, or liver. They can cause abdominal pain, nausea, vomiting, diarrhea, and weight loss.
CAUSES OF ABSCESSES
Abscesses are usually caused by bacteria, such as: Staphylococcus aureus, Streptococcus pyogenes, Escherichia coli, or Bacteroides fragilis. However, other microorganisms, such as fungi, parasites, or viruses, can also cause abscesses, especially in people with weakened immune systems or chronic diseases. Some of the factors that can increase the risk of developing abscesses are:
i). Trauma or injury to the skin or mucous membranes, such as cuts, burns, bites, or piercings, that allow bacteria to enter and infect the tissues.
ii). Poor hygiene or sanitation, such as not washing hands, not cleaning wounds, or sharing personal items, such as razors, needles, or toothbrushes, that can transmit bacteria from one person to another.
iii). Medical conditions or treatments that impair the immune system or blood clotting, such as diabetes, cancer, HIV, chemotherapy, steroids, or anticoagulants, that make it harder for the body to fight infections or stop bleeding.
iv). Foreign objects or materials that get stuck or implanted in the body, such as splinters, bullets, shrapnel, implants, or catheters, that can irritate and infect the tissues.
v). Inflammation or obstruction of the glands, ducts, or follicles, such as sweat glands, salivary glands, bile ducts, or hair follicles, that can trap bacteria and cause infection.
vi). Surgery or invasive procedures, such as abdominal surgery, dental surgery, or endoscopy, that can introduce bacteria into the body or damage the tissues.
SYMPTOMS OF ABSCESSES
The symptoms of abscesses depend on the location, size, and severity of the infection. Some of the common symptoms are:
• Pain, tenderness, and warmth in the affected area, which may increase with movement or pressure.
• Swelling, redness, and hardness in the affected area, which may form a visible lump or bump under the skin or mucous membrane.
• Pus or fluid drainage from the affected area, which may be white, yellow, green, or bloody, and may have a foul odor.
• Fever, chills, and malaise, which indicate a systemic infection or inflammation.
• Other symptoms related to the specific organ or tissue involved, such as: cough, shortness of breath, headache, confusion, abdominal pain, nausea, vomiting, diarrhea, or weight loss.
DIAGNOSIS OF ABSCESSES
The diagnosis of abscesses is based on the medical history, physical examination, and laboratory and imaging tests. Some of the diagnostic methods are:
a). Medical history: The healthcare provider will ask about the symptoms, duration, and progression of the infection, as well as any possible risk factors, such as injuries, surgeries, medical conditions, or medications.
b). Physical examination: The healthcare provider will examine the affected area and look for signs of inflammation, such as redness, warmth, swelling, and pus. The healthcare provider may also palpate or press on the affected area to feel for any lumps or fluid-filled pockets. The healthcare provider may also check the vital signs, such as temperature, pulse, blood pressure, and breathing rate, to assess the general health status.
c). Laboratory tests: The healthcare provider may order blood tests, such as complete blood count (CBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), or blood cultures, to check for signs of infection or inflammation in the blood. The healthcare provider may also take a sample of the pus or fluid from the abscess and send it to a laboratory for culture and sensitivity testing, which can identify the type and antibiotic resistance of the bacteria causing the infection.
d). Imaging tests: The healthcare provider may order imaging tests, such as ultrasound, X-ray, CT scan, or MRI, to visualize the abscess and its surrounding tissues. Imaging tests can help determine the size, shape, location, and extent of the abscess, as well as any complications, such as tissue damage, organ involvement, or infection spread.
COMPLICATIONS OF ABSCESSES
Abscesses are collections of pus that form due to an infection. They can cause serious complications if left untreated, such as:
1). Tissue death (necrosis) or gangrene, which may require amputation of the affected limb or organ. Spread of the infection to other parts of the body, such as the blood (sepsis), the heart (endocarditis), the bones (osteomyelitis), or the brain (brain abscess).
2). Recurrence of the abscess or development of multiple abscesses, which may be harder to treat and drain.
3). Damage to the surrounding tissues, organs, or structures, such as the skin, nerves, muscles, blood vessels, or teeth.
To prevent these complications, it is important to seek medical attention as soon as possible if you suspect you have an abscess or infection. Treatment usually involves draining the pus and taking antibiotics. Some abscesses may require surgery or other procedures to remove them.
TREATMENTS FOR ABSCESSES
The treatments for abscesses depend on the type, size, and severity of the infection, as well as the overall health status of the patient. Some of the treatment options are:
1). Drainage
This is the main treatment for most abscesses, as it helps to remove the pus and relieve the pressure and pain. Drainage can be done by:
a). Incision and drainage: This is a surgical procedure that involves making a small cut in the abscess and squeezing out the pus. The wound may be left open or closed with stitches, depending on the size and location of the abscess.
b). Needle aspiration: This is a procedure that involves inserting a needle into the abscess and drawing out the pus. This may be done under local or general anesthesia, depending on the size and location of the abscess.
c). Catheter drainage: This is a procedure that involves inserting a thin tube (catheter) into the abscess and leaving it in place for several days to allow the pus to drain out. This may be done under ultrasound or CT guidance, depending on the location of the abscess.
2). Antibiotics
These are medicines that kill or stop the growth of bacteria that cause the infection. Antibiotics may be given orally, intravenously, or topically, depending on the type and location of the abscess. Antibiotics may be used alone or in combination with drainage.
3). Surgery
This is a treatment option for abscesses that are large, deep, or complicated, or that do not respond to drainage or antibiotics. Surgery may involve removing the abscess and any damaged or infected tissue around it. Surgery may also be needed to repair any structures or organs that are affected by the abscess, such as the teeth, bones, or valves.
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