An abscess refers to a collection of pus that has built up within the tissue of the body.


Involves the growth of bacteria in a previous sterile site, with host mechanisms unable to clear the infection.

Can be simple or complex in nature.



Signs and symptoms of abscesses include redness, pain, warmth, and swelling.



It is a defensive reaction of the tissue to prevent the spread of infectious materials to other parts of the body.



The organisms or foreign materials in tissues kills the local cells, resulting in the release of cytokines. 



Released cytokines trigger an inflammatory response, which draws large numbers of white blood cells to the area and increases the regional blood flow.



The abscess wall, or capsule, that is formed by the adjacent healthy cells in an attempt to keep the pus from infecting neighboring structures. 



The formation of then encapsulation prevents immune cells from attacking bacteria in the pus, or from reaching the causative organism or foreign object.



Carbuncles and boils are types of abscess that often involve hair follicles, with carbuncles being larger.



Frequency of about 1% per year in the United States.



Abscesses are usually caused by a bacterial infection.



Multiple different types of bacteria may be  involved in a single infection.



The most common bacteria present in abscesses is imethicillin-resistant Staphylococcus aureus.



Rarely, parasites can cause abscesses.



Diagnosis of a skin abscess is usually made clinically.



Skin abscesses are common and have become more common due intravenous drug use, with rates reported as high as 65% among users.



Ultrasound imaging can locate abscesses.



Treatment: for most skin or soft tissue abscesses opening the abscess  and drainage.



Use of antibiotics provides benefits,although there does not appear to be any benefit in most cases.



A small amount of evidence did not find a benefit from packing the abscess with gauze.



Closing this cavity right after draining it rather may speed healing without increasing the risk of the abscess returning.



Skin abscesses have become more common in recent years: intravenous drug use, with rates reported as high as 65% among users.



Abscesses may occur in any kind of tissue but most frequently within the skin surface.



On the skin, they may be superficial pustules known as boils and deep skin abscesses



Abscesses occur  in the lungs, brain, teeth, kidneys, and tonsils. 



Complications of abscesses include: 


spreading of the abscess material to adjacent or remote tissues, and tissue death.



Skin abscess symptoms and signs include: redness, heat, swelling, pain, and loss of function, and there may be feverand chills.



Superficial abscesses may be fluctuant when palpated.



Internal abscesses  is more difficult to identify.



Internal abscesses may be identified by the presence of pain in the affected area, a fever and general unwell feeling.



Internal abscesses rarely heal themselves.



An abscess can potentially be fatal process, and is dependent on where it is located.



An abscess may be caused 


by bacterial infection, parasites, or foreign substances. 



Bacterial infection is the most common cause of abscesses.



Often many types of bacteria are involved in a single infection.



The most common bacteria present is methicillin-resistant Staphylococcus aureus.



Among spinal subdural abscesses, methicillin-sensitive Staphylococcus aureus is the most common organism involved.



Parasitic organisms can cause abscesses and this is more common in the developing world.



There is no evidence that fecal incontinence is a consequence of this surgery for abscess drainage.



Perianal abscesses can be seen in patients with inflammatory bowel disease or diabetes. 



An incisional abscess is a complication secondary to a surgical incision, presenting as redness and warmth at the margins of the incision.



Abscesses may be classified as either skin abscesses or internal abscesses. 



Internal abscesses tend to be harder to diagnose, and more serious



Abscesses are differentiated from empyemas, which are accumulations of pus in a preexisting, rather than a newly formed, anatomical cavity.



Standard treatment for an uncomplicated skin or soft tissue abscess is the act of opening and draining.



In most cases  of an uncomplicated skin abscess, antibiotics are not used.



With severe skin abscesses, multiple sites of infection, rapid disease progression, the presence of cellulitis, symptoms indicating bacterial illness throughout the body, or a health condition causing immunosuppression, in the very young or very old, antibiotics may be needed.



If an abscess does not heal with incision and drainage, or is difficult to drain such as the face, hands, or genitals, then antibiotics may be indicated.



In abscesses which do require antibiotic treatment, Staphylococcus aureus bacteria is a common cause.



Antibiotic therapy alone without surgical drainage of the abscess is seldom effective: antibiotics often are unable to get into the abscess and their ineffectiveness at low pH levels.



Culturing the wound is not needed if standard follow-up care can be provided after the incision and drainage of a skin abscess.



Skin abscess wound culture is unnecessary because it rarely gives information which can be used to guide treatment.



Packing wounds after draining causes pain to the person and does not decrease the rate of recurrence, nor bring faster healing, or fewer physician visits.



Closing an abscess immediately after draining speeds healing without increasing the risk of recurrence.



Anorectal abscesses may heal faster with drainage and closure, but has a higher rate of recurrence than those left open.



Skin abscesses rarely result in death.



Brain abscesses are fatal if untreated, and is 5-10% with treatment.



Brain abscess mortality is higher if the abscess ruptures.



Abscesses can occur in any tissue in the body.







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