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Abscess
An abscess is a collection of pus collected in a cavity formed by
the tissue on the basis of an infectious process (usually caused by
bacteria or parasites) or other foreign materials (e.g. bullet
wounds). It is a defensive reaction of the tissue to prevent the
spread of infectious materials to the other parts of the body.
Causes
The organisms or foreign materials that gain access to a part of
tissue kill the local cells, release toxins and trigger an
inflammatory response by drawing huge amounts of white blood cells to
the area and increasing the regional blood flow. So, pus is a
collection of local dead tissue cells, white blood cells, infecting
organisms or foreign material and toxins released by both organisms
and blood cells. The final structure of the abscess is an abscess wall
that is formed by the adjacent healthy cells in an attempt to build a
barrier around the pus that limits the infected material from
neighboring structures.
Symptoms
The cardinal symptoms and signs of any kind of inflammatory process
are redness, heat, swelling and pain. Abscesses may occur in any kind
of solid tissue but most frequently on skin surface (where they may be
superficial pustules or deep skin abscesses), in the lungs, brain,
kidneys and tonsils. Major complications are spreading of the abscess
material to adjacent or remote tissues and extensive regional tissue
death (gangrene). Abscesses in most parts of the body rarely heal
themselves, so prompt medical attention is indicated at the first
suspicion of an abscess.
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Treatment
The treatment of first choice is the surgical drainage of the
abscess. It is important to note that antibiotic therapy alone without
surgical drainage of the abscess is seldom effective. However, in
critical areas where surgery presents a high risk (such as the brain),
surgery may be delayed or used as a last resort. The drainage of the
lung abscess may be performed by giving the patient a certain position
that enables the contents to be discharged via the respiratory tract.
After surgical drainage, antibiotics are usually used to control the
infection. Warm compresses and elevation of the limb may be beneficial
for skin abscess.
Perianal abscesses are seen in patients with inflammatory bowel
disease, Crohn's disease, or diabetes. Often the abscess will start as
an internal wound caused by ulceration or hard stool. 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 the passage of time.
A sterile abscess is a medical condition caused by injecting large
amounts of material. It is most often relatively minor.
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