Abscess

An abscess is a collection of pus that has built up within the tissue of the body, usually caused by bacterial infection.

[1] Closing this cavity right after draining it rather than leaving it open may speed healing without increasing the risk of the abscess returning.

[14] The main symptoms and signs of a skin abscess are redness, heat, swelling, pain, and loss of function.

[3] Anorectal abscesses can be caused by non-specific obstruction and ensuing infection of the glandular crypts inside of the anus or rectum.

[17] An abscess is a defensive reaction of the tissue to prevent the spread of infectious materials to other parts of the body.

However, such encapsulation tends to prevent immune cells from attacking bacteria in the pus, or from reaching the causative organism or foreign object.

[30] For those with a history of intravenous drug use, an X-ray is recommended before treatment to verify that no needle fragments are present.

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

[31] Other conditions that can cause similar symptoms include: cellulitis, a sebaceous cyst, and necrotising fasciitis.

[24] The standard treatment for an uncomplicated skin or soft tissue abscess is the act of opening and draining.

[4] Antibiotics in addition to standard incision and drainage is recommended in persons with severe abscesses, many sites of infection, rapid disease progression, the presence of cellulitis, symptoms indicating bacterial illness throughout the body, or a health condition causing immunosuppression.

The Infectious Diseases Society of America advises that the draining of an abscess is not enough to address community-acquired methicillin-resistant Staphylococcus aureus (MRSA), and in those cases, traditional antibiotics may be ineffective.

[1] Alternative antibiotics effective against community-acquired MRSA often include clindamycin, doxycycline, minocycline, and trimethoprim-sulfamethoxazole.

The hypothesis is that though the heart's pumping action can deliver immune and regenerative cells to the edge of an injury, an abscess is by definition a void in which no blood vessels are present.

Packing is thought to provide a wicking action that continuously draws beneficial factors and cells from the body into the void that must be healed.

[35] Closing an abscess immediately after draining it appears to speed healing without increasing the risk of recurrence.

[12] This may not apply to anorectal abscesses as while they may heal faster, there may be a higher rate of recurrence than those left open.

This condition is estimated to occur in 2–10% of appendicitis cases and is usually treated by surgical removal of the appendix (appendicectomy).

[39] Needle exchange programmes often administer or provide referrals for abscess treatment to injection drug users as part of a harm reduction public health strategy.

[42] The word carbuncle is believed to have originated from the Latin: carbunculus, originally a small coal; diminutive of carbon-, carbo: charcoal or ember, but also a carbuncle stone, "precious stones of a red or fiery colour", usually garnets.

An abscess
A naturally drained abscess
Ultrasound showing dark (hypoechoic) area involving skin and subcutaneous tissue with moving internal debris in keeping with abscess [ 27 ]
Ultrasound image showing an abscess, appearing as a mushroom-shaped dark (hypoechoic) area within the fibroglandular tissue of the breast
Abscess five days after incision and drainage
Abscess following curettage