What is an Abscess?
An abscess is a collection of pus which can occur in tissues, organs or confined spaces in the body. Abscesses may lie superficially, like a boil just underneath the skin or deep within the body like a lung abscess. In most cases, an abscess is caused by bacteria and is the body’s mechanism to wall off the site of infection. Although an abscess can resolve spontaneously it often needs to be treated medically and surgically. Failure to do so could lead to serious complications depending on the site where the abscess is located.
The body’s immune system quickly responds to an infection at any site. Some immune cells that are present at the location start fighting off the infection at the site while large numbers of immune cells travel via the bloodstream to site of the infection. These immune cells then destroy the bacteria and become walled off between the layers of tissue. Connective tissue further contributes to this walling off process. Pus then accumulates at the site with inflammation extending to the surrounding tissues. The pus within the abscess is composed of leukocytes (white blood cells), dead and decomposing cells and the causative microorganism.
Although any person can develop an abscess especially when the skin is broken or microbes enter the tissue through some other means, it tends to arise more frequently in a person with weakened immune systems. This can include conditions such as :
- Diabetes mellitus (poorly managed cases)
- Cancer and patients on chemotherapy
- Injury that is extensive and severe like with burns
- Immune-suppressing drugs like corticosteroids
- Eating disorders
Picture from Wikimedia Commons
An abscess can occur at just about any site in the body affecting superficial or deep tissue. The symptoms may vary slightly in these cases. Superficial abscess may be visible as a raised area under the skin with overlying redness, heat, pain or tenderness. Deeper lying abscess are not visible by surface symptoms but is more likely to present with :
- Pain at the site
- Malaise – feeling uneasy or unwell
Apart from these symptoms there may be no other indication of an abscess unless its starts to compress vital structures around it or it ruptures thereby allowing any living microbes to reach other sites. It can further complicate to cause bleeding by damaging surrounding blood vessels or even lead to septicemia which can be life threatening.
The symptoms also depend to some degree on the location of the abscess. Read more on :
- Abdominal abscess
- Appendicular abscess (in the appendix)
- Brain abscess
- Liver abscess
- Lung abscess
Abscess Drainage and Treatment
An abscess may not heal unless it is drained, either by incision and drainage or fine needle aspiration. Antibiotics and anti-inflammatory drugs may be necessary to reduce pain and swelling, resolve the existing infection and prevent a recurrence of the infection. In some cases, an abscess may resolve spontaneously without drainage or treatment. This is usually slow and the pus is gradually broken down into a thin sterile fluid. This is then reabsorbed into the bloodstream. Abscess drainage must only be done by a medical professional as a rupture and incorrect post-drainage procedure and management can be dangerous.