What is an abscess?

An abscess is a collection of pus (dead neutrophils) that has accumulated 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. splinters, bullet wounds, or injecting needles). 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 kill the local cells, resulting in the release of toxins. The toxins trigger an inflammatory response, which draws large numbers of white blood cells to the area and increases the regional blood flow.

The final structure of the abscess is an abscess wall, or capsule, that is formed by the adjacent healthy cells in an attempt to keep the pus from infecting neighboring structures. However, such encapsulation tends to prevent immune cells from attacking bacteria in the pus, or from reaching the causative organism or foreign object.

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

Symptoms

Abscesses tend to get worse as time goes on. Symptoms include tenderness or pain and the site of the abscess being warm to the touch. Symptoms of discomfort or pain depend mainly on the site of the abscess, though larger ones - since they are a source of infection within the body – can cause fever, chills, sweating, and malaise.

Abscesses close to the skin usually cause inflammation with redness, increased skin temperature and tenderness.

When to seek medical help

You have a fever of 101.5°F or higher. You have a red streak going away from the abscess or with tender lymph nodes (lumps) in an area anywhere near the abscess. The sore continues to enlarge or becomes more painful.

At-home Treatment

Abscesses may be helped by applying warm compresses to the area for about 30 minutes 4 times daily. This will sometimes promote spontaneous drainage of the abscess which is important since the primary treatment of abscesses is to drain them. Do not attempt to drain the abscess by pressing on it. This can push the infected material into the deeper tissues. Do not stick a needle or other sharp instrument into the abscess center because you may injure an underlying blood vessel or cause the infection to spread.

Medical Treatment

If the abscess does not get better from the hot compresses, seek medical help. Usually, the doctor will open and drain the abscess. The area around the abscess will be numbed. It is often difficult to completely numb the area, but in general local anesthesia can make the procedure almost painless. You may be given some type of sedative if the abscess is large.The area will be covered with an antiseptic solution and sterile towels placed around it. The doctor will cut open the abscess and totally drain it of pus and debris. Once the sore has drained, the doctor will insert some packing into the remaining cavity to minimize any bleeding and keep it open for a day or two.A bandage will then be placed over the packing, and you will be given instructions as to home care. Most people feel better immediately after the abscess is drained. Antibiotics are usually prescribed to treat a bacterial infection, antifungal drugs to treat fungi, and antiamebic drugs to treat amebiasis. However, the lining of the abscess cavity tends to reduce the amount of drug that can penetrate the source of infection from the bloodstream. Without spontaneous or surgical drainage, sometimes an abscess will be reabsorbed into the bloodstream. Incomplete reabsorbtion leaves a cystic loculation (small pouches) within a fibrous wall where calcium salts sometimes accumulate to form a calcified mass.

Use proper procedures, and stay safe.