Abscess Flashcards
A young patient has pain, tenderness, redness and all features of a thigh abscess.
A young patient has pain, tenderness, redness and all features of a thigh abscess.
Q1. Define abscess.
An abscess is a localised tissue collection of pus. If pus forms in the pleural space or peritoneum it may be loculated and so considered to be an abscess (such as an appendix abscess or subdiaphragmatic abscess) or lie free and be an empyema or purulent generalised peritonitis.
Q. Define Pus
Pus is the product of acute inflammation composed of cellular and fluid, exudative phases. When the cause of pus formation is infective, the solid phase consists of:
· Live and dead polymorphs
· Live and dead macrophages
· Live and dead bacteria or other causative agent
· Dead human epithelial and connective tissue cells from the tissues involved in the acute inflammation
· A fibrin meshwork on which macrophages function much better
Q2. How does it differ from cellulitis?
Cellulitits; Diffuse and not well demarcated, no presence of pus
Abcess; localized, there’s pus
Q3. What are the constituents of pus?
Solid; live and dead bacteria and neutrophils and fibrin mesh
Liquid; cytokines, chemotacticans, exudatives
Q4. How do you know which organism is the cause without any test?
From the color
green; pseudomonus
Silver; actinomycosis
Q5: What are the causes of abscess?
Infection by bacteria / virus / fungi
Q6. What arc the causes of non-bacterial abscess?
Virus/ Fungi
Q7. How do you treat abscess?
I&D
Abx coverage
Q8. What’s the rationale of giving antibiotic in abscess?
Several recent trials have indicated benefits of abx therapy in abcess
Abx decrease the liklyhood of ttt failure and improve the outcome
decrease recurrence and mild adverse events
Timing; After obtaining culture.
Q9. Which stain is used to identify the causative organism?
Gram stain
Q10. How does abscess cause fever?
Inflammatory reaction
TNF and IL-1 / IL-6 which are pyrectics
Q. when to give Abx in abcess?
1- syst. Signs of toxicity like fever
2- Rapid progression of erythema or abcess
3- Extensive abcess
4- immunocompromised and old age
