Abscess

Question 1

Define

Answer 1

A painful collection of pus, usually caused by bacterial infection.

Question 2

What’s the aetiology?

Answer 2

hey can develop anywhere in the body

There are TWO main types of abscess:

Skin abscess

Internal abscess

Bacterial infection leads to activation of an immune response and recruitment of neutrophils to the site of infection

As the white cells attack the bacteria, surrounding tissue is damaged creating a cavity which fills with pus to form an abscess

Pus = mixture of dead tissue + white cells + bacteria

Question 3

Epidemiology?

Answer 3

Skin abscesses are relatively common

IV drug use is a major risk factor for skin abscesses

Internal abscesses are less common

Question 4

What are the presenting symptoms?

Answer 4

Swollen, pus-filled lump under the surface of the skin with associated fever and chills

Internal abscesses are not visible but are characterised by:

Pain in the affected area (or referred pain)

Swinging fevers

Malaise

Question 5

What’s the appropriate investigation?

Answer 5

Ultrasound

Question 6

What’s the management plan?

Answer 6

Some small skin abscesses may disappear by themselves

Incision and Drainage

Before doing this, check to see whether a foreign object is causing the abscess (e.g. needle fragments in IV drug users)

The abscess is cut open and drained of pus

Antibiotics

Can be used alongside incision and drainage

Question 7

Possible complications and prognosis?

Answer 7

Recurrence and prognosis is good with treatment