Abscess

Question 1

Definition

Answer 1

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

Question 2

Aetiology

Answer 2

• They can develop anywhere in the body
• 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

Two main types

Answer 3

o Skin abscess

o Internal abscess

Question 4

Epidemiology

Answer 4

• Skin abscesses are relatively common
• IV drug use is a major risk factor for skin abscesses
• Internal abscesses are less common

Question 5

Presenting symptoms/signs on physical examination

Answer 5

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

• Internal abscesses are not visible but are characterised by:
o Pain in the affected area (or referred pain)
o Swinging fevers
o Malaise

Question 6

Investigations

Answer 6

Ultrasound - can be useful in visualising an abscess

Question 7

Management plan

Answer 7

• Some small skin abscesses may disappear by themselves

• Incision and Drainage
o Before doing this, check to see whether a foreign object is causing the abscess (e.g. needle fragments in IV drug users)
o The abscess is cut open and drained of pus

• Antibiotics
o Can be used alongside incision and drainage

Question 8

Possible complications

Answer 8

Recurrence

Question 9

Prognosis

Answer 9

GOOD with treatment