abscess
(ab′ses )
[L. abscessus, a going away, departure]
A localized collection of pus in any body part, resulting from invasion of a pyogenic bacterium or other pathogen. Staphylococcus aureus, e.g., methicillin-resistant S. aureus (MRSA), is a common cause. The abscess is surrounded by a membrane of variable strength created by macrophages, fibrin, and granulation tissue. Abscesses can disrupt function in adjacent tissues and can be life threatening in some circumstances, e.g., in the lung or within the peritoneal cavity.
ANTECUBITAL ABSCESS Antecubital abscess opened to allow drainage of infection; SEE: inflammation; SEE: pus; SEE: suppuration
INTRA-ABDOMINAL ABSCESS CT scan shows abscess between stomach and spleen (Courtesy of Harvey Hatch, MD, Curry General Hospital)
acute abscess
An abscess associated with significant inflammation, producing intense heat, redness, swelling, and throbbing pain. The tissue over the abscess becomes elevated, soft, and eventually unstable (fluctuant) and discolored as the abscess comes to a head. An abscess can rupture spontaneously or be drained via an incision. If it is left untreated, the invading pathogens may spread to adjacent tissues or to other parts of the body through the bloodstream. Appearance of or increase in fever may indicate sepsis.
ACUTE ABSCESS Acute abscess of the skin with surrounding cellulitis
alveolar abscess
An abscess around the root of a tooth in the alveolar cavity. It is usually the result of necrosis and infection of dental pulp following the occurrence of dental caries.
SEE: periapical abscess
amebic abscess
An abscess, typically in the liver, caused by Entamoeba histolytica.
SYN: SEE: endamebic abscess
anorectal abscess
An abscess in the ischiorectal fossa. It occurs in patients with Crohn disease, diabetes mellitus, or anal fissures more often than in others. Incision, drainage, and antibiotics usually provide effective treatment.
SYN: SEE: rectal abscess ;
SYN: SEE: ischiorectal abscess
apical abscess
1. An abscess at the apex of a lung. SEE: 2. Periapical abscess.
appendicular abscess
An abscess around an inflamed or ruptured vermiform appendix.
axillary abscess
An abscess or multiple abscesses in the axilla, e.g., in patients with hidradenitis suppurativa.
Bartholin abscess
Bezold abscess
SEE: Bezold, Friedrich
bicameral abscess
An abscess with two pockets.
bile duct abscess
An abscess of the bile duct.
SYN: SEE: cholangitic abscess
biliary abscess
An abscess of the gallbladder. It is an infrequent complication of cholangitis or obstruction of the bile duct.
bone abscess
SEE: Brodie abscess.
brain abscess
An intracranial abscess involving the brain or its membranes. It is seldom primary but usually occurs secondary to infections of the middle ear, nasal sinuses, face, or skull or from contamination from penetrating wounds or skull fractures. It may also have a metastatic origin arising from septic foci in the lungs (as in bronchiectasis, empyema, lung abscess), in bone (as in osteomyelitis), or in the heart (as in endocarditis). Infection of nerve tissue by the invading organism results in necrosis and liquefaction of the tissue, with edema of surrounding tissues. Brain abscesses may be acute, subacute, or chronic. Their clinical manifestations depend on the part of the brain involved, the size of the abscess, the virulence of the infecting organism, and other factors.
SYN: SEE: cerebral abscess; SEE: intracranial abscess
SYMPTOMS AND SIGNS
Symptoms may include headache, fever, vomiting, malaise, irritability, seizures, or paralysis.
TREATMENT
Antibiotic therapy is the mainstay of treatment. Surgical drainage may sometimes be required.
breast abscess
SEE: Mammary abscess.
Brodie abscess
bursal abscess
An abscess in a bursa.
canalicular abscess
A breast abscess that discharges into the milk ducts.
caseous abscess
An abscess in which the pus has a cheesy appearance.
cerebral abscess
SEE: Brain abscess.
cholangitic abscess
SEE: Biliary abscess.
chronic abscess
An abscess containing pus but without signs of inflammation. It usually develops slowly as a result of liquefaction of tuberculous tissue. It may occur anywhere in or on the body but more frequently is found in the spine, hips, genitourinary tract, and lymph glands. Symptoms may be very mild. Pain, when present, is caused by pressure on surrounding parts; tenderness is often absent. Chronic septic changes accompanied by afternoon fever may occur. Amyloid disease may develop if the abscess persists for a prolonged period.
SYN: SEE: cold abscess
circumtonsillar abscess
cold abscess
SEE: Chronic abscess.
collar-button abscesses
Two pus-containing cavities, one larger than the other, connected by a narrow channel.
dental abscess
An acute inflammatory infection within the maxilla or mandible.
SEE: periapical abscess ; SEE: periodontal abscess
dentoalveolar abscess
SEE: Periapical abscess.
diffuse abscess
An abscess not circumscribed by a well-defined capsule.
dry abscess
An abscess that disappears without pointing or breaking.
embolic abscess
SEE: Metastatic abscess.
emphysematous abscess
An abscess containing air or gas, produced by organisms such as Clostridium perfringens.
SYN: SEE: gas abscess; SEE: tympanitic abscess
endamebic abscess
SEE: Amebic abscess.
epidural abscess
SEE: Extradural abscess.
extradural abscess
An abscess on the dura mater that is an occasional cause of back pain in febrile patients, usually in those who inject drugs.
SYN: SEE: epidural abscess
fecal abscess
An abscess containing both pus and stool.
SYN: SEE: stercoraceous abscess; SEE: stercoral abscess
filarial abscess
An abscess caused by parasitic infection with microfilariae.
follicular abscess
An abscess in a follicle.
fungal abscess
An abscess caused by a fungus, as in the syndrome mycetoma.
SYN: SEE: mycotic abscess
gas abscess
gingival abscess
An abscess of the gum.
helminthic abscess
SEE: Worm abscess.
hemorrhagic abscess
An abscess containing blood.
hepatic abscess
SEE: Liver abscess.
hot abscess
SEE: Acute abscess.
hypostatic abscess
SEE: Metastatic abscess.
idiopathic abscess
An abscess of unknown cause.
iliac abscess
An abscess in the iliac region.
iliopsoas abscess
An abscess in the psoas and iliacus muscles. It typically results from a local or regional spread of an intestinal or renal abscess or from a blood-borne infection, e.g., after a drug injection.
SYN: SEE: psoas abscess
intracranial abscess
SEE: Brain abscess.
intradural abscess
An abscess within the layers of the dura mater.
intraperitoneal abscess
SEE: Peritoneal abscess.
ischiorectal abscess
SEE: Anorectal abscess.
kidney abscess
An abscess in the kidney, typically following pyelonephritis or a blood-borne infection. The most common causative organisms are gram-negative bacteria from the lower urinary tract that spread to the kidneys and Staphylococcus aureus from a blood-borne infection. Immunocompromised patients may develop abscesses caused by Nocardia, Candida, or Aspergillus. Occasionally, Mycobacterium tuberculosis and Echinococcus are responsible agents.
SYN: SEE: renal
TREATMENT
Antimicrobial agents are used in combination with surgical drainage. Occasionally, nephrectomy or retroperitoneal exploration is required.
lacrimal abscess
An abscess in a lacrimal gland or in a lacrimal duct.
lateral alveolar abscess
An abscess occurring in periodontal tissue.
liver abscess
An abscess in the liver caused by pathogenic organisms such as those of species of Bacteroides, Streptococcus, Staphylococcus, or Entamoeba histolytica.
SYMPTOMS AND SIGNS
The patient generally has high fevers; sweats and chills; and an enlarged, painful, tender liver. Pus may be obtained by aspiration.
IMPACT ON HEALTH
Embolic (multiple) abscesses are generally fatal. Liver abscesses may heal after they have been drained and treated with antibiotics.
SEE: hepatic abscess
lumbar abscess
An abscess in the lumbar region.
lung abscess
An abscess in lung tissue, caused by anaerobic bacteria such as Staphylococcus aureus or Nocardia species.
lymphatic abscess
An abscess of a lymph node.
mammary abscess
An abscess in the female breast, esp. one involving the glandular tissue. It usually occurs during lactation or weaning.
SYN: SEE: breast abscess
mastoid abscess
An abscess of the mastoid portion of the temporal bone.
metastatic abscess
A secondary abscess at a distance from the focus of infection.
SYN: SEE: embolic abscess; SEE: hypostatic abscess; SEE: wandering abscess
miliary abscesses
Multiple small embolic abscesses.
milk abscess
A mammary abscess during lactation.
mycotic abscess
SEE: Fungal abscess.
nocardial abscess
An abscess caused by the genus Nocardia, e.g., in the lung.
orbital abscess
An abscess in the orbit of the eye.
palatal abscess
An abscess in a maxillary tooth, erupting toward the palate.
palmar abscess
An abscess in the tissues of the palm of the hand.
pancreatic abscess
An abscess of pancreatic tissue, usually as a complication of acute pancreatitis or abdominal surgery.
parafrenal abscess
An abscess on the side of the frenulum of the penis.
parametric abscess
An abscess between the folds of the broad ligaments of the uterus.
paranephric abscess
An abscess in the tissues around the kidney.
SYN: SEE: perinephric abscess
parapancreatic abscess
An abscess in the tissues adjacent to the pancreas.
SYN: SEE: peripancreatic abscess
parietal abscess
A periodontal abscess arising in the periodontal tissue other than the orifice through which the vascular supply enters the dental pulp.
parotid abscess
An abscess of the parotid gland.
pelvic abscess
An abscess of the pelvic peritoneum, esp. in the pouch of Douglas. It may arise as a complication of a sexually transmitted disease or diverticulitis.
perianal abscess
An abscess of the skin around the anus. It usually results from obstruction of intestinal crypts and subsequent fistula formation in the skin.
SYN: SEE: periproctic abscess
periapical abscess
An abscess at the apex of a tooth, usually resulting from dental caries or tooth trauma. It may be classified further as an acute periapical abscess, a chronic periapical abscess, a periapical granuloma, or a radicular cyst.
SYN: SEE: apical abscess (2); SEE: dentoalveolar abscess
pericemental abscess
An alveolar abscess not involving the apex of a tooth.
pericoronal abscess
SEE: Pericoronitis.
peridental abscess
An abscess of periodontal tissue.
perinephric abscess
SEE: Paranephric abscess.
periodontal abscess
An acute or chronic abscess found in the gingiva, periodontal pockets, or periodontal ligament.
peripancreatic abscess
peripleuritic abscess
An abscess in the tissue surrounding the parietal pleura.
periproctic abscess
SEE: Perianal abscess.
peritoneal abscess
An abscess within the peritoneal cavity usually following peritonitis. It is usually caused by enteric bacteria, e.g., Escherichia coli, enterococci, or Klebsiella.
SYN: SEE: intraperitoneal abscess
peritonsillar abscess
An abscess of the tissue around the tonsillar capsule. Needle aspiration of the abscess, with subsequent antibiotic therapy, is an effective treatment in 90% of cases.
SYN: SEE: circumtonsillar abscess
periureteral abscess
An abscess in the tissue around a ureter.
periurethral abscess
An abscess in tissue surrounding the urethra.
perivesical abscess
An abscess in tissue around the urinary bladder.
abscess, pneumococcal
An abscess due to infection with pneumococci (Streptococcus pneumoniae).
prelacrimal abscess
An abscess of the lacrimal sac, producing an inflamed, tender swelling at the inner canthus of the eye.
premammary abscess
A subcutaneous or subareolar abscess of the mammary gland.
prostatic abscess
An abscess within the prostate gland.
protozoal abscess
An abscess caused by a protozoon.
psoas abscess
SEE: Iliopsoas abscess.
pulp abscess
1. An abscess in the pulp chamber of a tooth.
2. An abscess of the tissues of the pulp of a finger.
pyemic abscess
A metastatic abscess, usually multiple, caused bypyogenic organisms.
rectal abscess
SEE: Anorectal abscess.
renal abscess
SEE: Kidney abscess.
retrocecal abscess
An abscess located behind the cecum. It is an occasional, severe complication of a ruptured appendix or Crohn disease.
retromammary abscess
An abscess between the mammary gland and the chest wall.
retroperitoneal abscess
An abscess located between the peritoneum and the posterior abdominal wall. It may arise from an abscess in the kidney or from the spread of an intraperitoneal infection posteriorly.
retropharyngeal abscess
An abscess of the lymph nodes in the walls of the pharynx. It sometimes simulates diphtheritic pharyngitis.
CAUSES
Staphylococcus aureus and group A beta-hemolytic streptococcus are the most common pathogens.
SYMPTOMS AND SIGNS
Typically, a history of pharyngitis is elicited. This is followed by high fever, dysphagia, and refusal to eat. The condition progresses to respiratory distress with hyperextension of the head (“sniffing position”), tachypnea, labored breathing, and drooling. An exquisitely tender bulge in the pharyngeal wall is usually evident.
TREATMENT
A retropharyngeal abscess, if fluctuant, should be treated with incision and drainage. If it is recognized before becoming fluctuant, the abscess should be treated with antibiotics, intravenously administered if the patient is unable to swallow.
retrovesical abscess
An abscess behind the bladder.
root abscess
A colloquial and veterinary term for periapical abscess.
runaround abscess
A colloquial term for a bacterial infection that surrounds a fingernail; a paronychia.
sacrococcygeal abscess
An abscess over the sacrum and coccyx.
septicemic abscess
An abscess resulting from septicemia.
spermatic abscess
An abscess of the seminiferous tubules.
spinal abscess
An abscess resulting from necrosis of a vertebra.
splenic abscess
An abscess of the spleen. It may arise either from the spread of infection from a neighboring organ (such as a diverticular abscess or a ruptured gastric ulcer) or from hematogenous spread in patients with infective endocarditis.
stercoraceous abscess
SEE: Fecal abscess
stercoral abscess
SEE: Fecal abscess.
sterile abscess
An abscess from which microorganisms cannot be cultivated, such as an occasional complication of an intramuscular injection.
stitch abscess
An abscess formed around a stitch or suture.
streptococcal abscess
An abscess caused by streptococci.
subaponeurotic abscess
An abscess beneath an aponeurosis or fascia.
subarachnoid abscess
An abscess of the midlayer of the covering of the brain and spinal cord.
subareolar abscess
An abscess underneath the areola of the mammary gland, sometimes draining through the nipple.
subdiaphragmatic abscess
An abscess beneath the diaphragm, e.g., a hepatic, splenic, or interperitoneal abscess.
SYN: SEE: subphrenic abscess
subdural abscess
An abscess beneath the dura of the brain or spinal cord.
subfascial abscess
An abscess beneath the fascia.
subgaleal abscess
An abscess beneath the galea aponeurotica (the epicranial aponeurosis).
subpectoral abscess
An abscess beneath the pectoral muscles.
subperiosteal abscess
A bone abscess below the periosteum.
subperitoneal abscess
An abscess between the parietal peritoneum and the abdominal wall.
subphrenic abscess
subscapular abscess
An abscess between the serratus anterior muscle and the posterior thoracic wall.
subungual abscess
An abscess beneath the fingernail. It may follow injury from a pin, needle, or splinter.
sudoriparous abscess
An abscess of a sweat gland.
suprahepatic abscess
An abscess in the suspensory ligament between the liver and the diaphragm.
syphilitic abscess
An abscess occurring in the tertiary stage of syphilis, esp. in bone.
thecal abscess
A spinal epidural abscess.
thymus abscess
An abscess of the thymus.
tonsillar abscess
Acute suppurative tonsillitis.
tooth abscess
SEE: Alveolar abscess.
tropical abscess
An amebic abscess of the liver.
tuberculous abscess
SEE: Chronic abscess.
tubo-ovarian abscess
An abscess involving both the fallopian tubes and the ovaries. It is typically transmitted sexually.
tympanitic abscess
tympanocervical abscess
An abscess arising in the tympanum and extending to the neck.
tympanomastoid abscess
An abscess of both the tympanum and the mastoid.
urethral abscess
An abscess in the urethra.
urinary abscess
An abscess caused by escape of urine into surrounding tissues.
urinous abscess
An abscess that contains pus and urine.
verminous abscess
SEE: Worm abscess.
wandering abscess
SEE: Metastatic abscess.
warm abscess
SEE: Acute abscess.
worm abscess
An abscess caused by or containing insect larvae, worms, or other animal parasites.
SYN: SEE: helminthic; SEE: verminous abscess