SKINIPEDIA - Skin Diseases & Conditions: Abscess

Skin Diseases and Conditions: Abscess

An abscess is an infection characterized by a collection of pus underneath a portion of the skin. Bacteria commonly causing abscesses are Staphylococcus aureus and Streptococcus. These bacteria enter the skin through any cracks or injury to the skin. That area of skin then becomes red, tender, warm, and swollen over days to 1–2 weeks and a fever may develop. Abscesses can sometimes form if minor superficial skin infections are not treated appropriately and in a timely fashion. Most abscesses resolve quickly once appropriately treated.

Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is a strain of "staph" bacteria resistant to antibiotics in the penicillin family, which have been the cornerstone of antibiotic therapy for staph and skin infections for decades. CA-MRSA previously infected only small segments of the population, such as health care workers and persons using injection drugs. However, CA-MRSA is now a common cause of skin infections in the general population.

While CA-MRSA bacteria are resistant to penicillin and penicillin-related antibiotics, most staph infections with CA-MRSA can be easily treated by health care practitioners using local skin care and commonly available non-penicillin-family antibiotics. Rarely, CA-MRSA can cause serious skin and soft tissue (deeper) infections. Staph infections typically start as small red bumps or pus-filled bumps, which can rapidly turn into deep, painful sores. If you see a red bump or pus-filled bump on the skin that is worsening or showing any signs of infection (ie, the area becomes increasingly painful, red, or swollen), see your doctor right away. Many patients believe incorrectly that these bumps are the result of a spider bite when they arrive at the doctor's office. Your doctor may need to test (culture) infected skin for MRSA before starting antibiotics. If you have a skin problem that resembles a CA-MRSA infection or a culture that is positive for MRSA, your doctor may need to provide local skin care and prescribe oral antibiotics. To prevent spread of infection to others, infected wounds, hands, and other exposed body areas should be kept clean and wounds should be covered during therapy.

Causes and Risk Factors of Abscess

Abscesses can be caused by minor breaks and punctures of the skin, obstruction of sweat glands and oil (sebaceous) glands, and inflammation of hair follicles. They contain dead cells, bacteria, and other debris, which causes inflammation and pain. Common bacteria, such as staphylococci, are the most common cause, although the bacillus responsible for tuberculosis is an important abscess-forming type.

Fungal infections sometimes cause abscesses, while amoebae (single-celled protozoal parasites) are an important cause of liver abscesses.

The infection usually reaches an organ via the bloodstream or penetrates tissues under the skin via an infected wound or bite.

People with weakened immune systems may be more prone to abscesses or may have more severe ones.

Symptoms of Abscess

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.

Tuberculous abscesses are the exception; hence their introduction as cold abscesses.

Call your doctor if you have a high fever, or if the abscess is larger than � inch across, is near your rectal area or groin, or if red streaks are radiating out from the abscess.

Diagnosis of Abscess

An abscess is diagnosed clinically by means of the history and a physical exam, demonstrating a tender mass with overlying erythema (redness).

Treatment of Abscess

Small abscesses may be helped by applying warm compresses to the area several times a day. This will sometimes promote spontaneous drainage of the abscess which is important since the primary treatment of abscesses is to drain them. However, it is also important to not attempt to drain an abscess yourself. This can lead to trauma of the surrounding tissue and potentially help spread the underlying infection.

Draining the abscess is done by making a cut in the lining and providing an escape route for the pus, either through a drainage tube or by leaving the cavity open to the skin. The area around the abscess will be numbed before draining. Most people feel immediately better after the draining.

Many abscesses subside after drainage alone; others subside after drainage and drug treatment. Occasionally, their presence within a vital organ, such as the liver or brain, damages enough surrounding tissue to cause some permanent loss of normal function.

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.

Questions To Ask Your Doctor About Abscess

- What medications are taken to relieve the pain?
- How long before the pain subsides?
- Will the abscess have to be drained?
- Will the abscess reoccur?
- What caused them to occur?
- Could this be Pilonidal Disease?

Abscess Video

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