A case of primary psoas abscess presenting as buttock abscess

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Pilonidal sinus – NHS

A pilonidal sinus is a small hole or tunnel in the skin at the top of the buttocks, where they divide (the cleft). It does not always cause symptoms and only needs to be treated if it becomes infected.

Check if you have an infected pilonidal sinus

Most people with a pilonidal sinus do not notice it unless it becomes infected and causes symptoms.

An infection will cause pain and swelling, and a pus-filled skin abscess can develop.

See what an infected pilonidal sinus looks like

An infected pilonidal sinus is red, painful and may bleed or leak pus

Credit:

GIRAND/SCIENCE PHOTO LIBRARY https://www.sciencephoto.com/media/127112/view

Non-urgent advice: See a GP if:

• you have a small lump at the top of your bottom (between your buttocks) that’s painful, red, bleeding or leaking pus

These symptoms can develop quickly, often over a few days. They’re signs of infection and need to be treated.

A pilonidal sinus that’s not infected

Treatment is not needed if there are no signs of infection. A “watch and wait” approach will be recommended.

It’s very important to keep the area between your buttocks clean by showering or bathing regularly.

Do not shave the affected area unless a GP advises you to.

Treatments for an infected pilonidal sinus

Treatment for an infected pilonidal sinus will depend on:

• your symptoms
• the size of the sinus
• whether it’s your first sinus or it keeps coming back

A pilonidal sinus abscess will need treatment with antibiotics. The pus inside will also probably need to be drained.

There are a number of treatment options for a pilonidal sinus that keeps coming back and that’s painful, bleeding or leaking discharge. Your doctor will discuss these with you.

In most cases you’ll be offered painkillers, such as paracetamol and anti-inflammatories to help reduce pain and swelling.

Minor operation to drain pus from sinus

Incision and drainage

Hospital procedure for an uncomplicated abscess. A small hole is made in the abscess so the pus can be drained.

• general anaesthetic or local anaesthetic, depending on the size of the abscess
• hospital stay (you can leave the same day)
• regular (daily) dressing changes
• recovery time is 4 to 6 weeks

Surgery to remove sinus (wound left open)

Wide excision and open healing

Surgery for a large or repeatedly infected sinus. The sinus is cut out and some surrounding skin removed. The wound is left open to heal naturally.

• general anaesthetic
• hospital stay (you can usually leave the same day)
• regular (daily) dressing changes
• lowest risk of sinus coming back
• recovery time is 6 to 12 weeks

Surgery to remove sinus (wound closed)

Excision and wound closure, often with flattening of the groove between the buttocks

Surgery for a large or repeatedly infected sinus. The sinus is removed and an oval-shaped flap of skin cut out on either side of it. The 2 sides are stitched together.

• general anaesthetic
• hospital stay (you can usually leave the same day)
• stitches removed about 10 days after the operation
• quicker recovery time than wide excision and open healing
• higher risk of infection (the wound may need to be opened and dressings changed regularly)

Procedure to clean sinus and encourage healing

Endoscopic ablation for a pilonidal sinus

An endoscope (a thin, flexible tube with a camera on the end) is used to give a clear view of the affected area.

Hair and infected tissue are removed, and the sinus cleaned with a special solution. Heat is used to seal the sinus.

• spinal or local anaesthetic
• hospital stay (you can usually leave the same day)
• less invasive than surgery as no cut needed
• good success rate with low risk of complications
• recovery time is about a month to completely heal (but can be quicker)

Plastic surgery is sometimes used if the area being treated is particularly large. The sinus is removed and the surrounding skin reconstructed.

Less invasive procedures, like injection with fibrin glue, are also available in some places.

Follow-up

You’ll have a follow-up appointment with your specialist after your surgery. This is usually about 6 weeks later, but may be slightly longer.

What to do after your operation

Do

• keep the affected area clean

• wear comfortable, loose-fitting cotton underwear

• eat plenty of fibre to make going to the toilet easier and avoid straining

Don’t

• do not lift heavy objects or do strenuous exercise for the first week or so

• do not ride a bike for 6 to 8 weeks

• do not go swimming until your wound has completely healed

How soon you can return to work depends on:

• the procedure you had
• how quickly you recover
• the type of job you do

Most people are able to return to work within 2 weeks of surgery.

Your surgeon will be able to give you more advice about your recovery.

Causes of pilonidal sinus

It’s not clear what causes a pilonidal sinus.

A skin problem, pressure or friction may cause hair between the buttocks to be pushed inwards.

This may either be hair growing around the buttock area, or loose hair shed from the buttocks or elsewhere that gathers around the buttock cleft and enters the pilonidal sinus.

Pilonidal sinuses are more common in men because they tend to be hairier.

Sitting for long periods can also increase your chances of getting a pilonidal sinus.

Page last reviewed: 11 December 2020
Next review due: 11 December 2023

causes, symptoms and treatments

Contents

• 1 Abscess of the buttocks: causes, symptoms and treatment after an injection
  • 1. 1 Abscess of the buttocks after an injection
  • 1.2 Abscess of the buttocks: basic information
    9000 5 1.2.1 What is a buttock abscess?
  • 1.3 Causes of an abscess of the buttocks
  • 1.4 What symptoms accompany an abscess of the buttocks?
  • 1.5 Diagnosis of buttock abscess: what does the doctor say?
  • 1.6 Complications of buttock abscess
  • 1.7 Treatment of buttock abscess
  • 1.8 How to avoid buttock abscess?
  • 1.9 Preparations for the treatment of buttock abscess
  • 1.10 What procedures can help in the treatment of buttock abscess?
    • 1.10.1 Conservative treatment:
  • 1.11 How to treat buttock abscess without medication?
  • 1.12 Diet for buttock abscess
  • 1.13 What is the recovery time after buttock abscess treatment?
  • 1.14 Abscess of the buttocks: traditional methods of treatment
  • 1.15 Exercises to help with buttock abscess
    • 1. 15.1 Possible HTML markup
  • 1.16 When should I see a doctor if I suspect a buttock abscess?
  • 1.17 Which specialist should I contact if I suspect a buttock abscess?
  • 1.18 Q&A:
    • • 1.18.0.1 What are the main causes of buttock abscess after an injection?
      • 1.18.0.2 What symptoms accompany the development of an abscess of the buttocks after an injection?
      • 1.18.0.3 What diagnostic methods are used to determine the buttock abscess after an injection?
      • 1.18.0.4 What methods of treatment are used for the development of an abscess of the buttocks after an injection?
      • 1.18.0.5 What are the advantages of local buttock abscess trepanation after injection before surgery?
      • 1.18.0.6 Is it possible to treat an abscess of the buttocks after an injection at home, without medical intervention?
      • 1.18.0.7 What are the possible complications in the absence of timely treatment of an abscess of the buttocks after an injection?
      • 1. 18.0.8 How can an abscess of the buttocks be prevented after an injection?
  • 1.19 What is the prognosis for buttock abscess?
  • 1.20 Related videos:

Buttock abscess is a dangerous complication after an injection, which manifests itself in the form of severe pain, swelling and redness of the skin. In the article, you will learn how to prevent the development of an abscess and how to treat an existing ailment.

Getting an injection is a common medical procedure, but it can lead to various complications, including buttock abscess. This is a serious disease that can lead to tissue destruction and spread of the infection to other parts of the body. Therefore, it is important to know the causes, symptoms, and treatments for a buttock abscess after an injection.

Abscess of the buttock is a pathological formation that develops as a result of infection after the insertion of a needle into deep tissue. Violation of the rules of asepsis and antiseptics during medical procedures, for example, with intramuscular administration of drugs, is the most common cause of the development of an abscess of the buttocks.

Buttock abscess symptoms may appear a few days after the procedure, when swelling, redness and pain appear in the injection area. Sometimes there may be an increased body temperature and local symptoms of intoxication, such as headache, nausea and weakness.

In the event of suspicious symptoms, medical attention should be sought immediately. Diagnosis of a buttock abscess includes a visual examination, blood tests, and an ultrasound. Treatment for a buttock abscess depends on the extent of the infection and may include an abscessectomy, antibiotics, and other measures.

In general, it is important to follow the rules of aseptic and antiseptic procedures in order to avoid the development of an abscess of the buttocks and other complications after the injection. If symptoms occur, do not hesitate to contact specialists to get qualified help.

Injection buttock abscess

Injection buttock abscess is a serious complication that can occur to anyone after an injection. Most often this happens due to a violation of the rules of asepsis and antisepsis during the procedure. In addition, the risk of developing an abscess is greatly increased by the use of cheap or poor quality injection instruments.

Symptoms of an abscess of the buttocks after an injection may appear early in the form of redness, swelling and tenderness in the injection area. In the future, a purulent abscess may form at the injection site, which must be treated in a timely manner.

Treatment of an abscess of the buttock after an injection consists primarily in washing the purulent cavity with antiseptics and the use of anti-inflammatory and antibacterial drugs. In some cases, surgical intervention may be required – opening and drainage of a purulent abscess.

• To prevent the occurrence of an abscess of the buttocks after an injection, it is necessary to follow the rules of asepsis and antisepsis during injections.
• The use of quality instruments and disposable syringes can also minimize the risk of complications.
• At the first sign of an abscess, a doctor should be consulted and appropriately treated to avoid possible complications and health consequences.

In general, good injection practice and good health will help avoid problems with abscesses and other injection-related complications.

Buttock abscess: basic information

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What is a buttock abscess?

Abscess of the buttocks is a disease characterized by the formation of a pustule (abscess) in the tissues of the buttocks. It occurs as a result of an infection that can enter the body from the outside through injections, wounds, or other skin lesions.

Depending on whether the abscess is located in deep or superficial tissues, it can cause pain, fever and other symptoms. As a rule, such ulcers are best treated by a doctor using local anesthesia and other medications.

If an abscess of the buttocks is not treated, the infection can spread to deeper layers of tissues and organs, which can lead to serious consequences, including sepsis, a dangerous infectious disease that requires emergency medical attention.

Causes of buttock abscess

One of the main causes of buttock abscess is improper injection. When the needle enters the deep layers of the muscles, it can lead to tissue damage and infection. The use of non-sterile or expired medical products is especially dangerous.

A weakened immune system also increases the chance of developing an abscess. People who are battling chronic diseases or taking medications to suppress the immune system are at risk of infection and disease.

Also, a risk factor may be disorders of blood circulation in the gluteal region, for example, with prolonged sitting on a cold surface, injuries or operations in this area.

More rarely, an abscess of the buttocks may result from various diseases such as diabetes, skin diseases and other pathologies.

What symptoms accompany an abscess of the buttocks?

Abscess of the buttock after an injection is characterized by characteristic symptoms that should not be ignored. One of the main symptoms is severe pain in the buttocks, which increases with movement and with pressure on the affected area.

The following symptoms may also occur:

1. Redness of the skin in the area of ​​the abscess;
2. Swelling and thickening of the tissue around the abscess;
3. Increased body temperature;
4. General malaise, weakness and fatigue.

If you notice these symptoms, you need to see a doctor for qualified help. Self-treatment can lead to serious complications, so do not delay a visit to the doctor.

Buttock abscess diagnosis: what does the doctor say?

A buttock abscess following an injection is a serious infection that can lead to many complications if not properly treated. Doctors diagnose this condition based on the patient’s symptoms and the results of a physical examination.

One of the main signs of a buttock abscess is the rapid onset of a painful swelling on the buttock that may be red and hot to the touch. In addition, the victim may experience pain on movement, as well as fever and general weakness.

After an initial assessment of symptoms and a physical exam, your doctor may order additional tests, such as an ultrasound or CT scan, to determine the exact location and extent of the infection.

If a buttock abscess is confirmed, the doctor may recommend various treatments, including antibiotics, drainage, etc. He should also monitor the patient throughout treatment to ensure full recovery and avoid re-infection.

Complications of a buttock abscess

Don’t ignore the first signs of a buttock abscess, as time is the key to fast and effective treatment. If you ignore the signs of infection and do not treat it in time, it can cause serious complications.

The most common complications of buttock abscess are deterioration in general well-being, inflammation of the bones and joints, perirectal abscess, sepsis, and impaired renal function. In young children and the elderly, complications can be serious and life-threatening.

If left untreated, the abscess may rupture and cause the infection to spread throughout the body, which may lead to sepsis. Sepsis causes life-threatening conditions and may require intensive care and hospitalization in the intensive care unit.

Perirectal abscess is a serious complication of buttock abscess. Inflammation of the rectum and colon can occur from the anus, and also spread from the scar after surgery. This complication can cause severe abdominal pain that affects the buttocks and thighs, as well as fever.

Treatment of buttock abscess

Treatment of buttock abscess requires immediate intervention and professional medical attention. The doctor may recommend a draining operation, in which an incision is made, to remove the purulent contents and speed up healing.

In addition to surgery, the patient may be given antibiotics to fight the infection causing the abscess. Applying warm compresses can relieve pain and help improve circulation to the affected area.

It is important to take all prescribed medications and follow medical advice to avoid relapses and complications. In cases where an abscess is a consequence of an injection, it is necessary to contact a qualified specialist and strictly follow the rules for injections in order to avoid a recurrence of the situation in the future.

• Abscess drainage;
• Use of antibiotics to fight infection;
• Use of warm compresses.

If medical advice is followed, a buttock abscess can be successfully treated in a few weeks, but all prescribed procedures must be followed and self-treatment must be avoided.

How to avoid the development of an abscess of the buttocks?

Always clean and disinfect the injection site before giving an injection. It is important to follow the rules of asepsis and antisepsis to reduce the risk of infection.

Do not inject where you have been before. This can damage the tissue and increase the risk of infection.

If you suffer from skin conditions such as boils or acne, injections in these areas should be avoided. Wounds or damage to the skin can lead to infection.

Do not abuse injections, especially when you are not a medical professional. Frequent and incorrect use of needles can lead to foci of inflammation.

If you are being treated by a doctor, be sure to report any medical conditions you have to avoid unwanted side effects and improve the effectiveness of your treatment.

If the first signs of an abscess of the buttocks appear, you should immediately consult a doctor. The doctor will take the necessary measures to remove the purulent mass and prevent the development of complications.

Drugs for buttock abscess

Buttock abscess treatment may include antibiotics to fight infection and symptomatic treatment to reduce pain and inflammation.

Antibiotics that can be used to treat an abscess of the buttocks include cephalosporins, penicillins, tetracyclines, and others. The choice of drug depends on the causative agent of the infection and the location of the abscess.

If the abscess is large enough, it may need to be drained to remove the accumulated fluid. In such cases, local anesthetics can be used, as well as tools to remove the purulent mass.

To reduce pain and inflammation, patients may be prescribed anti-inflammatory and pain medications such as ibuprofen, paracetamol, and others.

Consult your doctor before taking any medicine and follow his recommendations. Improper treatment can lead to complications and serious consequences.

What procedures can help treat a buttock abscess?

In the event of an abscess in the buttocks after an injection, seek immediate medical attention. In most cases, a buttock abscess is treated conservatively, but in severe situations, surgery may be required.

Conservative treatment:

• Anti-inflammatory therapy. In an abscess of the buttocks, antibiotics are given first to fight the infection. ;
• Application of warm compresses. Dry heat helps to reduce swelling and soreness, accelerates the maturation of the abscess and its opening.;
• Complex physical activity restrictions. One of the prerequisites for the treatment of buttock abscess is the observance of bed rest and the complete rejection of any physical activity;
• Abscess opening. In cases where the abscess does not open spontaneously, drilling or cutting may be required;

It is important to remember that the treatment of a buttock abscess must be supervised by a specialist. Do not self-medicate or ignore symptoms. Take care of your health and seek medical help on time.

How to treat a buttock abscess without medication?

There are several treatments for buttock abscess without drugs:

• Warm compression. This method can help speed up recovery, as heat improves blood circulation and resorption of purulent deposits. To do this, you can use a heating pad, hot water in a plastic bottle, or just hot towels. Such compresses should be done several times a day for several days.
• Applying medical ointments to a sore spot. To do this, you can use antibacterial or anti-inflammatory ointments, which are sold in pharmacies without a doctor’s prescription.
• Drink more fluids. Drinking plenty of water and natural juices can help the body get rid of purulent deposits faster.

However, if a buttock abscess does not go away on its own within a few days, or symptoms get worse, see a doctor. The doctor may prescribe antibiotics to treat the infection that may be causing the abscess.

Diet for buttock abscess

When treating a buttock abscess, a diet should be followed to help speed up wound healing and strengthen the immune system. It is important to eliminate foods from your diet that can cause inflammation or slow down the healing process.

It is recommended to increase the amount of fresh vegetables and fruits, which contain many vitamins and antioxidants. It is also helpful to add green vegetables, protein foods (meat, fish, eggs), nuts, grains, and dairy products to your diet.

Foods containing a lot of sugar and animal fats, smoking products, alcohol and coffee should be excluded from the diet. It is also not recommended to eat spicy and fatty foods, which can irritate the intestines and cause the opposite effect.

In addition, it is important to increase your water intake, which helps rejuvenate cells and cleanse the body of toxins. It is recommended to consume at least 2 liters of water per day.

All of these suggestions will help relieve and speed up the healing of a buttock abscess. However, before starting treatment, you should consult your doctor and get dietary advice.

What is the recovery time after buttock abscess treatment?

Recovery time after buttock abscess treatment varies depending on the severity of the disease and the treatment chosen. In most cases, patients will be able to return to normal activities 2-4 weeks after the start of treatment.

It is important to note that full healing does not occur immediately, but takes time for the wound to heal. After the abscess has been promptly removed, a course of antibiotics is given for several days to prevent recurrence of the infection. Then you have to monitor the features of wound healing and continue to use the medicines prescribed by the attending physician until the end of the course.

However, if the abscess was inoperable and cleared up on its own or with lesser conservative treatment, it may take significantly longer to heal. The body requires a minimum of 2-3 weeks to fully recover and return to the normal rhythm of life.

Buttock Abscess: Traditional Treatments

There are many traditional treatments that can help treat a buttock abscess. However, it should be remembered that without consulting a doctor, the use of such methods can lead to an aggravation of the disease.

One of the most popular folk methods is wrapping. To do this, you need to mix equal proportions of flax seeds and gruel from these seeds with coconut oil. The resulting mass must be heated, and then applied to the affected area of ​​\u200b\u200bthe body and covered with a cloth.

Also, a good remedy for an abscess of the buttocks is lime. To prepare the medicine, you need to mix lime with hot water to the state of gruel and apply to the affected area of ​​​​the body. From above it is necessary to cover with gauze and attach with a bandage. This method helps to soften the skin and accelerate the process of abscess maturity.

However, it must be understood that traditional methods do not replace professional treatment. In the event of an abscess of the buttocks, you should consult a doctor and get a recommendation for treatment.

Buttock abscess exercises

Buttock abscess can be very painful and it is important to keep the body healthy during treatment. One way to help yourself recover is through exercise.

For those suffering from a buttock abscess, simple exercises such as slow, deep breaths can help relieve panic and reduce stress in the body. This promotes improved blood circulation in the body, which can aid in the healing process.

If you do not have complications such as tissue damage, you may also consider light exercises such as stretching the legs and arms. This can help support blood flow and give the body extra energy.

However, if you feel soreness or notice any changes in the area of ​​the abscess, it is important to stop exercising immediately and contact your doctor for a more detailed examination and advice.

Before you begin to exercise, read the instructions of the specialist and be sure to ventilate the previously unexamined area. Remember that the right path to healing is a slow and steady process, and patience and care will be your best friends along the way.

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    When should I see a doctor if I suspect a buttock abscess?

    Seek immediate medical attention at the first sign of an abscess in the buttocks. Almost always, the disease begins with a feeling of discomfort, pain or tightness on the buttocks. However, in many cases, patients attribute these symptoms to past exercise or other daily causes and ignore them.

    It is especially necessary to see a doctor if the disease progresses with increasing soreness, pustules on the skin, the appearance of fistulas and open wounds. If there is an abscess in the left or right buttock, it may also be accompanied by localized fever and irritability, fatigue and insomnia.

    Even if you know for sure that it is a buttock abscess, but you do not have the appropriate medicines with you, it is not recommended to try to treat the disease yourself at home. This can only worsen the state of health and lead to complications that may require more complex and expensive treatment at a later date.

    As soon as you find signs of a buttock abscess, it is recommended to see a surgeon. He will analyze the symptoms and may prescribe appropriate treatment, including antibiotics, anti-inflammatories, and, in some cases, surgery to drain the pus inside and clear the affected area of ​​infection.

    If such a disease manifests itself after an intramuscular injection, as well as in the presence of other diseases such as diabetes mellitus, profound immune disorders and other diseases, you should immediately consult a doctor.

    Which specialist should I contact if I suspect a buttock abscess?

    If a buttock abscess is suspected, a qualified medical professional should be consulted.

    In this case, the surgeon is the most suitable specialist for the diagnosis and treatment of buttock abscess. He will conduct an examination, take a blood and urine test and prescribe additional tests if necessary.

    In some cases, it may be necessary to consult other specialists, such as a general practitioner or infectious disease specialist, to determine the cause of the buttock abscess and treat the underlying disease.

    It is important to see a specialist in a timely manner to avoid serious complications and quickly start treatment for a buttock abscess.

    Q&A:

    What are the main causes of buttock abscess after an injection?

    The main reasons for the development of an abscess of the buttocks after an injection are: incorrect injection technique, negligence in skin preparation, infection in the injection, extensive subcutaneous hematomas and other mechanical damage to soft tissues.

    What symptoms accompany the development of an abscess of the buttocks after an injection?

    Symptoms of an abscess of the buttocks after an injection may include: pain at the injection site, swelling, redness and hot touch of the skin surface, general malaise, fever and symptoms of intoxication.

    What diagnostic methods are used to determine the abscess of the buttocks after an injection?

    Techniques such as visual inspection, palpation, laboratory blood tests, and computed tomography (CT) or ultrasound diagnostics can be used to determine the exact location of the abscess and its size to determine the exact location of the abscess and its size.

    What methods of treatment are used for the development of an abscess of the buttocks after an injection?

    Treatments that may be used for an abscess of the buttock after an injection include: local abscess trepanation and removal of its contents, antibiotics and anti-inflammatories, serveral treatment, topical drugs and physical procedures, and surgery if necessary.

    What are the advantages of local buttock abscess trepanation after injection before surgery?

    Local trepanation of an abscess of the buttock after an injection is a less invasive and less traumatic procedure than surgery. This method has a lower likelihood of complications and pain, allows for accurate diagnosis, as well as rapid removal of the contents of the abscess.

    Is it possible to treat an abscess of the buttocks after an injection at home, without medical intervention?

    Treatment of an abscess of the buttock after an injection at home is possible only in cases where the abscess is small and not accompanied by serious symptoms. In this case, you can apply anti-inflammatory and antibacterial agents, make compresses and observe hygiene measures. However, for any serious symptoms, it is best to seek medical attention.

    What are the possible complications in the absence of timely treatment of an abscess of the buttocks after an injection?

    In the absence of timely treatment of an abscess of the buttocks after an injection, the following complications may occur: spread of infection to the lymph nodes, bacteremia, sepsis, cellulitis and soft tissue necrosis, which can lead to serious complications and even death in some cases.

    How can an abscess of the buttocks be prevented after an injection?

    To prevent the development of an abscess of the buttocks after an injection, it is necessary to follow the rules of hygiene, thoroughly disinfect the injection site before performing it, prevent mechanical damage to soft tissues, and use disposable syringes and needles.

    What is the prognosis for buttock abscess?

    The prognosis for a buttock abscess depends on the extent of the disease and how quickly the patient seeks medical help. In the case of timely diagnosis and treatment, the prognosis is favorable and the buttock abscess can be successfully treated without negative consequences for the patient’s health.

    However, an advanced buttock abscess can lead to various complications such as sepsis, phlegmon, and tissue destruction. In such cases, the prognosis may be poor and require serious treatment, sometimes including surgical intervention.

    To prevent buttock abscess, it is strongly recommended not to use poor-quality injections, to monitor the hygiene of the injection site, not to violate the technique of administering medications, and to seek medical help at the first sign of the disease.

    Related videos:

    Post-injection abscess. What is a post-injection abscess?

    IMPORTANT
    The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.

    Post-injection abscess is a limited purulent-inflammatory focus at the injection site of the drug. An abscess is characterized by the appearance of local edema and reddening of the skin, gradually increasing in the volume of compaction, an increase in pain of a bursting nature, and fluctuation. The diagnosis is made on the basis of the anamnesis and clinical picture (the appearance of a purulent-inflammatory focus at the site of intramuscular and intravenous injections), ultrasound data, MRI of soft tissues. At the stage of infiltration, conservative treatment is effective. The formed abscess is opened surgically and drained.

    ICD-10

    L02.3 L02.4

    • Causes
    • Pathogenesis
    • Symptoms of post-injection abscess
    • Complications
    • Diagnostics
    • Treatment of post-injection abscess
    • Prognosis and prevention
    • Prices for treatment

    General information

    Cases of post-injection abscess formation of soft tissues occur in people of all ages, more often in obese, obese patients. Most post-injection ulcers develop in the buttocks, since the gluteal muscle is most often used for parenteral administration of drugs. Children have a high proportion of shoulder abscesses as a result of vaccinations. Intravenous drug administration is the most common cause of the formation of a focus of suppuration in the region of the cubital fossa. Post-injection abscesses of this localization are 69% of all cases of purulent-inflammatory processes of soft tissues in drug addicts.

    Post-injection abscess

    Causes

    For the formation of a post-injection focus of suppuration, it is not enough just to get bacteria into the tissues. The human immune system is able to cope with a small number of pathogenic and opportunistic microorganisms that have overcome the protective barrier of the skin. Other contributing factors must be present for abscess to develop:

    • High pathogenicity of microorganisms. Different types of bacteria have different rates of cell division and the ability to resist the immune system. Staphylococcus aureus or Pseudomonas aeruginosa more often cause the formation of a post-injection abscess than opportunistic species that make up the skin microflora.
    • Weakening of immunity. It may be the result of a banal seasonal SARS or a serious concomitant disease. The likelihood of developing abscesses is higher in patients with diabetes mellitus, severe cardiovascular, endocrine, and infectious diseases.
    • Local circulatory disorders. This is facilitated by the simultaneous introduction of significant volumes of the solution into the muscle (more than 5 ml), the simultaneous introduction of several drugs into one buttock. The first sign of abscess formation is a significant induration at the injection site. The risk of post-injection suppuration increases in bedridden patients, patients with bedsores.
    • Local irritant effect of drugs. Not only bacteria, but also chemicals can provoke purulent fusion of tissues. Incorrect intramuscular injection of drugs intended for intravenous or subcutaneous infusions can cause necrosis and inflammation. An individual reaction can be given by a drug that is approved for intramuscular use, but is not suitable for a particular patient.
    • Violation of injection technique. The factors for the development of post-injection complications are non-compliance with the rules of asepsis and antisepsis, the use of the wrong solvent, too rapid administration of solutions, and incompatibility of different drugs. One of the consequences of improper technique can be damage to vessels of various diameters with a needle. Blood clots are a substrate for the multiplication of microorganisms and the formation of a post-injection abscess.

    Pathogenesis

    The development of an inflammatory reaction is based on the release of a large number of lysosomal enzymes from damaged and dead cells into the extracellular environment, which change the metabolism in the pathological focus. In the zone of necrosis, the metabolism slows down, and in the areas adjacent to it it sharply increases, which leads to an increase in the consumption of oxygen and nutrients, the development of acidosis due to the accumulation of underoxidized products: lactic, pyruvic and other acids.

    The blood supply of the pathological focus changes: the blood flow increases and the outflow slows down. This explains the redness of the affected area. Blood vessels dilate, the permeability of capillaries to blood plasma and cells increases. Leukocytes and macrophages enter the tissues. Local influx of fluid leads to the formation of edema. Compression of the nerve endings provokes pain. This is the stage of infiltration, when there is no pus in the focus of inflammation yet. Under favorable conditions at the stage of infiltration, the changes are reversible.

    At the stage of abscessing, dead tissue and dead cells of the immune system form pus. Post-injection abscess is located in the center of the focus of inflammation. Pus clots are delimited from healthy tissues by a granulation shaft. Pus does not resolve. It is possible to eliminate inflammation only if conditions are created for the outflow of the contents of the abscess.

    Symptoms of post-injection abscess

    The pathological focus forms within a few days. The onset of the disease may go unnoticed by the patient due to the slight severity of symptoms. The first manifestations of developing purulent inflammation can be masked by pain and swelling of the injection sites, due to the physiological response to the administration of drugs. It is possible to distinguish between the formation of an inflammatory infiltrate and a reaction that is normal for intramuscular injections with a careful attitude to your feelings.

    Pain after an injection, immediately sharp bursting, then aching. Its intensity decreases rather quickly. Pain with a ripening abscess is constantly increasing. Normally, the seal after injections is quite uniform, its temperature does not differ from the temperature of the surrounding areas, the skin over the seal is of a normal color. The addition of an inflammatory reaction is marked by a noticeable local increase in temperature. The increase in swelling and pain in the buttock leads to the fact that it is impossible to sit on the affected side. Unpleasant sensations are aggravated by walking and performing other movements. Pressure on the abscess area is sharply painful, while the usual seal can be felt without provoking pronounced discomfort in the patient.

    Post-injection abscess is characterized by fever with an increase in body temperature up to 39-40°C. However, focusing only on this symptom is not worth it. If the inflammatory focus develops against the background of ongoing injections of non-steroidal anti-inflammatory drugs that have analgesic and antipyretic effects, then there is no hyperthermia.

    Complications

    The rapid development of infection in the focus can provoke the formation of pus in the intermuscular spaces. The spread of bacteria in the tissues causes the development of extensive phlegmon of the buttocks, thighs, and shoulders. There is a danger of the formation of long-term non-healing fistulas of soft tissues and rectal fistulas. A breakthrough of pus into the bloodstream causes sepsis, pericarditis, osteomyelitis, DIC – in these cases, even with the appointment of adequate treatment, the outcome for the patient may be unfavorable.

    Diagnosis

    Diagnosis is easy for the consulting surgeon. A characteristic pentad of signs of inflammation (redness, swelling, pain, fever, dysfunction) at the injection site allows you to quickly determine the nature of the pathological process. A positive symptom of fluctuation indicates the presence of fluid in the focus, which is an indication for a surgical operation. To confirm the diagnosis of post-injection abscess in doubtful cases, the following is performed:

    • Abscess ultrasound. In three out of four cases, the accumulation of pus is localized in the thickness of the muscle and intermuscular spaces, and only in 25% of cases in the subcutaneous tissue. The shape of the purulent cavity is oval. Its largest radius is parallel to the axis of the body. Ultrasound of soft tissues makes it possible to distinguish between infiltration and suppuration with a deep location of the pathological focus in the tissues, to identify streaks and “pockets” that may go unnoticed during the surgical operation.
    • MRI of the affected area. It is prescribed in cases where the information content of ultrasound is insufficient to make a correct diagnosis. On the pictures obtained by magnetic resonance imaging, soft tissues, bones, and internal organs of the area under study are visualized. This allows you to detect pathological changes, conduct differential diagnosis, and identify complications.
    • Laboratory tests. In order to select an effective antibacterial drug, sowing of the contents of the abscess on the flora and its sensitivity to antibiotics can be performed. It is mandatory to perform a general and biochemical blood test, a general urine test to exclude pathology from the internal organs.

    Treatment of post-injection abscess

    Approaches to the treatment of abscesses at the stages of infiltration and suppuration are fundamentally different. In the first case, conservative therapy is indicated, in the second – a surgical operation. The basic principles of conservative local treatment of infiltrates can be successfully applied to the rapid resorption of post-injection seals that do not have signs of inflammation.

    • General treatment. Its volume is determined by the doctor based on the clinical picture. Anti-inflammatory drugs and antibiotics are aimed at resolving the inflammatory process. Additionally, infusion therapy may be prescribed to combat intoxication.
    • Topical therapy. It involves the application of Vishnevsky ointment to the affected area or the use of compresses with dimexide. At the initial stages, it is allowed to perform an iodine grid. If the condition does not improve within a day, it is advisable to use more effective drugs.
    • Physiotherapy. All thermal influences are prohibited. Effective electrophoresis of anti-inflammatory drugs, diadynamic currents. Physiotherapeutic procedures are prescribed simultaneously with local and general anti-inflammatory treatment.
    • Surgical operation. Opening and drainage of the purulent cavity is performed under local anesthesia. Under general anesthesia, the operation is performed when the post-injection abscess is located deep in the tissues. In the postoperative period, general and local conservative treatment is carried out, physiotherapy procedures are prescribed.

    Prognosis and prevention

    The prognosis of post-injection suppuration is favorable, provided timely seeking medical help. Otherwise, the development of complications of the disease is possible. Spontaneous opening and emptying of a deep abscess is impossible, and without the evacuation of pus from the cavity, recovery does not occur. Surgical opening of the abscess allows you to solve the problem in one day.

    Prevention of post-injection complications involves the introduction of drugs parenterally in medical institutions by medical personnel, the rejection of self-treatment. It is advisable to change the injection sites for solutions during a course appointment: if seals have already formed on the buttocks, you can inject drugs into the muscles of the anterior surface of the thigh. Do not administer intravenous infusions into muscles, even if the veins are thin and brittle. It is desirable to make the injection course as short as possible, continuing the treatment with tablets.

    You can share your medical history, what helped you in the treatment of post-injection abscess.

    Sources

    1. Surgical treatment of post-injection soft tissue abscesses and pharmacological possibilities in improving the efficiency and safety of injections: Abstract of the thesis / Elkhov I.V. – 2007.
    2. Post-injection bruises, infiltrates, necrosis and abscesses / Urakov AL, Urakova NA// Modern problems of science and education. – 2012 – No. 5.
    3. Local post-injection complications or drug-iatrogenic disease – injection disease/ Urakova N.
       

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