Abscess painful. Abscesses: Causes, Symptoms, and Treatment Options – Comprehensive Guide
What are abscesses. How do abscesses form. What are the common symptoms of abscesses. How are abscesses diagnosed and treated. Can abscesses be prevented. What are the different types of abscesses.
Understanding Abscesses: Definition and Formation
An abscess is a localized collection of pus that forms as a result of a bacterial infection. These painful swellings can develop virtually anywhere in the body, but they commonly occur either on the skin (cutaneous abscesses) or internally within organs or spaces between organs (internal abscesses).
How exactly do abscesses form? The process typically unfolds as follows:
- Bacteria enter the body, often through a small cut or break in the skin
- The immune system responds by sending white blood cells to fight the infection
- As white blood cells attack bacteria, some surrounding tissue dies
- A cavity forms, which fills with pus – a mixture of dead tissue, white blood cells, and bacteria
This accumulation of pus leads to swelling, inflammation, and the characteristic painful lump we recognize as an abscess.
Common Causes and Risk Factors for Abscess Formation
While bacterial infections are the primary culprit behind abscess formation, several factors can increase one’s risk of developing these painful swellings:
- Poor hygiene practices
- Weakened immune system
- Chronic skin conditions like acne or eczema
- Ingrown hairs
- Blocked sweat glands or oil glands
- Injecting drugs with unsterile equipment
- Recent surgery or trauma to the area
For internal abscesses, the causes are often related to existing health conditions. For instance, a burst appendix can lead to the spread of bacteria within the abdominal cavity, potentially resulting in an internal abscess.
Recognizing the Symptoms: When to Suspect an Abscess
The symptoms of an abscess can vary depending on its location, but there are some common signs to watch for:
Skin Abscess Symptoms:
- A swollen, red, and painful lump under the skin
- The affected area feels warm to the touch
- Pus or fluid may be visible
- Fever and chills
- Fatigue or general malaise
Internal Abscess Symptoms:
- Pain or discomfort in the affected area
- High temperature (fever)
- Feeling generally unwell
- Loss of appetite
- Weight loss
- Night sweats
Is it possible for an abscess to heal on its own? In some cases, small skin abscesses may drain naturally or simply shrink and disappear without treatment. However, larger abscesses or those located internally often require medical intervention.
Diagnosing Abscesses: Medical Procedures and Tests
Accurate diagnosis is crucial for effective treatment of abscesses. The diagnostic process typically involves:
- Physical examination: A healthcare provider will visually inspect and palpate the affected area.
- Medical history: The doctor will inquire about symptoms, duration, and any relevant medical conditions.
- Imaging tests: For suspected internal abscesses, imaging studies such as CT scans, MRIs, or ultrasounds may be ordered.
- Laboratory tests: Blood tests can help identify signs of infection and inflammation.
- Aspiration: In some cases, a needle may be used to extract a sample of fluid for laboratory analysis.
Are there any specific signs that differentiate an abscess from other skin conditions? While redness, swelling, and pain can be associated with various skin issues, the presence of a fluctuant (fluid-filled) mass that is warm to the touch is highly suggestive of an abscess.
Treatment Approaches: From Antibiotics to Surgical Drainage
The treatment of abscesses aims to eliminate the infection and provide relief from symptoms. The approach can vary based on the size, location, and severity of the abscess:
1. Antibiotics:
Oral or intravenous antibiotics may be prescribed, especially for larger abscesses or those accompanied by cellulitis (infection of the surrounding skin).
2. Incision and Drainage:
This is the primary treatment for most skin abscesses. The procedure involves:
- Numbing the area with local anesthetic
- Making a small incision to allow the pus to drain
- Cleaning the cavity with sterile saline solution
- Packing the wound with gauze to promote healing from the inside out
3. Needle Aspiration:
For some internal abscesses, a needle guided by imaging technology may be used to drain the pus.
4. Surgical Drainage:
Larger or deep-seated abscesses may require more extensive surgical intervention under general anesthesia.
5. Warm Compresses:
Applying warm, moist compresses to small abscesses can help draw the pus to the surface and promote natural drainage.
How long does it typically take for an abscess to heal after treatment? The healing time can vary depending on the size and location of the abscess, as well as the individual’s overall health. Most skin abscesses begin to improve within a few days of treatment, but complete healing may take 1-2 weeks or longer.
Preventing Abscesses: Hygiene and Health Practices
While it’s not always possible to prevent abscesses, especially internal ones, there are several steps you can take to reduce your risk of developing skin abscesses:
- Practice good hand hygiene by washing hands regularly with soap and water
- Keep cuts, scrapes, and other wounds clean and covered
- Avoid sharing personal items like towels, razors, or toothbrushes
- Maintain good overall hygiene, including regular bathing
- Boost your immune system through a healthy diet, regular exercise, and adequate sleep
- Manage chronic skin conditions effectively
- Avoid picking or squeezing pimples, which can introduce bacteria
Can certain lifestyle changes help prevent recurrent abscesses? For individuals prone to recurrent abscesses, doctors may recommend using antibacterial soap or applying topical antibiotics to areas where abscesses frequently occur. In some cases, underlying conditions like diabetes or immune disorders may need to be addressed to reduce the risk of abscess formation.
Types of Abscesses: Beyond Skin Deep
While skin abscesses are the most common, there are various other types of abscesses that can form in different parts of the body:
1. Dental Abscess:
A collection of pus that forms in the teeth or gums, often due to untreated tooth decay or gum disease.
2. Peritonsillar Abscess (Quinsy):
An abscess that forms between a tonsil and the wall of the throat, usually as a complication of tonsillitis.
3. Anorectal Abscess:
An abscess that develops near the anus or rectum, often due to infection of a blocked anal gland.
4. Pilonidal Abscess:
An abscess that forms in the cleft between the buttocks, typically due to ingrown hairs.
5. Brain Abscess:
A rare but serious condition where an abscess forms within the brain tissue, often as a result of a bacterial or fungal infection spreading from another part of the body.
6. Liver Abscess:
A pus-filled mass in the liver, which can be caused by various infections or conditions affecting the biliary tract.
7. Spinal Cord Abscess:
An abscess that forms around the spinal cord, which can cause severe neurological symptoms if left untreated.
How do the treatment approaches differ for these various types of abscesses? While the general principle of draining the abscess remains consistent, the specific techniques and considerations vary based on the location and surrounding anatomy. For instance, brain abscesses require extreme precision and may involve stereotactic aspiration guided by advanced imaging techniques.
Complications and Long-term Outlook
While most abscesses can be successfully treated, there are potential complications to be aware of:
- Spread of infection to nearby tissues or the bloodstream (sepsis)
- Formation of a fistula (an abnormal connection between organs or tissues)
- Scarring
- Recurrence of the abscess
- Damage to surrounding structures (particularly with internal abscesses)
What factors influence the long-term prognosis for individuals who have had abscesses? The outlook generally depends on:
- The location and size of the abscess
- How quickly treatment was initiated
- The individual’s overall health and immune status
- Whether any underlying conditions are present
With prompt and appropriate treatment, most people recover well from abscesses. However, those with recurrent abscesses or compromised immune systems may require ongoing management and preventive strategies.
In conclusion, abscesses are common but potentially serious infections that require proper medical attention. Understanding the causes, symptoms, and treatment options can help individuals seek timely care and take steps to prevent these painful conditions. As with any medical concern, it’s always best to consult with a healthcare professional for personalized advice and treatment.
Abscess – NHS
An abscess is a painful collection of pus, usually caused by a bacterial infection. Abscesses can develop anywhere in the body.
This article focuses on 2 types of abscess:
- skin abscesses – which develop under the skin
- internal abscesses – which develop inside the body, in an organ or in the spaces between organs
Symptoms of an abscess
A skin abscess often appears as a swollen, pus-filled lump under the surface of the skin. You may also have other symptoms of an infection, such as a high temperature and chills.
Credit:
It’s more difficult to identify an abscess inside the body, but signs include:
- pain in the affected area
- a high temperature
- generally feeling unwell
Read more about the symptoms of an abscess.
When to see your GP
See your GP if you think you may have an abscess. They can examine a skin abscess or refer you to hospital if you may have an internal abscess.
There are several tests available to help diagnose an abscess, depending on where it’s located.
Read about diagnosing an abscess.
Causes of abscesses
Most abscesses are caused by a bacterial infection.
When bacteria enter your body, your immune system sends infection-fighting white blood cells to the affected area.
As the white blood cells attack the bacteria, some nearby tissue dies, creating a hole which then fills with pus to form an abscess. The pus contains a mixture of dead tissue, white blood cells and bacteria.
Internal abscesses often develop as a complication of an existing condition, such as an infection elsewhere in your body. For example, if your appendix bursts as a result of appendicitis, bacteria can spread inside your tummy (abdomen) and cause an abscess to form.
Read about the causes of abscesses.
Treating an abscess
A small skin abscess may drain naturally, or simply shrink, dry up and disappear without any treatment.
However, larger abscesses may need to be treated with antibiotics to clear the infection, and the pus may need to be drained. This will usually be done either by inserting a needle through your skin or by making a small incision in the skin over the abscess.
Read more about treating an abscess.
Preventing a skin abscess
Most skin abscesses are caused by bacteria getting into a minor wound, the root of a hair or a blocked oil or sweat gland.
Ensuring that your skin is clean, healthy and largely free of bacteria can help reduce the risk of skin abscesses developing.
You can reduce the risk of bacteria spreading by:
- washing your hands regularly
- encouraging people in your family to wash their hands regularly
- using separate towels and not sharing baths
- waiting until your skin abscess is fully treated and healed before using any communal equipment, such as gym equipment, saunas or swimming pools
Do not squeeze the pus out of the abscess yourself, because this can easily spread the bacteria to other areas of your skin. If you use tissues to wipe any pus away from your abscess, dispose of them straight away to avoid germs spreading. Wash your hands after you’ve disposed of the tissues.
Take care when shaving your face, legs, underarm areas or bikini area to avoid nicking your skin. Do not share razors or toothbrushes.
It may also help to reduce your risk of skin abscesses by:
It’s difficult to prevent internal abscesses, as they’re often complications of other conditions.
Other types of abscess
There are many other types of abscess not fully covered here, including:
- an anorectal abscess – a build-up of pus inside the bottom (the rectum and anus)
- a Bartholin’s cyst – a build-up of pus inside one of the Bartholin’s glands, which are found on each side of the opening of the vagina
- a brain abscess – a rare but potentially life-threatening build-up of pus inside the skull
- a dental abscess – a build-up of pus under a tooth or in the supporting gum and bone
- a quinsy (peritonsillar abscess) – a build-up of pus between one of the tonsils and the wall of the throat
- a pilonidal abscess – a build-up of pus in the skin of the cleft of the buttocks (where the buttocks separate)
- a spinal cord abscess – a build-up of pus around the spinal cord
Page last reviewed: 04 November 2019
Next review due: 04 November 2022
Abscess in Adults: Condition, Treatments, and Pictures – Overview
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Images of Abscess
Overview
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.
Factors that predispose individuals to developing an abscess include:
- Any skin infection, especially those that are untreated
- Diabetes
- Obesity
- Intravenous drug abuse
- Weakened immune system due to underlying illness or medication
Who’s at risk?
Abscesses can occur in anyone and occur anywhere on the body.
You might be able to sense fluid in an abscess when you press on the abscess with a finger.
Signs and Symptoms
A worsening red, tender swelling that arises over a period of 1–2 weeks. The pus underneath the skin is usually not visible. You may have a fever or a general sense of not feeling well.
Self-Care Guidelines
There are no self-care options for abscesses. While waiting to see your doctor, you can try applying a warm compress to the affected area and take ibuprofen to help with the swelling and pain.
When to Seek Medical Care
A worsening red, tender swelling should prompt you to make an appointment with your physician as soon as possible. If the area involves your face, is spreading rapidly, or is in an area that severely limits your functionality, you should seek emergency care.
Treatments Your Physician May Prescribe
Your doctor may drain the pus and fluid collection by making a small incision in the skin after it has been numbed. This will drain a majority of the bacteria, helping the body fight the small amount that remains. This fluid may then be sent to a laboratory for testing (culture), but not necessarily. The culture can tell the doctor not only what type of bacterium is causing the infection but also what antibiotics will work best to treat it. This may take as little as 2–3 days. Your doctor may choose to have you start oral antibiotics aimed at treating the most common bacteria that cause abscesses while awaiting these results. However, if the infection is small and it has been drained, your doctor may decide to not treat you with oral antibiotics.
If your symptoms are not improving or it is determined that the bacterium is not one of the common types, your doctor may prescribe different antibiotics. If your doctor prescribes antibiotics, it is important to take the entire course as prescribed, even if you are feeling better or the infection appears to be gone after just a few days. If you have been taking antibiotics and the infection itself or the way you are generally feeling have not improved in about 2–3 days, return to see your doctor.
Trusted Links
MedlinePlus: Abscesses
Clinical Information and Differential Diagnosis of Abscess
References
Bolognia, Jean L. , ed. Dermatology, p. 1126. New York: Mosby, 2003.
Wolff, Klaus, ed. Fitzpatrick’s Dermatology in General Medicine. 7th ed, pp. 874, 1702. New York: McGraw-Hill, 2008.
Cutaneous Abscess – Dermatologic Disorders
Some small abscesses resolve without treatment, coming to a point and draining. Warm compresses help accelerate the process. Incision and drainage are indicated when significant pain, tenderness, and swelling are present; it is unnecessary to await fluctuance. Under sterile conditions, local anesthesia is given as either a lidocaine injection or a freezing spray.
Patients with large, extremely painful abscesses may benefit from IV sedation and analgesia during drainage. A single puncture with the tip of a scalpel is often sufficient to open the abscess. After the pus drains, the cavity should be bluntly probed with a gloved finger or curette to clear loculations. Irrigation with normal saline is optional. Packing the cavity loosely with a gauze wick reduces the dead space and prevents formation of a seroma. The wick is typically removed 24 to 48 hours later. However, recent data have not proved the effectiveness of routine irrigation or packing (1, 2). Local heat and elevation may hasten resolution of inflammation.
Antibiotics have traditionally been considered unnecessaryCutaneous Abscess : Treatment references unless the patient has signs of systemic infection, cellulitis, multiple abscesses, immunocompromise, or a facial abscess in the area drained by the cavernous sinus. In these cases, empiric therapy should be started with a drug active against MRSA (eg, trimethoprim/sulfamethoxazole, clindamycin; for severe infection, vancomycin) pending results of bacterial culture. However, recent studies have suggested marginally better results when antibiotics are added to usual treatment of even uncomplicated abscesses (3).
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1. Chinnock B, Hendey GW: Irrigation of cutaneous abscesses does not improve treatment success. Ann Emerg Med 67(3):379-383, 2016. doi: 10.1016/j.annemergmed.2015.08.007
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3. Talan DA, Mower WR, Krishnadasan A: Trimethoprim-sulfamethoxazole versus placebo for uncomplicated skin abscess. N Engl J Med 374(9):823-832, 2016. doi: 10.1056/NEJMoa1507476
Signs of tooth abscess | Ada
What is a dental abscess?
An abscess is a pocket of pus that forms within body tissues. Abscesses are the result of an infection, generally bacterial, localized in the area where the abscess forms. They are almost always accompanied by swelling and inflammation. Dental abscesses are abscesses affecting the teeth and adjacent jaw tissue.
Each tooth is made up of several layers. The outermost layer is the enamel, which covers a softer layer, the dentin. The dentin and enamel are the tooth’s protective layers. Underneath the dentin is the pulp, where the tooth’s nerves and blood vessels are situated. The pulp runs down the center of the root of the tooth, which connects the tooth to the underlying bone of the upper or lower jaw. Infections in the pulp can therefore easily spread into the bone of the jaw. Likewise, if the gum around the tooth becomes infected, the tooth is at risk of damage as well. Some abscesses affect the pulp first and spread to the bone, while others affect the surrounding tissues of the gum and do not start in the pulp.
In abscesses, the presence of plaque and gingivitis are likely to make the situation worse. Antibiotics are sometimes necessary to control the infection. If treated correctly, dental abscesses are not life-threatening. Treatment of dental abscesses is usually carried out by dentists, and often involves taking an antibiotic and root canal treatment. In rare cases, however, the infection can spread, and the condition may become very severe and possibly life-threatening in extremely rare cases.
Treatment for dental abscesses involves draining the pus from the tooth and filling or removing the tooth to prevent re-infection.
There are two major subtypes of dental abscess: periapical and periodontal.
Good to know: A third type, pericoronitis, is much less common. In pericoronitis, the infection affects the gum flap, known as the operculum, which covers a tooth that has not yet erupted through the gum. This article deals with periapical and periodontal abscesses. For more information on pericoronitis, please see the FAQs.
Periapical abscesses: affecting the inside of the tooth
Periapical abscesses usually occur near the tip of the root of the tooth. They are more common among children than among adults. Children with poor dental hygiene are particularly at risk of periapical abscesses.
Poor dental hygiene, including inadequate brushing or flossing, can cause caries, also known as cavities, which erode the enamel and dentin, admitting bacteria to the pulp. As a result of this, the pulp becomes inflamed, and this can lead to the death of nerves in the tooth. Because dead tissue is more vulnerable to infection, this puts the tooth at high risk of an abscess.
In periapical abscesses, damage to the enamel and dentin, as in the case of later-stage cavities admits bacteria to the pulp, leading to an inflammatory condition known as pulpitis. Periapical abscesses are a common complication of severe, long-term pulpitis. They can cause swelling in the jaw, cheeks and the floor of the mouth.
Periodontal abscesses: affecting the gums
Periodontal abscesses are more common among adults than children and are often a complication of gum disease. They tend to originate in the alveolar bone and periodontium. Gum disease or injury can cause teeth to become loose and/or inflamed, including the surrounding area. The resulting pocket that forms between the tissue and the tooth is vulnerable to infection by bacteria which can then form a periodontal abscess.
Signs and symptoms of a dental abscess
Dental abscesses are usually painful. The pain may be situated in the tooth itself, the surrounding gum or be more generalized, including the jaw, cheeks, or even neck or face, depending on the location of the abscess. The affected tooth may:
- Feel tender
- Feel loose in the jaw
- Be sensitive to heat and/or cold in the mouth
- Be sensitive to pressure on the tooth, or to being tapped
- Be slightly raised
People with a dental abscess may experience pain in the affected area. If you are concerned that you may have a dental abscess, you can do a free symptom check with the Ada app or find out more about how it works.
Other symptoms of dental abscesses include:
- Swelling in the gums or face
- Redness of the skin over the affected part of the gum
- Bleeding in the gums
- Swollen lymph glands in the neck
- Generally feeling unwell (malaise)
- Loss of appetite or inability to eat
- Fever
Dental examination may also reveal swelling and redness around the tooth in the mouth and a fluctuant (movable/shiftable) mass in the area.Periodontal abscesses may also present with a gum boil. A gum boil, also known as a parulis, is a soft red papule that appears where a sinus or channel from an abscess reaches the outside of the gum, between the gum and the inside of the cheek. It is the result of an abscess, so it is a definite sign that an abscess is present, but it is not itself an abscess.
Rarely, in severe cases of dental abscess, the affected person may also experience:
- Cellulitis, a bacterial infection of skin and subcutaneous tissues
- Lockjaw (trismus)
- Difficulty swallowing, due to pain and swelling
- Difficulty breathing, due to swelling
- Difficulty speaking
- Dehydration
Generally, a spreading dental infection as a result of an abscess may cause the affected person to feel very unwell. They may have a fever (a body temperature of 38 C / 100.4 F or higher), swelling in the floor of the mouth, the face or the jaw and severe pain that does not respond to maximum doses of over-the-counter painkillers such as.
If any of these symptoms occur, the affected person should seek emergency dental care from a dentist or, if no dental care is available, visit a hospital emergency department or see another doctor as soon as possible. While doctors are not trained to handle dental procedures, they will be able to assist with antibiotics and painkillers to control the infection and pain until dental care is accessed.
Causes of dental abscesses
Dental abscesses are the result of bacterial infection. When the gum tissue surrounding a tooth becomes damaged or the tooth itself is damaged, bacteria that are already in the mouth and, under usual circumstances not harmful, may enter the area and cause infection.
One of the most common causes of damage to the teeth and gums is poor dental hygiene, such as inadequate brushing and flossing, high sugar or carbohydrate consumption, and lack of regular checkups at the dentist. These factors may lead to dental caries or cavities, gingivitis and periodontitis, which can admit bacteria to the inside of the tooth or the gum. Maintaining healthy teeth and gums is therefore one of the best ways of reducing the risk of developing dental abscesses, as it removes one of the main causes of abscesses.
Diagnosing dental abscesses
If a dental abscess is suspected, the affected person should visit the dentist as soon as possible. The dentist will perform an examination of the affected area. They may test the affected tooth by pressing on it or tapping it with an instrument. If the tooth is infected, it will usually be very sensitive to pressure or tapping (percussion), and may often be painful. Further, if the abscess is periapical, the swelling at the root will push the tooth upwards in its socket, and it will feel higher than the surrounding teeth.
While laboratory testing is not usually needed to establish whether or not an abscess is present, dentists will usually do an X-ray of the affected tooth and the mouth as a whole to establish the exact location and the size of the abscess.
The abscess may be aspirated and the pus cultured to determine which strains of bacteria are involved. This helps to guide antibiotic therapy if it is needed.
Treatment of dental abscesses
The usual treatment for a dental abscess is to drain pus as soon as it is possible to do so. This will be done surgically, either by a dentist or a maxillofacial surgeon, a surgeon that has trained as a dentist as well as a doctor and handles complex jaw, tooth and mouth conditions. They may make an incision in the gum or drill a hole in the tooth to allow the pus to drain.
Once the pus has drained away, the area will be cleaned. In periapical abscesses, all dead pulpal tissue will be removed to prevent infection recurring. In periodontal abscesses, a very deep cleaning of the teeth and specifically the gum and roots will be done. A root canal may also be necessary if the whole tooth is compromised. If the decay is severe, the tooth may be removed.
Root canal treatment
Root canal treatment is the standard treatment for the removal of pulpal tissue in cases where the tooth will be retained and not extracted, and it may also be an option in cases where pain is ongoing even after the abscess is resolved. The person undergoing a root canal will be given a local anesthetic injection to numb the parts of the jaw and mouth affected by the abscess. During the procedure, the dead or infected pulp is removed, the inside of the pulp canals are smoothed, and the pulp is replaced with a filling, often gutta percha. In a few months time, an X-ray and dental checkup will be done to check that the site is healing properly.
Pain management and antibiotics
As abscesses are painful, people may need acetaminophen or to control the pain. Essential oil of cloves has topical anesthetic properties and can be applied to the painful area, although it is very important to maintain strict hygiene while doing this. Home remedies like the above mentioned oil may provide some pain relief, but will not cure an abscess or prevent further infection.
In uncomplicated abscesses, antibiotics may not be necessary.
If the infection is severe or has spread, or if the abscess cannot be drained, antibiotics will be prescribed to help bring the infection under control. Antibiotics commonly prescribed for dental abscesses include:
- Penicillin
- Amoxicillin, alone or in combination with clavulanate
- Azithromycin
- Metronidazole
- Cefoxitin
If the patient is allergic to amoxicillin and/or penicillin, clindamycin may be prescribed. Penicillin is the usual antibiotic used to treat mild or moderate infections. Because antibiotics alone don’t always penetrate the abscess very well, the abscess may also be surgically drained.
Most dental abscesses are straightforward to treat and resolve completely after they are drained.
Home treatment of dental abscesses
Although essential oil of cloves can be used to manage the pain and sensitivity associated with dental abscesses, it will not cure the abscess. Abscesses will not go away on their own and cannot be treated at home. Untreated abscesses can develop secondary infections and other serious complications that are extremely hazardous to health (see below). It is possible for an untreated abscess to become a medical emergency requiring urgent care from a doctor or dentist. It may also lead to jaw bone loss.
Only a qualified medical or dental professional is properly equipped to administer treatment for an abscess safely and effectively. It is strongly advised that people affected by abscesses, or who suspect they may have a dental abscess, seek out the advice of a dentist as soon as they can. It is not safe to try to drain an abscess at home or to leave an abscess untreated.
When to seek emergency treatment for dental abscesses
Ideally, a person affected by a dental abscess, or who suspects that they may have a dental abscess, should visit the dentist as soon as possible. Because it is not always possible to see a dentist in time, some people may need to be treated for their abscesses in a hospital emergency department. Medical doctors are not specifically trained to handle dental issues, but will be able to stabilize the affected person, providing antibiotics and pain relief, until they can see the dentist.
Good to know: Dentists do not form part of the regular staff in most hospital emergency departments. Treatment by a doctor at a hospital will not replace seeing a dentist. Doctors are not trained to deal with dental problems but will be able to assist with managing infection and pain.
If a person with an abscess or a suspected abscess shows any of the signs listed below, they should seek urgent medical care as soon as possible. Danger signs for tooth abscesses include:
- An abscess of more than 1cm in diameter, or which feels large
- Severe swelling or hard lumps on the gums or the face
- Bleeding on the gums or in the mouth
- Fever or a body temperature of more than 38 C / 101.4 F
- Tender lymph nodes in the neck area
If a person shows the symptoms listed below, they should immediately be seen by a hospital emergency department:
- Severe pain that cannot be controlled with painkillers
- Shortness of breath or other difficulty breathing
- Difficulty swallowing due to swelling, or difficulty taking in liquids leading to dehydration
- Severe difficulty opening the mouth
- Swelling of the neck or around the eyes, or severe swelling of the face in general
- Secretions in the mouth they can’t handle due to difficulty swallowing, opening the mouth or others
Complications of dental abscess
In rare cases, complications do arise. These can include:
- Cellulitis, an infection of the skin and subcutaneous tissues.
- Ludwig’s angina, which occurs when cellulitis spreads into the tissues under the tongue, in the lower jaw and under the chin. It is also known as submandibular cellulitis/submandibular space infection.
- Osteomyelitis, an infection of underlying bone.
- Parapharyngeal abscess, an abscess at the back of the mouth, near the throat. It is caused by staphylococcal and/or streptococcal bacteria. It is most common in children aged five years or younger.
- Cavernous sinus thrombosis, which can occur when the infection spreads into the blood vessels in the sinuses of the head.
- Sepsis
These conditions require very urgent medical attention and are best evaluated via a hospital emergency department.
Cellulitis and facial cellulitis
Cellulitis is an infection of the skin. Facial cellulitis, for example, can be caused by infections of the upper respiratory tract, middle ear infections or tooth abscesses. Although these conditions can increase the risk of facial cellulitis, they do not directly cause it; the condition results when an infection spreads to the skin. Symptoms of facial cellulitis include:
- Swollen, red skin on the face, especially the cheek
- Itching and burning of the affected skin
- A painful, possibly swollen, tongue
- Fever
If you are concerned that you or a loved one may have cellulitis or a tooth abscess, you can start a free symptom assessment right now using the Ada app.
Parapharyngeal abscesses and Ludwig’s angina
Parapharyngeal abscesses and Ludwig’s angina can both cause swelling severe enough to obstruct the airways and cause difficulty breathing. Parapharyngeal abscesses require a and needle aspiration to diagnose. Ludwig’s angina is diagnosed by, needle aspiration and X-rays.
Treatment for Ludwig’s angina, parapharyngeal abscess, osteomyelitis, cellulitis and cavernous sinus thrombosis involves drainage of any pus that is present, possibly via surgery and antibiotics and possibly intravenous antibiotics. People affected by Ludwig’s angina, if untreated, may require a tracheostomy to open their airways and thereby help them breathe if the swelling obstructs the windpipe.
Spreading infection
A spreading untreated infection from a dental abscess can cause pain around the eyes, ear pain, nose pain and swelling in the eyes or face. Severe dental infections can spread to other parts of the body, causing potentially serious medical conditions such as bacterial meningitis and infective endocarditis.
An untreated dental abscess or one that does not respond to treatment can very rarely cause sepsis, which is potentially life-threatening.
Read more about Sepsis »
Dental abscess FAQs
Q: Can a dental abscess be dangerous?
A: Dental abscesses, especially if they are properly treated, typically do not cause severe or long-term problems. However, if it is left untreated or if improperly treated, a severe dental abscess can potentially cause complications, possibly even serious ones.
Q: Are dental abscesses contagious?
A: No, they are not. Dental abscesses cannot be spread from one person to another.
**Q: How can dental abscesses be prevented? **
A: As dental abscesses are most often the result of dental caries or gum disease admitting bacteria to the vulnerable pulp of the tooth or into a gum pocket, the first line of prevention is preventing caries and gum disease. This involves maintaining good dental hygiene, including:
- Regular, twice daily brushing
- Regular, daily flossing and use of mouthwash
- Eating a healthy diet with limited sugar, particularly limiting or avoiding sugary drinks
- Avoiding smoking
Q: Are there any factors which predispose people to dental abscesses?
A: Some medications, such as anticholinergics, protease inhibitors, SSRI antidepressants and SNRI antidepressants can cause xerostomia, meaning dry mouth. Dry mouth results from a decrease in the amount of saliva, which causes the amount of bacteria in the mouth to increase and can therefore worsen tooth decay. This can be prevented by taking especially good care of proper dental hygiene, drinking plenty of water and possibly talking to a doctor for further treatment options for the xerostomia itself.
People who are immunocompromised may be at higher risk of dental abscesses because their immune systems cannot always adequately handle bacterial invasions. People at risk include:
- People who are HIV positive or have AIDS
- People who are undergoing chemotherapy
- People who have sickle cell anemia
- People who use steroids
- People who have had a splenectomy
- People taking immunosuppressive medication after transplantation
- People with severe autoimmune diseases, taking immunosuppressive medication
It is recommended that most people have a dental checkup at least once a year. Children and people who are at risk, or who have a history of dental problems, should go more often, at least twice per year. If a dental abscess is suspected, dental help should be sought immediately.
Q: What foods are safe to eat and drink after treatment for a dental abscess?
A: Many people find it best to eat soft, bland foods after treatment for a dental abscess, as there may be some mouth pain. Foods such as milkshakes, bananas, applesauce, yogurt, cooked cereals, scrambled eggs, mashed potato and custard or soft pudding may be suitable. It is important to ensure that the affected person stays well hydrated.
Q: What is pericoronitis?
A: Pericoronitis is a condition involving infection in the gum that covers an unerupted tooth, the operculum. It is particularly associated with wisdom teeth, especially impacted wisdom teeth. Sometimes the gum above the unerupted tooth breaks, and bacteria lodge in the damaged tissue, causing infection.
Acute cases of pericoronitis can have symptoms such as pain in the jaw and pain when the affected person opens their mouth, as well as swelling and fever. Bad breath may also be a symptom. Abscesses can also occur. Chronic pericoronitis may present with mild inflammation that comes and goes.Pericoronitis will require the treatment and care of a dentist.
Pericoronitis can be treated with warm salt-water rinses and antibiotics such as metronidazole, phenoxymethylpenicillin, or erythromycin.
Q: Can dental abscesses affect wisdom teeth?
A: Wisdom teeth, also known as third molars, usually erupt into the mouth in late adolescence. Occasionally, due to the position of the other teeth in the mouth, there is not enough space for them and as a result impaction may occur. Impaction can occur at any age and means that the teeth cannot erupt properly and get stuck completely or partly below the surface of the gum. Although this does not always cause problems, it can cause pericoronitis, an inflammation (see above), which may then develop into an abscess.
Q: Can a dental abscess cause swelling but no pain?
A: Yes. However, this is a cause for concern: if an abscessed tooth that has been painful initially stops being painful, it generally means that the affected tooth has died. Pain may also lessen considerably if the abscess ruptures and drains. It does not mean that the abscess is gone, however. Infection can still spread and become very serious even if the tooth is not painful, and the affected person should see a dentist as soon as they can.
Q: Are all dental abscesses visible?
A: No. Those dental abscesses that develop a fistula or a gum-boil are visible, but it is possible for there to be no visible sign that an abscess has formed. If someone is experiencing mouth pain and/or any of the symptoms listed above, they should see a dentist to determine what is causing the pain, even if they cannot see anything obviously wrong in the mouth.
Q: Can a dental abscess be hard?
A: While most abscesses are usually soft and warm to the touch, occasionally they can feel firm or even hard to the touch. Anyone with a suspected abscess, jaw swelling, jaw pain or tooth pain who feels a hard lump in the mouth should see a dentist as soon as possible.
Q: Can dental abscesses develop next to or underneath a crown, dentures, dental implant or a dental bridge?
A: Yes. Dental work such as crowns or implants can cause dental abscesses, but only if they are improperly done, damaged or broken. Crowns are often used to help preserve a tooth after a root canal has been done, meaning that they are attached to a tooth that is already compromised. Although it is rare for abscesses to affect crowns, it is possible. Dentures can cause injury to the gums beneath them if they do not fit properly; an injured gum is vulnerable to infection. It is important to make sure that dentures fit properly, and it is necessary to replace any denture that does not fit properly to reduce the risk of infection, injury and poor dental hygiene. Dental implants are used to replace missing teeth and are not natural teeth. They are a little more susceptible to mechanical stress and therefore to colonization by bacteria that may lead to abscesses. However, most dental implants are successful. Dental bridges do not have roots and cannot themselves become abscessed, but it is possible for one of the supporting teeth on either side of the bridged tooth to become abscessed.
Q: Can trauma or an injury to the mouth cause a dental abscess?
A: Yes. A trauma like a blow to a tooth, or, over the longer term, increased wear and tear, such as might result from chronically grinding or clenching teeth, can damage structures of the tooth and therefore increase the risk of a dental abscess developing by bacteria having easier access to this tooth’s sensitive areas.
Q: Can dental abscesses appear under the tongue?
A: An abscess under the tongue is not a dental abscess, but it could possibly be the result of a dental abscess that has led to Ludwig’s angina, a form of cellulitis that affects the tissue below the tongue, below the lower jaw, and the floor of the mouth. Ludwig’s angina is a medical emergency, and the affected person should seek medical help in a hospital without delay.
A Tooth Abscess Can Be Painful Infection in the Tissue Of Your Tooth
A Tooth Abscess: How It Occurs and How to Fix It
A tooth abscess will definitely ruin your day. These dangerous infections can quickly spread from a small bump on the gums to a large swelling that is at risk for cutting off your airway! You should never ignore a dental abscess. Reading this article will help you to be prepared in the event that you or a loved one suffers from one.
How a Tooth Abscess Occurs
There are two types of dental abscesses, and the distinction results from the original site of infection. Eventually the infection ends up in the bone and gums surrounding the tooth. It can begin inside the tooth, called an endodontic infection. Or it can begin around the tooth, called a periodontal infection.
Endodontic Infections
An infection that begins inside a tooth will spread to the surrounding bone and gums if left untreated. This type of infection generally starts with a cavity in the tooth. Cavities are bacterial penetration and infection of the hard tissues of a tooth (the enamel outer coating and underlying dentin). When you don’t stop a cavity by having dental treatment, it continues to grow inward toward the hollow space in each tooth called the pulp chamber. The pulp chamber is full of nerves and blood vessels.
Once bacteria reaches the pulp chamber in the center of a tooth, it continues to grow and spread out the tiny hole at the tip of each root. This is how it infects the jawbone around a tooth. Usually, the infection will destroy the bone until it makes an “opening” under the gums that allows for spreading and swelling of the gum tissues. This is the source of the bump near the infected tooth.
Periodontal Infections
A periodontal infection begins with bacteria around the tooth. Disease-causing bacteria collects on the teeth under the gums in the form of soft plaque and hard tartar buildup. These collections of bacteria produce toxins that penetrate the gums. The body responds to these toxins by producing inflammation, and over time, the inflammation actually destroys the tissues that should remain attached to the tooth.
The inflammatory destruction of a tooth’s supporting structures leads to deeper pockets and gaps around the teeth, which continue attract more bacterial buildup. These infections can develop deep into the surrounding jawbone and then spread in the same way endodontic infections can. The swelling around periodontal abscesses may be less painful as there is less pressure buildup. They may also drain from the gums surrounding the teeth instead of from a small, pimple-like bump as an endodontic infection typically does.
How to Fix a Tooth Abscess
Unfortunately, there is no quick fix for a tooth abscess. Because the source of the infections are either in or around the teeth, there is nothing you can do to actually cure the infection. Only dental treatment is able to remove the original source of bacteria and prevent the infection from returning in full force.
Dental Treatment
In the case of endodontic infections, you must remove the bacterial infection from the pulp chamber of the tooth (which requires a root canal) or remove the entire tooth itself (a tooth extraction). Antibiotic medication cannot penetrate into the internal pulp chamber of a tooth to kill the bacteria present there. You cannot leave an infected or dead nerve inside a tooth. If you do, it will be a constant source of infection and never heal.
If you have a dental abscess from an infection inside a tooth, your dentist will discuss your treatment options with you. If you already know there is a large cavity in the tooth, you should expect to hear the words “root canal” and “extraction”. In cases where a root canal would not have a high long-term success rate, you may only have the option of removing the entire tooth.
In the case of a periodontal abscess, the treatment depends on the state of the supporting structures of the teeth. Your dentist may be able to provide specialized gum therapy to remove the bacterial buildup deep under the gums and promote healing around the tooth. If the damage is severe, and the surrounding tissues are unlikely to reattach to the tooth, an extraction will be necessary.
How to Manage a Tooth Abscess
What if you are unable to seek dental treatment right away?
If you have a tooth abscess and cannot seek urgent dental care, there are a few things you can do to manage it until the opportunity for dental treatment arises.
First, you need to reach out to a doctor for a prescription for antibiotics. As we mentioned earlier, the antibiotics cannot completely cure the infection. However, they are an important tool in stopping the spread of the infection. They can also relieve some of the pain by reducing the pressure of the infection inside the jawbone. You can call your medical or dentist if you have a good relationship with him or her. You can also go to a local urgent care facility. One option that is gaining in popularity is telemedicine, so you may be able to have a virtual doctor consult and receive a prescription for the medication necessary to stop this abscess from worsening.
You can take over-the-counter pain relievers such as Tylenol and Advil in an alternating schedule to manage your pain. We recommend warm salt-water rinses for one to two minutes of vigorous swishing. You can do this four to five times per day, and it will flush out bacteria from the abscess, reducing inflammation and keeping the site clean.
What NOT to Do
It is extremely important that you know what NOT to do in addition to what you should do.
- Do not take old, expired antibiotics. As antibiotics age, they weaken, making them less able to kill the bacteria in your infection. What happens is that they could kill the weakest bacteria, allowing the stronger ones to take over and making your infection even worse.
- Do not take someone else’s antibiotics. There are many different kinds of antibiotics, and they are specific to which bacteria they kill. A dental abscess does not contain the same bacteria as a urinary tract infection. Taking the wrong antibiotics will not fight the bacteria in your tooth infection.
- Do not attempt to squeeze or pop the abscess. We know it is tempting to “deflate” the bump that develops on the gums when you have a tooth abscess. The problem is that when you squeeze or pop the abscess, you actually introduce even more bacteria into the infection. Leave it alone!
- Do not ignore it! Some abscesses do not hurt, but they are all dangerous. Ignoring a dental abscess allows it to spread, and in rare cases, it can spread to areas that will kill you like your airway, bloodstream or brain!
More Questions about Tooth Abscesses?
Call your nearest Premier Dental of Ohio location today to schedule a consultation with one of our skilled dentists. We can answer any tooth abscess question you have and work with you to make sure you stay safe from the risks of the abscess spreading.
Symptoms, Diagnosis & Treatment from Healthily
What is an abscess?
An abscess is a painful collection of pus, usually caused by a bacterial infection. Abscesses can develop anywhere in the body.
This article focuses on two types of abscess:
- skin abscesses – which develop under the skin
- internal abscesses – which develop inside the body, in an organ or in the spaces between organs
Symptoms of an abscess
A skin abscess often appears as a swollen, pus-filled lump under the surface of the skin. You may also have other symptoms of an infection, such as a high temperature (fever) and chills.
It’s more difficult to identify an abscess inside the body, but signs include:
- pain in the affected area
- a high temperature
- generally feeling unwell
Read more about the symptoms of an abscess.
When to see your doctor
See your doctor if you think you may have an abscess. They can examine a skin abscess or refer you to hospital if you may have an internal abscess.
There are several tests available to help diagnose an abscess, depending on where it’s located.
Read about diagnosing an abscess.
Causes of abscesses
Most abscesses are caused by a bacterial infection.
When bacteria enter your body, your immune system sends infection-fighting white blood cells to the affected area.
As the white blood cells attack the bacteria, some nearby tissue dies, creating a hole which then fills with pus to form an abscess. The pus contains a mixture of dead tissue, white blood cells and bacteria.
Internal abscesses often develop as a complication of an existing condition, such as an infection elsewhere in your body. For example, if your appendix bursts as a result of appendicitis , bacteria can spread inside your tummy (abdomen) and cause an abscess to form.
Read about the causes of abscesses.
Treating an abscess
A small skin abscess may drain naturally, or simply shrink, dry up and disappear without any treatment.
However, larger abscesses may need to be treated with antibiotics to clear the infection, and the pus may need to be drained. This will usually be done either by inserting a needle through your skin or by making a small incision in the skin over the abscess.
Read more about treating an abscess.
Preventing a skin abscess
Most skin abscesses are caused by bacteria getting into a minor wound, the root of a hair or a blocked oil or sweat gland.
Ensuring that your skin is clean, healthy and largely free of bacteria can help reduce the risk of skin abscesses developing.
You can reduce the risk of bacteria spreading by:
- washing your hands regularly
- encouraging people in your family to wash their hands regularly
- using separate towels and not sharing baths
- waiting until your skin abscess is fully treated and healed before using any communal equipment, such as gym equipment, saunas or swimming pools
Don’t squeeze the pus out of the abscess yourself, because this can easily spread the bacteria to other areas of your skin. If you use tissues to wipe any pus away from your abscess, dispose of them straight away to avoid germs spreading. Wash your hands after you’ve disposed of the tissues.
Take care when shaving your face, legs, underarm areas or bikini area to avoid nicking your skin. Clean any wounds immediately and visit your doctor or local NHS walk-in centre if you think there may be something trapped in your skin. Don’t share razors or toothbrushes.
Read more about looking after your skin.
It may also help to reduce your risk of skin abscesses by:
- maintaining a healthy, balanced diet
- losing weight if you’re overweight or obese
- stopping smoking
It’s difficult to prevent internal abscesses, as they’re often complications of other conditions.
Other types of abscess
There are many other types of abscess not fully covered here, including:
- an anorectal abscess – a build-up of pus in the rectum and anus
- a Bartholin’s abscess – a build-up of pus inside one of the Bartholin’s glands, which are found on each side of the opening of the vagina
- a brain abscess – a rare but potentially life-threatening build-up of pus inside the skull
- a dental abscess – a build-up of pus under a tooth or in the supporting gum and bone
- a retropharyngeal abscess – a build-up of pus at the back of the throat
- a quinsy (peritonsillar abscess) – a build-up of pus between one of your tonsils and the wall of your throat
- a pilonidal abscess – a build-up of pus in the skin of the cleft of the buttocks (where the buttocks separate)
- a spinal cord abscess – a build-up of pus around the spinal cord
What are the symptoms of an abscess?
The symptoms of an abscess depend on where it develops in your body.
Skin abscesses
Signs of a skin abscess can include:
- a smooth swelling under your skin that can feel hard or firm
- pain and tenderness in the affected area
- warmth and redness in the affected area
- a visible build-up of white or yellow pus under the skin in the affected area
- a high temperature (fever)
- chills
A boil is a common example of a skin abscess.
Internal abscesses
Abscesses that develop inside an organ or in the spaces between organs can be more difficult to identify than skin abscesses. The symptoms can be vague and there may be no obvious external signs of a problem.
The symptoms of an internal abscess can also vary depending on exactly where in the body the abscess develops. For example, a liver abscess may cause jaundice , whereas an abscess in or near the lungs may cause a cough or shortness of breath .
General symptoms of an internal abscess can include:
- discomfort in the area of the abscess
- fever
- increased sweating
- feeling sick
- vomiting
- chills
- pain or swelling in your tummy (abdomen)
- loss of appetite and weight loss
- extreme tiredness (fatigue)
- diarrhoea or constipation
What causes abscesses?
Most abscesses are caused by an infection with staphylococcal bacteria.
When bacteria enter the body, the immune system sends white blood cells to fight the infection. This causes swelling (inflammation) at the site of infection and the death of nearby tissue. A cavity is created, which fills with pus to form an abscess.
The pus contains a mixture of dead tissue, white blood cells and bacteria. The abscess may get larger and more painful as the infection continues and more pus is produced.
Some types of staphylococcal bacteria produce a toxin called Panton-Valentine leukocidin (PVL) which kills white blood cells. This causes the body to make more cells to keep fighting the infection, and can lead to repeated skin infections.
In rare cases, an abscess may be caused by a virus, fungi or parasites.
Skin abscesses
When bacteria gets under the surface of your skin, an abscess can form. This can occur anywhere on the body, although skin abscesses tend to be more common in the:
- underarms
- hands and feet
- trunk
- genitals
- buttocks
Bacteria can get into your skin and cause an abscess if you have a minor skin wound, such as a small cut or graze, or if a sebaceous gland (oil gland) or sweat gland in your skin becomes blocked.
Internal abscesses
Abscesses that develop inside the tummy (abdomen) are caused by an infection reaching tissue deeper within the body. This can occur as a result of:
- an injury
- abdominal surgery
- an infection spreading from a nearby area
There are many ways an infection can spread into the abdomen and cause an abscess to develop.
For example, a lung abscess can form after a bacterial infection in your lungs, such as pneumonia , and a burst appendix can spread bacteria within your abdomen.
Increased risk
In addition to the specific causes mentioned above, things that increase the likelihood of an abscess developing can include:
- having a weakened immune system – this could be because of a medical condition such as HIV , or a treatment such as chemotherapy
- having diabetes
- having an underlying inflammatory condition, such as hidradenitis suppurativa
- being a carrier of staphylococcal bacteria
However, many abscesses develop in people who are otherwise generally healthy.
How are abscesses diagnosed?
See your doctor if you think you may have an abscess. There are several tests used to diagnose an abscess, depending on where it’s located.
Skin abscesses
If you have a skin abscess, your doctor will first examine the affected area and ask you:
- how long you’ve had the abscess
- whether you’ve injured that area
- whether you have any other symptoms
A sample of pus may be taken from your abscess and sent for testing. This allows the specific bacteria causing the abscess to be identified, which can help determine the best way of treating it.
If you’ve had more than one skin abscess, you may be asked to give a urine sample. This will be tested for glucose, which is a sign of diabetes . People with diabetes have an increased risk of developing skin abscesses.
If you have recurring boils and abscesses, your doctor may ask the laboratory to test the bacteria further to see if it’s producing Panton-Valentine leukocidin (PVL) toxin. Additional treatments may be recommended, such as a body wash or an antibiotic cream, to stop these bacteria living on the body.
Internal abscesses
Abscesses that develop inside your body are more difficult to diagnose than skin abscesses because they can’t be seen.
Your doctor will ask you about your symptoms and any other health conditions you may have. If necessary, they’ll refer you to a specialist in hospital.
Abscess treatment
Abscesses can be treated in a number of different ways, depending on the type of abscess and how large it is.
The main treatment options include:
Skin abscesses
Some small skin abscesses may drain naturally and get better without the need for treatment. Applying heat in the form of a warm compress, such as a warm flannel, may help reduce any swelling and speed up healing.
However, the flannel should be thoroughly washed afterwards and not used by other people, to avoid spreading the infection.
For larger or persistent skin abscesses, your doctor may prescribe a course of antibiotics to help clear the infection and prevent it from spreading.
Sometimes, especially with recurrent infections, you may need to wash off all the bacteria from your body to prevent re-infection (decolonisation). This can be done using antiseptic soap for most of your body and an antibiotic cream for the inside of your nose.
However, antibiotics alone may not be enough to clear a skin abscess, and the pus may need to be drained to clear the infection. If a skin abscess isn’t drained, it may continue to grow and fill with pus until it bursts, which can be very painful and can cause the infection to spread or recur.
Incision and drainage
If your skin abscess needs draining, you’ll probably have a small operation carried out under anaesthetic – usually a local anaesthetic , where you remain awake and the area around the abscess is numbed.
During the procedure, the surgeon makes a cut (incision) in the abscess, to allow the pus to drain out. They may also take a sample of pus for testing.
Once all of the pus has been removed, the surgeon will clean the hole that is left by the abscess using sterile saline (a salt solution).
The abscess will be left open but covered with a wound dressing, so if any more pus is produced it can drain away easily. If the abscess is deep, an antiseptic dressing (gauze wick) may be placed inside the wound to keep it open.
The procedure may leave a small scar.
Internal abscesses
The pus usually needs to be drained from an internal abscess, either by using a needle inserted through the skin (percutaneous abscess drainage) or with surgery.
The method used will depend on the size of your abscess and where it is in your body.
Antibiotics will usually be given at the same time, to help kill the infection and prevent it spreading. These may be given as tablets or directly into a vein (intravenously).
Percutaneous drainage
If the internal abscess is small, your surgeon may be able to drain it using a fine needle. Depending on the location of the abscess, this may be carried out using either a local or general anaesthetic .
The surgeon may use ultrasound scans or computerised tomography (CT) scans to help guide the needle into the right place.
Once the abscess has been located, the surgeon drains the pus using the needle. They may make a small incision in your skin over the abscess, then insert a thin plastic tube called a drainage catheter into it.
The catheter allows the pus to drain out into a bag and may have to be left in place for up to a week.
This procedure may be carried out as a day case procedure, which means you’ll be able to go home the same day, although some people will need to stay in hospital for a few days.
As with the incision and drainage procedure for skin abscesses, percutaneous drainage may leave a small scar.
Surgery
You may need to undergo surgery if:
- your internal abscess is too large to be drained with a needle
- a needle can’t get to the abscess safely
- needle drainage hasn’t been effective in removing all of the pus
The type of surgery you have will depend on the type of internal abscess you have and where it is in your body. Generally, it involves making a larger incision in your skin to allow the pus to be washed out.
Abscess incision and drainage | healthdirect
On this page
This page will give you information about an abscess incision and drainage. If you have any questions, you should ask your GP or other relevant health professional.
What is an abscess?
An abscess is a collection of pus surrounded by a wall of tissue. It causes a painful lump and can make you feel unwell.
An abscess happens when your body tries to control infection by forming a wall around an infected area. Pus forms within this wall. As the amount of pus increases, the lump grows and causes pain. You can get an abscess anywhere in your body.
Abscess incision and drainage.
What are the benefits of surgery?
You should no longer have the abscess and should be free of pain. Surgery should prevent the serious complications that an abscess can cause.
Are there any alternatives to surgery?
If an abscess is small, antibiotics may work but will not be effective in most cases. Sometimes draining the pus with a needle can help but the pus may come back.
What does the operation involve?
A small abscess can be drained under a local anaesthetic but most need a general anaesthetic. The operation usually takes 10 to 20 minutes.
Your surgeon will make a cut on your skin over the abscess. This allows the pus to drain out.
Once the pus has been removed, the cavity needs to heal upwards from the inside out, so the opening in your skin is left open.
If the cavity is deep, your surgeon will place a pack (antiseptic dressing) in it to keep it open, allowing pus to drain out and your wound to heal properly.
What complications can happen?
Some complications can be serious and can even cause death.
General complications of any operation
- pain
- bleeding
- unsightly scarring of your skin
- blood clot in your leg
- blood clot in your lung
Specific complications of this operation
- the abscess keeps coming back
- slow healing, if your wound was packed
How soon will I recover?
You should be able to go home the same day or the day after.
Your doctor will tell you when you can return to work.
Most people make a full recovery and can return to normal activities.
Summary
An abscess is a collection of pus that can make you feel unwell. Surgery should prevent the serious complications that an abscess can cause.
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90,000 Abscesses | ChUZ “KB” RZD-Medicine “Voronezh”
Abscess (abscess) – a local accumulation of pus that appears due to acute or chronic local infection, as a result of which tissue destruction begins in the focus. An abscess develops with inflammation of the skin or tissue under it after penetration of microbes through abrasions, injections, wounds.
A characteristic feature of the abscess is that the tissues adjacent to the focus of inflammation create a kind of wall-membrane that separates the infected area and limits the purulent process and tissue death, which is a protective reaction of the body.
There are many types of abscesses: soft tissues, paratonsilar, pulmonary, post-injection and even brain abscess. But, regardless of their location, abscesses are always accompanied by pain and bring a lot of inconvenience.
Causes of abscess
Most often, an abscess occurs due to a focal bacterial infection, mainly staphylococcal, as it leads to a weakening of immunity and reduces the body’s ability to fight diseases.
There are many ways for microbes to enter the body and ways of occurrence of abscesses: microscopic damage to the skin, suppuration of the accumulation of outflowing blood (hematomas), the spread of infection from a local focus, as well as boils, cysts, purulent infections and much more.
An abscess may occur due to the ingress of chemicals under the skin, as well as after medical procedures (subcutaneous infusions, injections) performed without observing aseptic rules.
Symptoms of an abscess
There is a possibility of an abscess on the skin and on any organ or tissue. Internal organ abscesses are most difficult to diagnose, and externally visible abscesses are located in the dermis, in the muscles, or in the tissue under the skin.
The first sign of an abscess is the appearance of a painful hard nodule and redness around it. After a few days or weeks, a pus-filled capsule forms on this site.
Symptoms of an abscess coincide with the typical manifestations of purulent-inflammatory processes, regardless of their location. As a rule, these are general weakness, malaise, high body temperature (in especially severe cases, up to 41 °).
The final phase of the formation of an abscess is often its spontaneous rupture, leading to the release of pus. With superficial abscesses, pus comes out into the external environment and in the case of complete cleansing, the abscess loses volume, subsides and, in the absence of negative influences, eventually turns into a scar.
With abscesses of internal organs, the release of pus in the body cavity can lead to the development of various purulent processes.
Treatment of an abscess
Early diagnosis is very important for the successful treatment of an abscess. Treatment of an abscess, regardless of the place of its occurrence, is reduced to opening a capsule with pus and emptying it.
Most often, abscess is the cause of for surgery and hospitalization, but with small superficial inflammations, they can be treated on an outpatient basis.
In case of abscesses of internal organs (liver or lung), a puncture is sometimes done to remove pus and antibiotics are injected into the vacated cavity.
The extreme stage of surgical intervention for chronic abscesses is the resection of the organ along with the abscess.
After opening, the abscess is treated in the same way as purulent wounds. The patient is provided with rest, good nutrition, it is possible to prescribe a transfusion of blood products or blood substitutes. The course of antibiotics is prescribed only taking into account the sensitivity of the microflora to them.People with diabetes should be especially careful in the treatment of abscesses, since they will need a complete correction of their metabolism.
With timely treatment of abscesses and correctly performed surgical intervention, the percentage of complications is minimal. But a neglected, undrained abscess can become chronic or lead to the spread of infection to healthy tissues. A fistula may form at the site of a poorly cleansed abscess.
Abscess is a surgical disease , therefore, in order to avoid unwanted complications, at the first sign of it, you should consult a doctor.
Paratonsillar abscess: treatment of the disease | Clinic Rassvet
Fast passage
Paratonsillar abscess (PTA) is a collection of pus between the tonsil capsule and the pharyngeal muscles.
Anterior PTA is most often diagnosed, it is localized between the upper pole of the amygdala and the anterior palatine arch. Also distinguish between the posterior PTA – between the amygdala and the posterior palatine arch, the lower PTA – at the lower pole of the amygdala, the external PTA – outside the amygdala.
Paratonsillitis – an infectious inflammatory disease of the tissue surrounding the palatine tonsil, without the formation of an abscess (cavity with pus).
Paratonsillitis or PTA is usually preceded by acute tonsillopharyngitis, but in some cases the disease can develop without a previous pharyngeal infection, which is associated with blockage of the salivary glands.
Paratonsillar abscess is the most common deep-tissue infection of the neck in children and adolescents, accounting for at least 50% of cases.The annual incidence of PTA is 30-40 cases per 100,000 people aged 5 to 59 years.
The main pathogens of PTA are Streptococcus pyogenes (beta-hemolytic streptococcus group A, GABHS), Streptococcus anginosus (angiotic streptococcus), Staphylococcus aureus (Staphylococcus aureus, including methicillin-resistant strains – MRSA …
Symptoms of paratonsillar abscess
A typical clinical manifestation of PTA is severe sore throat (usually one-sided), fever, muffled voice.Patients may also complain of drooling and difficulty swallowing.
Trismus (spasm of the chewing muscles), associated with irritation and reflex spasm of the internal pterygoid muscle, occurs in almost 2/3 of patients and is an important distinguishing feature of PTA in comparison with the severe course of acute tonsillopharyngitis. Also, patients may complain of neck swelling and ear pain on the affected side.
Diagnostics
In the overwhelming majority of cases, the diagnosis of PTA is made clinically – according to the results of pharyngoscopy (examination of the pharynx).Confirmed by obtaining a purulent discharge when draining an abscess or by data from instrumental studies (most often ultrasound).
Pharyngoscopy reveals a swollen and / or fluctuating amygdala with a deviation of the uvula in the opposite direction to the lesion, hyperemia (redness) and swelling of the soft palate. In some cases, plaque or fluid is present in the tonsil. There is an increase and soreness of the cervical and submandibular lymph nodes.
Bilateral PTA is extremely rare, its diagnosis is more difficult, due to the absence of asymmetry in the pharynx, as well as the rarely present spasm of the masticatory muscles.
Laboratory tests are not required for the diagnosis; they are additionally prescribed to determine the severity of the course and the selection of the treatment method.
Laboratory research may include:
- general blood test with leukocyte count;
- study of electrolytes (potassium, sodium, chlorine) with signs of dehydration;
- strepta test to exclude GABHS;
- culture for aerobic and anaerobic bacteria, if drainage of the abscess was carried out (culture is recommended only for complicated PTA, recurrent PTA, or in patients with immunodeficiency states).
Instrumental examination methods – ultrasound, computed tomography, lateral projection of the neck, magnetic resonance imaging or angiography – are optional and are performed to exclude other diseases if the diagnosis of PTA is not obvious.
Differential Diagnostics
Severe course of acute tonsillopharyngitis . Frequent pathogens are Epstein-Barr virus, herpes simplex virus, Coxsackie virus (herpangina), adenovirus, diphtheria, GABHS, gonorrhea.It is manifested by bilateral swelling in the throat, hyperemia, plaque may be present on the tonsils.
Epiglottitis . Inflammatory disease of the epiglottis, usually caused by Haemophilus influenzae. More common in young children who have not been vaccinated against Haemophilus influenzae type b. Progresses faster than PTA. Manifested by a sore throat, drooling, difficulty swallowing, respiratory failure.
Retropharyngeal abscess (retropharyngeal abscess) .Purulent inflammation of the lymph nodes and tissue of the pharyngeal space. Most often seen in children from 2 to 4 years old. With pharyngoscopy, minimal changes are noted. The main complaints are: a stiff neck, pain on movement, especially when the neck is extended (as opposed to the increased pain in flexion seen with meningitis), swelling and soreness of the neck, chest pain, difficulty swallowing, drooling, muffled voice, spasm of the masticatory muscles ( present only in 20% of cases).
Complications
Early diagnosis and timely, appropriate treatment of paratonsillar infection are critical to prevent complications. Complications of PTA are rare but potentially fatal. The infection can spread from the paratonsillar space to the deep spaces of the neck, adjacent areas, and into the bloodstream.
Treatment of paratonsillar abscess
In case of a complicated course, children (especially young children) are shown hospitalization and treatment in a hospital setting.
The main treatment for PTA is systemic antibiotic therapy. In severe cases, severe intoxication, difficulty swallowing, nausea, antibiotic therapy is prescribed parenterally (bypassing the gastrointestinal tract) with subsequent transfer to oral forms of drugs – until the completion of the 14-day course of treatment. Antibiotic therapy for less than 10 days increases the likelihood of disease recurrence.
After the appointment of systemic antibiotic therapy, dynamic observation is recommended for 24 hours.It is acceptable in patients with suspected paratonsillitis, without obvious signs of PTA, without signs of airway obstruction, sepsis, severe spasm of the masticatory muscles, or other signs of a complicated course of the disease. And also in children under 7 years of age with minor abscesses and rare episodes of acute tonsillopharyngitis in history.
Studies have shown that the appointment of systemic antibiotic therapy is effective even without drainage of the abscess. According to the available data, 50% of children responded to systemic antibiotic therapy and did not need drainage of an abscess or removal of tonsils.
Systemic antibiotic therapy should include antibiotics active against GABHS, Staphylococcus aureus and respiratory anaerobes. With PTA, the most commonly prescribed are amoxicillin-clavulanate, ampicillin-sulbactam, clindamycin. In the absence of response or severe course, vancomycin or linezolid is added to treatment to ensure optimal coverage of potentially resistant Gram-positive cocci.
There are 3 methods of PTA drainage:
- PTA puncture – purulent discharge is removed through an aspiration needle;
- drainage of the PTA through the incision;
- tonsillectomy.
Drainage of an abscess never precludes the appointment of systemic antibiotic therapy.
All 3 abscess drainage techniques are comparable in effectiveness. The choice of procedure depends on the patient’s condition, the severity of the disease, the presence of complications, the patient’s age and the patient’s ability to cooperate with the doctor.
For patients without spasm of the masticatory muscles or recurrent acute tonsillopharyngitis in history, puncture drainage of the PTA or drainage of the abscess through an incision is recommended, which can be performed on an outpatient basis under local anesthesia.
Tonsillectomy is preferred in the following cases:
- Previous episodes of PTA or recurrent tonsillopharyngitis;
- significant upper airway obstruction or other complications;
- ineffective drainage of the abscess;
- Other indications for tonsillectomy (eg, upper airway obstruction and snoring due to large tonsils).
Randomized studies comparing PTA puncture drainage with PTA drainage through an incision showed comparable abscess resolution in more than 90% of cases.
Data on the benefits of systemic hormonal therapy (glucocorticoids) in the treatment of PTA are contradictory. Some studies show that the use of glucocorticoids (dexamethasone) can shorten the duration of symptoms of the disease, as well as reduce pain after draining the PTA. In other studies, however, no clear benefits of glucocorticoid administration in adults and children have been recorded. Since the number of patients participating in these studies was small (40 to 250 cases), further research is needed on the effectiveness of the routine use of glucocorticoids in the treatment of PTA.
Recurrences of PTA occur in 10-15% of cases, more often in patients with a history of recurrent acute tonsillitis pharyngitis.
Risk factor for PTA – smoking.
How is the treatment of paratonsillar abscess in the clinic Rassvet
With timely and appropriate treatment, most paratonsillar infections resolve without complications. For all patients with diagnosed paratonsillitis or PTA, we prescribe systemic antibiotic therapy for 10-14 days.
According to indications, we perform drainage of the abscess under local anesthesia on an outpatient basis.
In case of a complicated course, recurrent PTA or acute tonsillopharyngitis, ineffectiveness of antibiotic therapy and ineffectiveness of abscess drainage, we refer the patient to a hospital for tonsillectomy.
As anesthetic therapy, we prefer NSAIDs (ibuprofen) or acetaminophen (paracetamol), rather than local anesthetics in the form of gargles, sprays and lozenges.
For the treatment of paratonsillitis and PTA, we do not prescribe homeopathic, naturopathic, immunomodulatory and other drugs whose effectiveness has not been proven.
Author:
Chekaldina Elena Vladimirovna
otorhinolaryngologist, Ph.D.
90,000 causes, symptoms, diagnosis and treatment
HomeBlog Tooth abscess: causes, symptoms, diagnosis and treatment
What causes a tooth abscess? What are the symptoms?
How is a tooth abscess diagnosed?
Tooth abscess is an infection in or around a tooth.A tooth abscess can be very painful. If left untreated, the infection can spread and you could lose a tooth or have other health problems.
What causes a tooth abscess?
Tooth damage, tooth decay, or gum disease can cause a tooth abscess.
If tooth decay is left untreated, the inside of the tooth (called the pulp) can become infected. The bacteria can spread from the tooth to the tissue around it, creating an abscess.
Gum disease causes the gums to pull away from the teeth, leaving pockets. If food accumulates in one of these pockets, bacteria can grow and an abscess can form. Over time, an abscess can lead to resorption of the bone around the tooth.
Symptoms of a tooth abscess:
- throbbing pain, especially when chewing;
- red, swollen gums
- unpleasant salty taste in the mouth;
- fever;
- Red, swollen lump in the mouth that may ooze blood or pus;
- tooth that is very tender or painful to feel.
90,093 swelling of the jaw or face;
Over time, as the infection spreads, the bone in the jaw may begin to dissolve. When this happens, you may feel less pain, but the infection will still occur. If you lose too much bone, your tooth will become shaky and may need to be removed.
If you have severe toothache, swelling of the gums or face, or outflow of pus, see your dentist immediately. You may have a tooth abscess. If left untreated, the infection can spread and become dangerous.
How is a tooth abscess diagnosed?
Your dentist will ask about your symptoms and look for swelling and other signs of infection in your mouth. He can knock on the tooth and apply heat or cold to it.
Your dentist can also take x-rays of your teeth.
Abscess treatment
Tooth abscess requires immediate treatment. Your dentist can:
1. Give you antibiotics to kill the bacteria that cause the infection.
2. Make a hole in the tooth to drain fluid / pus and relieve pain.
3. Make a root canal to remove the infected pulp in the tooth.
4. Remove tooth . This may be necessary if there is no point in making a root canal.
You and your doctor will decide what is best for you.
To reduce pain and swelling, you can place an ice pack on your cheek.You can also try acetaminophen (paracetamol) or ibuprofen. If you smoke or use any type of tobacco, try not to do so while your tooth is healing.
How to prevent tooth abscess?
The best way to prevent tooth abscess is to take good care of your teeth and gums:
1. Brush your teeth 2 times a day, morning and evening. Use a fluoride toothpaste.
2. Use dental floss.
3. See your dentist for regular checkups.
4. Eat healthy foods and also limit snacks between meals.
If your mouth is very dry, you may be more at risk of tooth decay and dental infections. To prevent dry mouth, drink water frequently, chew sugarless gum, or suck on sugarless candy. Talk to your doctor about medications that can help.
Prostate abscess: description of the disease, causes, symptoms, diagnosis and treatment
An abscess of the prostate gland is a dangerous polyetiological purulent-necrotic inflammatory disease, which is characterized by purulent fusion of the glandular tissue of the prostate.After this, single or multiple purulent cavities will form. If an abscess occurs, the patient needs urgent hospital treatment. In most cases, the appearance of a prostatic abscess is a serious complication of an acute or chronic infection of the lower urinary tract.
According to statistics, this pathology occurs in no more than 3% of all prostate diseases. Now this disease belongs to a rather rare phenomenon.Moreover, if we talk about a developed country. The reason for the significant decrease in the incidence of prostate abscess is the decrease in the incidence of gonococcal urethritis. Before modern antibiotic therapy appeared, more than 50% of prostate abscesses were provoked by gonococci. In addition, the mortality rate due to this disease was about 27%.
Since antibiotic therapy appeared, there has been a change in the bacteriology of prostate abscess. Initially, the disease was provoked by gonococci, Staphylococcus aureus and Koch’s bacillus.Now prostate abscess appears due to gram-negative bacteria. This includes E. coli and staphylococci.
Why does the disease
occur
Given the cause of the development of an abscess, it is primary and secondary. Primary abscess is referred to as an independent disease. In the emergence of such a process, the main role is played by the transfer of bacteria from the infectious focus to the prostate gland. This happens through the bloodstream. The cause may be chronic tonsillitis or tonsillitis.
However, this situation rarely happens. The appearance of a secondary prostate abscess is mainly observed. The cause is acute or chronic prostatitis. This happens due to inadequate treatment of prostatitis or careless instrumental intervention. The inflammatory process intensifies, it provokes stagnation and edema, then metabolic products accumulate in the prostate gland, as a result of which it is damaged.
At the first stage, small abscesses are formed, then they develop, after which they are combined into one large abscess.This process is also an abscess of the prostate gland.
Sometimes the disease develops as a complication after surgery on the prostate or bladder. The emergence of an abscess occurs when obstruction of the excretory duct of the prostate formed by calculi.
Also, a predisposing factor for the development of prostate abscess is a weakened immune system. The cause of the weakening may be hypothermia, congestion in the pelvic region, smoking, impaired regularity of intercourse.
How does the disease manifest
There are a number of pronounced clinical manifestations of the disease:
The body temperature rises, chills, fever appear.
Development of intoxication.
There is an increase in sweating and an increase in heart rate.
Consciousness is impaired.
If we talk about the organs of the urinary system, the following signs may appear:
Urination becomes more frequent.
Painful and difficult urine discharge.
Development of acute urinary retention.
Urine includes blood.
The patient notices the appearance of painful sensations in the lower back, perineum. A distinctive feature of an abscess is one-sided localization. Soreness is present in the place where the lobe of the prostate gland is affected by inflammation.
If we talk about the nature of the pain, then it is intense, sharp, pulsating. In most cases, it can be felt in the rectum. Sometimes defecation is disturbed, gases are hardly escaping.
The appearance of the above clinical symptoms indicate that the stage of infiltration has begun.When the pathological process occurring in the prostate gland moves to the next stage (purulent), the patient will feel that his condition has improved significantly. For example, there will be a decrease in the intensity of painful sensations, a decrease in body temperature.
But it should be remembered that this is only an imaginary well-being. At this time, a formed abscess can break through. Pus may be in the urethra or in the paravesical tissue space near the bladder.In the future, the risk of developing a dangerous complication increases. For example, phlegmon may occur.
After a spontaneous breakthrough of the abscess, the following symptoms may appear:
Pus appears in the urine.
The urine changes its color to cloudy, with an admixture of flakes.
An unpleasant pungent smell joins.
Sometimes, after the abscess has opened, a purulent mass can enter the rectum, resulting in the formation of a rectal fistula.In this condition, the feces will contain mucus and pus.
After the abscess has burst, it is not emptied completely. This means that the disease may recur in the future.
In the presence of an abscess of the prostate gland in a person who has been diagnosed with an immunodeficiency virus, the following will occur:
How the disease is diagnosed
For an accurate diagnosis of “prostate abscess”, the totality of all signs is taken into account, as well as the results of laboratory and instrumental studies, diagnostic operations (biopsy).A blood test can determine the presence of typical signs of an acute inflammatory process. That is, the number of leukocytes increases, the erythrocyte sedimentation rate. According to the general analysis of urine, leukocyturia, proteinuria are determined.
On palpation of the prostate gland, the doctor can determine the presence of a rounded protruding formation, and also feel fluctuation, since the abscess consists of fluid. In addition, there is an increase in the prostate gland, its tension.Palpation of the prostate gland gives the patient a lot of painful sensations. Performing a digital rectal examination of the prostate gland is carried out with extreme caution, as bacteriotoxic shock may develop.
Another effective diagnostic method is computed magnetic resonance imaging. A more reliable way to identify an abscess of the prostate gland. In addition, the condition of the surrounding tissues is assessed, and distant foci of inflammation are determined.
Also, the patient may be prescribed a transurethral ultrasound examination. It reveals the presence of a hypoechoic focus, which has a round or oval shape. The appearance of such a focus is due to the fact that the prostate is enlarged and edematous.
With the help of ultrasound, not only the presence of an abscess is detected, but also the size and localization are determined. Also, this diagnostic method helps to control the process of puncture of the abscess, when some of the contents are taken in order to identify the cause of the disease.
If the doctor suspects that a fistula has developed, the man is prescribed ureteroscopy, cystoscopy, ultrasound examination of the bladder, anoscopy. In addition, it is necessary to consult a proctologist. Differential diagnosis of acute prostatitis, pyelonephritis, epididymitis is also carried out.
How prostate abscess can be complicated
In the absence of timely and adequate treatment of prostate abscess, the risk of serious complications increases.These include:
Development of urosepsis. The man’s body temperature rises, a fever develops. The appearance of tachycardia, severe weakness, nausea, vomiting is also observed. The amount of urine excreted decreases in volume.
Development of peritonitis. It is characterized by acute pain, nausea, vomiting, chills, fever, loss of appetite.
Phlegmon is formed.It can be located in various locations. It can be retroperitoneal, subcutaneous tissue of the perineum, scrotum, abdominal wall. Puffiness appears, painful sensations in the place where the inflammatory process is present. In addition, the lymph nodes increase, all the signs of intoxication are evident, the skin may turn red.
The patient may die.
How is the disease treated
The strategy and tactics of treatment measures are determined based on what stage of the disease is present in the patient.The inflammatory process can be infiltrative or purulent-destructive.
In modern medicine at the moment there is no single consensus and algorithm for the treatment of purulent-destructive processes in the prostate. According to all urological guidelines in the world, parenteral antibiotic therapy and adequate drainage of the purulent focus are used to treat prostate abscess. The latter is carried out in a hospital.
The stage of infiltration requires the following conservative treatment:
A broad-spectrum antibacterial agent is administered parenterally.This includes cephalosporins, fluoroquinolones, aminoglycosides.
Detoxification and immunostimulating therapy consists in the intravenous administration of an appropriate solution.
To eliminate the pain syndrome, a local anesthetic is administered (Lidocaine, Novocaine).
If, during an ultrasound examination, a formed purulent cavity was visualized, the patient is prescribed an opening and drainage of the purulent focus.Drainage of prostate abscess can be carried out using three methods: transrectal, transurethral, transperineal.
For drainage of prostate abscess, the advantage is given to the minimally invasive puncturing technique. For its implementation, local anesthesia is introduced. In addition, such methods are diagnostic measures as well.
Patients can safely tolerate the drainage process if it is monitored by transrectal ultrasound.This is a very effective way. If the abscess is located deep in the prostate gland, performing percutaneous drainage involves monitoring computed tomography.
The traditional open method consists in transperineal opening of the purulent focus, followed by drainage of the purulent cavity. In most cases, doctors use the perineal approach, due to which a wide opening of the abscess occurs. Using this method, secondary infection will not occur, and a rectal urethral fistula does not form.After surgery, intensive antibacterial and detoxification therapy is prescribed.
What is the prognosis of the disease
If a man promptly turned to a medical center for qualified help, where he was diagnosed and prescribed adequate treatment, one can safely count on a favorable outcome of the development of the disease. In addition, there is hope that the patient’s reproductive potential will remain.
If the prostate abscess is not recognized in time, the infection will generalize, urosepsis will develop, and the risk of death increases.
The risk of developing the disease increases if:
Existing secondary immunodeficiency. This includes a cold, an acute respiratory viral infection, a persistent sluggish chronic inflammatory process in a particular organ, the presence of pulmonary or extrapulmonary tuberculosis.
Alcohol abuse and smoking.
The presence of diabetes mellitus.
Tooth abscess – acute purulent inflammation. Important information from dentists
dentistry in Chelyabinsk
Inflammation that occurs in any part of the human body, including the oral cavity, is always a painful, unpleasant and completely unexpected process. After reading this article, you will not only be able to determine if you have an abscess by its characteristic signs, but you will also be able to understand what types of dental abscesses are, what complications may arise and in what ways to treat it.
Symptoms and types of disease
Specialists distinguish 3 types of this disease, such as:
- gingival, which appears on the soft tissues of the mucosa and does not affect the teeth;
- periodontal – the inflammatory process is localized at the root and leads to slight mobility of the diseased tooth;
- Periapical – Inflammation appears inside the tooth.
This disease is characterized by certain symptoms, in the presence of which it is necessary to immediately begin treatment of the tooth abscess.
At the initial stage of the disease, a person may find slight redness and induration in the area of soft tissues.
Facial asymmetry in case of inflammation
After a certain period of time, the swelling increases, and the soft tissues in the jaw area begin to swell gradually, which leads to some asymmetry of the face. In addition to the external manifestations of the disease, the patient develops general symptoms in the form of weakness, general malaise, loss of appetite and sleep problems.
In the area of the affected tooth, painful sensations arise, which are significantly aggravated by eating food and pressing on the inflamed gums.The enamel sensitivity begins to increase, and the patient experiences severe discomfort when eating sour, spicy, hot, sweet and cold foods.
In the area of redness, a characteristic sac is formed, which is filled with pus. If it breaks through on its own, then an ulcer forms in its place.
In some patients, when an abscess occurs, there may be an increase in body temperature or swelling of the lymph nodes in the neck. It also happens that at a certain moment the symptoms subside or disappear completely on their own, which indicates the death of the injured tooth root.After a couple of days, the painful sensations return and intensify, and the infection can reach the jawbone.
Sometimes the pouch is opened without any manipulation by the patient or doctor, and pus drains out, as a result of which the person feels significant relief. For a certain time, pain, swelling disappears and the patient’s general well-being improves. To avoid the reappearance of pustules, you need to consult a dentist.
Treatment order
During the examination, to make the correct diagnosis, the doctor can not only conduct a visual examination for the presence of characteristic abscesses, but also interrogate the patient, identifying symptoms that indicate a tooth abscess.In rare cases, the dentist may send the patient for an x-ray to confirm the presence of the disease.
The standard treatment for this disease is surgery, by which the doctor opens the patient’s cavity, thereby ensuring the outflow of pus.
After the open wound is treated with an antiseptic and anti-inflammatory drug. In some cases, the dentist may drain the wound. Passing through the canal, he removes tissue in the area of the tooth root, and then applies a filling.
In the event that the infection has almost completely destroyed the tooth, the dental surgeon removes it and offers the patient to install a temporary crown. In case of severe inflammation, it is extremely undesirable to preserve the tooth, since the risk of a second abscess is significantly increased.
The modern method of treatment of tooth abscess is laser dissection. A significant advantage of this method is that after using it, wound healing occurs much better and faster, and the procedure itself gives the patient less pain.
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Abscess and phlegmon of the larynx – Clinic of medical examinations
Abscess and phlegmon are the most dangerous diseases, which in most cases end in both immediate and delayed complications.
Abscess and phlegmon of the larynx are themselves complications of paratonsillar abscess, as well as purulent inflammation of the sublingual tonsil. Also, an abscess can develop if the larynx is damaged by a foreign body, followed by infection.
Cases are described when an abscess of the larynx developed against the background of influenza laryngitis. However, abscess and phlegmon in the larynx develop under the influence of bacteria. Influenza can serve as an indirect cause in the form of a weakening of the factors of nonspecific immune defense of the body as a whole, as well as inflammation in the larynx, which contributes to the attachment of a secondary bacterial infection.
The main pathogens are streptococcus, staphylococcus, pneumococcus. With the development of gangrene, the addition of anaerobic microflora is possible.
Symptoms
Abscess and phlegmon of the larynx are always accompanied by a sharp sore throat, pain when swallowing, fever with a rise in temperature to 39 degrees and above. The symptoms of an abscess are similar to those of inflammatory edema, but they are more pronounced.
Most often, with purulent inflammation, symptoms develop with lightning speed. Also, with phlegmon and abscess, the patient’s general condition worsens quickly enough.
The pain is localized in the larynx and radiates to the occipital and temporal regions.Many patients experience particularly severe pain when coughing.
Also, abscess and phlegmon are accompanied by symptoms of general intoxication: nausea, possibly vomiting, with an increase in body temperature, confusion, dizziness, thirst, sweating may be present.
With the development of an abscess, the initial condition of the throat resembles that of edematous laryngitis. On days 2 – 3 of the disease, yellow infiltrates may appear on the mucous membrane. The surrounding mucous membrane is hyperemic (has a red-burgundy color).In the course of the development of inflammation, the surrounding tissues swell, and a purulent fistula begins to form.
An abscess most often develops on the lingual surface of the epiglottis and in the area of the valecules. There have also been cases of abscess in the scooped-supraglottic ligaments.
With the development of an abscess, there is an increase in regional lymph nodes. They can become dense, painful, however, they do not solder with the surrounding tissues.
With a large volume of abscess, it can break into the trachea, causing purulent inflammation of the lower respiratory tract and lung abscess.
It is important to note that improper or untimely treatment can lead to chondroperichondritis of the larynx, damage to the joints of the larynx, fusion of the cartilage of the larynx, and go into a generalized process.
Treatment
Phlegmon and laryngeal abscess are a condition requiring immediate initiation of complex therapy. The unbearable sore throat will not go away on its own. There is no objective reason to postpone treatment.
The tactics of treatment consists of a combination of antibiotic therapy, anti-edema and desensitizing therapy, surgical assistance in the form of opening the abscesses and suctioning their contents.
The first antibiotic is empirically prescribed based on national clinical guidelines for otorhinolaryngology and guidelines for antibiotic therapy. Self-selection of antibiotics and self-medication in this case can lead to the creation of an antibiotic-resistant strain – superinfection. It is possible to stop phlegmon of the larynx only in a complex manner. When opening the abscesses, a bacteriological culture is done with an analysis for sensitivity to antibiotics. The fact is that many microorganisms, especially streptococcus and staphylococcus, have adapted to popular antibiotics, it is often necessary to use reserve antibiotics that are sensitive to certain strains of bacteria.The doctor monitors the effectiveness of antibiotic therapy on the second and fifth days after prescribing the drugs. If the antibiotic is ineffective against a particular strain, then it must be replaced immediately. In this case, the correct choice of antibiotic therapy and adherence to the exact time and frequency of taking antibiotics are critical.
It is important to note that after the results of the resistance test are obtained, the antibiotic can be changed again. Currently, there are no express methods for isolating pure cultures and studying their interaction with antibiotics.A full-fledged bacteriological study is required, which can not always be replaced by PCR studies or ELISA.
If the patient’s condition deteriorates significantly, the patient is hospitalized. Outpatient treatment is possible only if the patient’s condition is not life threatening, it was possible to open and drain all purulent foci, an empirically selected antibiotic was effective.
You can get help from an ENT doctor in the Clinic of Medical Examinations at the Diagnostic Center on Bolshaya Nizhegorodskaya and in the Hospital on Bolshaya Moskovskaya.
Abscess and phlegmon of the larynx can cause swelling and difficulty in breathing. This condition is urgent and can lead to death.
Lancing of an abscess in Ufa
An abscess is a purulent-necrotic inflammation, which has a limited spread with the formation of a cavity. This cavity is filled with pus in various organs and is limited by the pyogenic membrane. The disease can appear, as an independent, and also be with various complications of any infectious type of disease.The main method that is used in the treatment of an abscess is to open and cleanse, as well as drain the cavity where the accumulation of pus is located. This makes it possible to significantly improve the general condition of the patient who suffers from this disease. If you do not open and clean the abscess, over time it will increase in size, which will lead to the rupture of the capsule and the penetration of the infection into the tissues of the human body. With the help of a surgical operation, the abscess is opened and drained, and an aseptic bandage is applied.After the completion of the surgical procedure, the patient is prescribed antibacterial, anti-inflammatory and desensitizing medical therapy. The doctor, taking into account the indications, chooses the method that will be used to open the abscess.
Lancing of an abscess
Areas where an abscess develops are the head, neck, as well as the face, underarms and genitals. The qualified and experienced doctors of the clinic can remove abscesses quickly as well as safely.Within one hour, a person can get rid of the abscess and eliminate possible complications.
Symptoms for surgical treatment
The first sign that can be noticed with purulent inflammation is redness of an insignificant size of a dense type. The person feels pain when pressing on it. Over time, it becomes larger in size and reaches 2-3 centimeters. After 3-4 days, this seal becomes softer, and in the very center you can see a yellow or white abscess.At this time, a person feels a deterioration in his general condition, his temperature rises, which reaches 40 degrees, and he also experiences weakness. During this period of time, it opens up on its own and pus comes out. The pains disappear and the patient’s condition improves. It is worth noting that in certain cases one should not wait.
Features of the procedure
To diagnose inflammation on the skin, there is no need to perform additional studies. The doctor examines the area of inflammation and decides whether it is necessary to open the abscess, as well as drain the abscess.
Ask question
or make an appointment
How is operation
In our clinic, the medical procedure for opening an abscess is performed on an outpatient basis using local anesthesia. The healthcare professional performs the procedure for treating the site of inflammation using antiseptics. If required, then several injections are given for pain relief. After that, a small incision is made at the site of the swelling.The doctor performs the procedure for removing pus, and also flushes the cavity using special means. Upon completion of the procedure, a gauze bandage is applied to the site of the abscess opening.
Patient rehabilitation period
In direct proportion to the severity of the disease, the doctor in some cases prescribes antibiotics, which are necessary to speed up the healing process. The patient will need to visit the doctor again in 1-2 to remove the established drainage. Most often, the wound heals after surgery in 2 weeks.Paratonsillar abscess, when a peritonsillar abscess forms in the tissues of the throat next to one of the tonsils. An abscess is a collection of pus that forms near an infected area of skin or other soft tissue. An abscess can cause pain, swelling and, in severe cases, a blocked throat. If the throat is blocked, swallowing, speaking, and even breathing are difficult.
A peritonsillar abscess, also known as tonsillitis, is a localized collection of pus in the peritonsillar space at the back of the mouth, next to one of the tonsils (between the tonsil capsule and the superior constrictor muscle).A peritonsillar abscess can be very painful and make it difficult to open the mouth. A peritonsillar abscess can also cause swelling, which can push the tonsil toward the uvula (a dangling, fleshy object in the back of the mouth). This can clog the throat, making it difficult to swallow, speak, and sometimes even breathe. Peritonsillar abscess is usually caused by a complication of tonsillitis. Peritonsillar abscess is most common in older children, adolescents, and young adults. But this infection can occur in all age groups, with the highest incidence in adults between 20 and 40 years old.Peritonsillar abscess is rare before the age of five. Symptoms of a peritonsillar abscess include:
- Severe sore throat that is worse on one side.
- Fever and chills.
- Swollen lymph glands.
- Problems with swallowing.
Peritonsillar abscess is a common infection of the head and neck area. The prognosis of peritoneal abscess is good in most patients.However, there may be complications that are very dangerous to human health and life. A peritonsillar abscess that goes untreated can lead to more serious health problems. The usual treatment for a peritonsillar abscess involves draining the abscess by a doctor. The doctor does this either by removing the pus with a needle (called aspiration), or by making a small incision in the abscess with a scalpel so that the pus can drain out. If that doesn’t work, the patient’s tonsils may be removed in a procedure called a tonsillectomy.This is especially true for people who have had tonsillitis a lot or who have had a peritoneal abscess in the past.
If eating or drinking is difficult, patients may need intravenous (vein) fluids to hydrate. The doctor will also prescribe pain relievers and antibiotics. Whenever the patient takes antibiotics, the full course of treatment is needed as prescribed, even if the patient feels better after a few days. Otherwise, the infection may return.People who have had tonsillectomy may require a short hospital stay. This way, doctors can monitor them to make sure everything went as planned.
Before surgery, the patient is given local anesthesia. A surgical incision is then made using a scalpel. In each case, the doctor individually chooses the best place for the incision. As a rule, this area is the most edematous part. Here, a Hartmann syringe is used, and with its help the surgeon removes pus from the purulent cavity.Upon completion of the surgical procedure, the doctor will prescribe postoperative treatment. This treatment includes taking antibiotics as well as using various antiseptics to rinse the area undergoing surgery. These remedies should be water-based and decongestant medications are recommended.
Parapharyngeal abscesses are deep abscesses involving the parapharyngeal space. It is a serious and potentially fatal disease that requires immediate diagnosis and treatment.A person of any age can develop a parapharyngeal abscess, but it is most often seen in children and adolescents. Immunocompromised adults are also at increased risk. The disease is variable, the first symptoms of a parapharyngeal abscess are similar to those of uncomplicated acute pharyngitis or tonsillitis (fever, sore throat, nasal voice, dysphonia, cervical lymphadenopathy). The progression of signs and symptoms is key as it refers to inflammation and obstruction of the upper airway or gastrointestinal tract, and there may be dysphagia, shortness of breath, neck stiffness, drooling, and chest pain.
If a parapharyngeal abscess is found, treatment should be started immediately. It can usually be treated with broad-spectrum parenteral antibiotics and surgical drainage. Sometimes small abscesses can only be treated with intravenous antibiotics.
Tonsillogenic abscesses develop due to the breakthrough of pus, as well as complications that appear after opening the purulent space. In the same way, infection of the space appears during anesthesia in patients who suffer from chronic tonsillitis.