Pain relief for skin abscess: The request could not be satisfied
Abscess, Antibiotic Treatment Only
An abscess happens when bacteria get trapped under the skin and start to grow. Pus forms inside the abscess as the body responds to the bacteria. An abscess can happen with an insect bite, ingrown hair, blocked oil gland, pimple, cyst, or puncture wound. It is sometimes call a boil.
In the early stages, your wound may be red and tender. For this stage, you may get antibiotics. If the abscess does not get better with antibiotics, it will need to be drained with a small cut.
These tips will help you care for your abscess at home:
Soak the wound in hot water or apply hot packs (small towel soaked in hot water) to the area for 20 minutes at a time. Do this 3 to 4 times a day, or as instructed. Use a new towel each time. Wash the towels afterward because they may be contaminated with bacteria after use.
Don’t cut, squeeze, or pop the boil yourself.
Put antibiotic cream or ointment on the skin 3 to 4 times a day, unless something else was prescribed. Some ointments include an antibiotic plus a pain reliever.
If your healthcare provider prescribed antibiotics, don’t stop taking them until you have finished the medicine or you are told to stop.
You may use an over-the-counter pain medicine to control pain, unless another pain medicine was prescribed. Talk with your provider before taking these medicines if you have chronic liver or kidney disease or ever had a stomach ulcer or digestive bleeding.
Follow up with your healthcare provider, or as advised. Check your wound each day for the signs that the infection may be getting worse (see below).
When to seek medical advice
Get prompt medical attention if any of these occur:
An increase in redness or swelling
Red streaks in the skin leading away from the abscess
An increase in local pain or swelling
Fever of 100.4ºF (38ºC) or higher, or as directed by your healthcare provider
Pus or fluid coming from the abscess
Boil returns after getting better
Boils and carbuncles – Diagnosis and treatment
Your doctor will likely be able to diagnose a boil or carbuncle simply by looking at it. A sample of the pus may be sent to the lab for testing. This may be useful if you have recurring infections or an infection that hasn’t responded to standard treatment.
Many varieties of the bacteria that cause boils have become resistant to certain types of antibiotics. So lab testing can help determine what type of antibiotic would work best in your situation.
You can generally treat small boils at home by applying warm compresses to relieve pain and promote natural drainage.
For larger boils and carbuncles, treatment may include:
- Incision and drainage. Your doctor may drain a large boil or carbuncle by making an incision in it. Deep infections that can’t be completely drained may be packed with sterile gauze to help soak up and remove additional pus.
- Antibiotics. Sometimes your doctor may prescribe antibiotics to help heal severe or recurrent infections.
Lifestyle and home remedies
For small boils, these measures may help the infection heal more quickly and prevent it from spreading:
- Warm compresses. Apply a warm washcloth or compress to the affected area several times a day, for about 10 minutes each time. This helps the boil rupture and drain more quickly.
- Never squeeze or lance a boil yourself. This can spread the infection.
- Prevent contamination. Wash your hands thoroughly after treating a boil. Also, launder clothing, towels or compresses that have touched the infected area, especially if you have recurrent infections.
Preparing for your appointment
You’re likely to see your family doctor or primary care provider first, who may then refer you to a specialist in skin diseases (dermatologist) or infectious diseases.
What you can do
List all your signs and symptoms and when they first occurred. Record how long the bumps lasted and if any recurred. Make a list of all medications — including vitamins, herbs and over-the-counter drugs — that you’re taking. Even better, take the original bottles and a list of the doses and directions.
For boils and carbuncles, some basic questions to ask your doctor include:
- Are tests needed to confirm the diagnosis?
- What is the best course of action?
- Is there a generic alternative to the medicine you’re prescribing?
- Can I wait to see if the condition goes away on its own?
- What can I do to prevent the infection from spreading?
- What skin care routine do you recommend while the condition heals?
What to expect from your doctor
Your doctor is likely to ask you a number of questions, such as:
- What did the boil look like when it first started?
- Are your symptoms painful?
- Have you had a boil or carbuncle before?
- Are you having fever or chills?
- Do you have artificial heart valves, joints or other implanted devices?
Sept. 18, 2021
- Spelman D et al. Cellulitis and skin abscess: Clinical manifestations and diagnosis. https://.uptodate.com/contents/search. Accessed Aug. 1, 2019.
- Downey K et al. Technique of incision and drainage for skin abscess. https://www.uptodate.com/contents/search. Accessed Aug. 1, 2019.
- How to treat boils and styes. American Academy of Dermatology. https://www.aad.org/public/skin-hair-nails/skin-care/boils-and-styes. Accessed Aug. 1, 2019.
- Habif TP. Bacterial infections. In: Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 6th ed. Elsevier; 2016. https://www.clinicalkey.com. Accessed Aug. 1, 2019.
- Mukwende M, et al. Basics. In: Mind the Gap: A Handbook of Clinical Signs in Black and Brown Skin. St. George’s University of London; 2020. https://www.blackandbrownskin.co.uk/mindthegap. Accessed July 13, 2021.
- Kelly AP, et al. Bacterial infections. In: Taylor and Kelly’s Dermatology for Skin of Color. 2nd ed. McGraw-Hill Education; 2016. https://accessmedicine.mhmedical.com. Accessed July 13, 2021.
Skin Infections | Community | Antibiotic Use
When to Seek Medical Care
See a doctor right away if your child is younger than 3 months old and has a fever of 100.4 °F (38 °C) or higher.
See a doctor if you have symptoms of cellulitis or abscess. Although most cases of cellulitis resolve quickly with treatment, some can spread to the lymph nodes and bloodstream and can become life-threatening.
Your doctor will determine if you have a skin infection by asking about symptoms and doing a physical examination.
Antibiotics are needed to treat cellulitis.
If you have a skin abscess, your doctor may need to drain the pus from the abscess. Antibiotics are sometimes needed for abscesses after the pus has been drained.
Any time you take antibiotics, they can cause side effects. Side effects can range from minor issues, like a rash, to very serious health problems, such as antibiotic-resistant infections and C. diff infection, which causes diarrhea that can lead to severe colon damage and death. Call your doctor if you develop any side effects while taking your antibiotic.
In some cases, severe infections need to be treated in the hospital.
How to Feel Better
If you are prescribed antibiotics for your skin infection:
- Take them exactly as your doctor tells you.
- Do not share your antibiotics with others.
- Do not save them for later. Talk to your pharmacist about safely discarding leftover medicines.
Talk with your doctor if you have any questions about your antibiotics. Keeping the area clean is important so your skin infection can get better. If the infection is in the leg, elevating the leg can help decrease swelling.
You can help prevent skin infections by doing the following:
- Clean your hands.
- Wash cuts with soap and water.
- Talk to your doctor about steps you can take to prevent skin infections, especially if you have a condition, such as diabetes, that increases your risk of certain skin infections.
Everything You Need to Know About an Abscess
An abscess is a cavity containing pus and surrounded by inflamed tissue, formed as a result of a localized infection.
An abscess may develop, enlarge or subside, depending on whether microorganisms or leukocytes (white blood cells) gain the upper hand in any one of a number of locations in the body. Abscesses may develop in any organ and in the soft tissues beneath the skin in any area.
Common sites include the breast, gums and peri-rectal area. Rarer sites include the liver and the brain. Common sites for abscesses under the skin include the axilla (armpit) and the groin. These two areas have a large number of lymph glands that are responsible for fighting infection.
A collar-button abscess is one in which a small abscess cavity under the skin connects via a sinus to (channel) to a much larger one in deeper tissues.
Abscesses can be caused by minor breaks and punctures of the skin, obstruction of sweat glands and oil (sebaceous) glands, and inflammation of hair follicles. They contain dead cells, bacteria, and other debris, which causes inflammation and pain. Common bacteria, such as staphylococci, are the most common cause, although the bacillus responsible for tuberculosis is an important abscess-forming type.
Fungal infections sometimes cause abscesses, while amoebae (single-celled protozoal parasites) are an important cause of liver abscesses.
The infection usually reaches an organ via the bloodstream or penetrates tissues under the skin via an infected wound or bite.
People with weakened immune systems may be more prone to abscesses or may have more severe ones.
Abscesses tend to get worse as time goes on. Symptoms include tenderness or pain and the site of the abscess being warm to the touch. Symptoms of discomfort or pain depend mainly on the site of the abscess, though larger ones – since they are a source of infection within the body – can cause fever, chills, sweating, and malaise.
Abscesses close to the skin usually cause inflammation with redness, increased skin temperature and tenderness.
Tuberculous abscesses are the exception; hence their introduction as cold abscesses.
Call your doctor if you have a high fever, or if the abscess is larger than ½ inch across, is near your rectal area or groin, or if red streaks are radiating out from the abscess.
An abscess is diagnosed clinically by means of the history and a physical exam, demonstrating a tender mass with overlying erythema (redness).
Small abscesses may be helped by applying warm compresses to the area several times a day. This will sometimes promote spontaneous drainage of the abscess which is important since the primary treatment of abscesses is to drain them. However, it is also important to not attempt to drain an abscess yourself. This can lead to trauma of the surrounding tissue and potentially help spread the underlying infection.
Draining the abscess is done by making a cut in the lining and providing an escape route for the pus, either through a drainage tube or by leaving the cavity open to the skin. The area around the abscess will be numbed before draining. Most people feel immediately better after the draining.
Many abscesses subside after drainage alone; others subside after drainage and drug treatment. Occasionally, their presence within a vital organ, such as the liver or brain, damages enough surrounding tissue to cause some permanent loss of normal function.
Antibiotics are usually prescribed to treat a bacterial infection, antifungal drugs to treat fungi, and antiamebic drugs to treat amebiasis. However, the lining of the abscess cavity tends to reduce the amount of drug that can penetrate the source of infection from the bloodstream.
Without spontaneous or surgical drainage, sometimes an abscess will be reabsorbed into the bloodstream. Incomplete reabsorbtion leaves a cystic loculation (small pouches) within a fibrous wall where calcium salts sometimes accumulate to form a calcified mass.
Pain Management in ED for Incision and Drainage of Abscess – Full Text View
Patients presenting with painful procedures in the Emergency Department (ED) have been shown to frequently have inadequate pain management. The incision and drainage of an abscess is a common procedure that is usually treated by emergency physicians with only localized anesthetic for pain management. For those abscesses that require incision and drainage, a physician will usually inject a local anesthetic to help decrease sensation to the affected area prior to incision and drainage. Occasionally, physicians will administer a systemic pain medication, in addition to the localized anesthetic, as a method to better help alleviate pain associated with more complex procedures.
Wilson and Pendleton (1989) wrote a landmark study that highlighted the problem of physicians undertreating patients pain in the ED, a problem known as oligoanalgesia. They found that only 50% of patients with moderate to severe pain were receiving narcotics. Since then the literature has highlighted a number of additional deficits in the use of pain medication in the ED to include the amount of time it takes patients to receive medication, the lack of education medical personnel receive in pain management, the bias that physicians have toward using pain medication, and the lack of pain medication given for painful procedures. Five areas of inadequate management of painful conditions in the ED include 1) failure to acknowledge pain, 2) failure to assess initial pain, 3) failure to have pain management guidelines, 4) failure to document pain and assess treatment adequacy, and 5) failure to meet patients expectations. The use of adequate pain medication for painful procedures covers has been a recent attempt to fill in the gap of one area contributing to oligoanalgesia.
Incision and drainage procedures are a common condition that emergency physicians manage yet there is no evidence to suggest whether they are appropriately managing the pain associated with their treatment. We propose a trial to determine whether intramuscular (IM) Fentanyl, given prior to the incision and drainage of the abscess, decreases the level of pain during/after the procedure and increases the patients overall satisfaction with the procedure.
This double blind protocol will randomize 50 patients with abscesses to receive either a combination of an intramuscular injection of Fentanyl followed by subcutaneous (SC) local bupivacaine analgesia (Fentanyl Group), or a combination of an intramuscular injection of normal saline (Control Group) IM followed by SC local bupivacaine analgesia. Patients will receive a questioner administered by a research assistant after the procedure to assess outcomes of study.
Neither treating physicians, nurses nor patients and research assistants will be aware to which group the patient has been randomized. Fentanyl was chosen due to the rapidity of onset (7-8 minutes) and clearance (1-2 hours). The choice of abscess was made given the ease at which to make a diagnosis, standard treatment with incision and drainage and known association with pain during and after the procedure.
After appropriate identification, screening, and consenting, the patient will then be randomized to receive intramuscular Fentanyl (1 ug/kg) OR Normal Saline (1.5 ml) 7-8 minutes before the procedure is began. Patients in either group will still receive usual care with local subcutaneous bupivacaine anesthetics. Patients are at liberty to request more local subcutaneous bupivacaine and or more pain systemic pain medication and the treating provider may deliver more at their discretion. Contamination may occur if patients receiving IM Normal Saline request systemic narcotics for pain levels not controlled with local bupivacaine alone. These patients may receive systemic narcotics again at the discretion of treating providers. However all patients will remain in the initial group to which they were assigned and data will be evaluated on an intention to treat analysis basis.
Abscesses | healthdirect
Abscesses can develop just about anywhere in the body and can be painful. Often treatment is needed to heal an abscess and to stop infection spreading, so see your doctor if you think you might have an abscess.
What is an abscess?
An abscess is a collection of pus inside the body, usually from an infection. If near the surface of the body, pus may break through the surface and drain.
Causes of abscesses
Abscesses usually develop when you have a bacterial infection that your immune system tries to contain. In the process of fighting the infection, pus (a liquid or semi-liquid mixture of bacteria and dead cells) is produced.
Other causes include non-bacterial infections, ingrown hairs, or a blocked gland or duct.
Types of abscesses
There are many different types of abscesses, including:
- skin abscesses or boils — often affecting the face, throat, armpits or groin
- dental abscesses — inside the tooth or gum
- pilonidal abscesses or cysts — in the crease of the buttocks
- anal or anorectal abscesses — in or around the anus
- breast abscesses — can develop if mastitis is not treated quickly
- vaginal abscesses also called Bartholin’s cysts
Abscesses can also develop in other parts of the body, such as the brain, kidney, or other organs, usually as a complication of an existing medical condition.
Symptoms of abscesses
The symptoms of an abscess depend on where it develops.
If you have an abscess under the skin or in the mouth, symptoms may include swelling and redness in the area. As pus builds up, it may cause pain. You may also have swollen glands (lymph nodes) and a fever.
If you have an internal abscess, you may have pain in the affected area, fever, and generally feel unwell. Imaging tests such as ultrasound may be needed to find the problem.
Treatment and prevention of abscesses
Small abscesses can sometimes burst and heal on their own. However, larger or internal abscesses need to be drained by a doctor (sometimes involving surgery). You may also need to take antibiotics.
If you have an abscess, follow instructions from your doctor on taking care of it. It will normally be covered by a bandage. Always wash your hands with soap and water before you change the bandage.
If the abscess is in your mouth, put a cold compress on the outside of your cheek to control the swelling and see a dentist immediately.
If you have an abscess that hasn’t been drained, you can use heat to relieve symptoms. Put a towel over the abscess and use a heat pack or heating pad for 20 to 30 minutes. Remove the heat source if your skin gets red.
If you have an abscess, seek medical attention if you develop a fever, chills, the area around the abscess get warm or the redness and swelling get worse.
Once an abscess has drained, it usually heals quickly and doesn’t cause long-term consequences.
To help prevent abscesses:
- keep your skin clean and healthy
- avoid scratches or nicks to your skin
- eat healthily to build your immune system and keep a healthy weight.
- avoid smoking
Causes, Symptoms, Treatments & Removal
What is a pilonidal cyst?
A pilonidal cyst is a round sac of tissue that’s filled with air or fluid. This common type of cyst is located in the crease of the buttocks and is usually caused by a skin infection. Pilonidal cysts are a common condition, with more than 70,000 cases reported in the U.S. every year. But many people feel too embarrassed to mention it – even to their healthcare providers.
Pilonidal cysts can cause pain and need to be treated. Pilonidal cysts can be a one-time (acute) problem or you may have chronic (returning) cysts. If they’re not treated, chronic pilonidal cysts can also lead to abscesses (swollen pockets of infection) and sinus cavities (empty spaces underneath the skin).
A pilonidal cyst (also called pilonidal cyst disease, intergluteal pilonidal disease or pilonidal sinus) is a skin condition that happens in the crease of the buttocks — anywhere from the tailbone to the anus. A pilonidal cyst can be extremely painful especially when sitting.
These cysts are usually caused by a skin infection and they often have ingrown hairs inside. During World War II, pilonidal cysts were often called “Jeep driver’s disease” because they’re more common in people who sit often.
Who can get a pilonidal cyst?
Anyone can get a pilonidal cyst, but certain people are at higher risk:
- Men (men are three to four times more likely to be diagnosed with a pilonidal cyst than women)
- People between puberty and age 40 (the average age is between 20 and 35).
- Workers who sit all day (like truck drivers and office workers).
- Overweight people (ranging from overweight to obese).
- People with thick or rough body hair (this can run in your family).
- People who wear tight clothing (this can worsen the skin condition).
Is a pilonidal cyst hereditary?
In some cases, a pilonidal cyst can be hereditary (you can inherit it from a family member). Your family history can play a role in determining if you get pilonidal cysts, for example if rough body hair runs in your family.
Is a pilonidal cyst contagious?
A pilonidal cyst is a non-contagious skin condition – you can’t spread it (just like a pimple). Currently, many researchers believe that pilonidal cysts are caused by ingrown hairs.
Symptoms and Causes
What causes a pilonidal cyst?
Experts don’t yet know all the causes of pilonidal cysts. However, they do know that ingrown hairs found in the crease of the buttocks result in a skin infection that causes a pilonidal cyst to form. Think of this condition like getting a sliver of wood stuck in your skin, except it’s an ingrown hair instead.
If it’s not treated, a pilonidal cyst can possibly lead to an abscess or a sinus cavity. Those are both signs that the skin infection is getting worse.
What are the symptoms of a pilonidal cyst?
- Quickly get medical attention if you notice any of these symptoms:
- Pain which often gets worse when you’re sitting.
- A small dimple or large swollen area between your buttocks. This is usually the pilonidal cyst. You may notice the area is red and feels tender.
- An abscess with draining pus or blood. This fluid may be foul-smelling.
- Nausea, fever and extreme tiredness (fatigue).
Can I get a pilonidal cyst while I’m pregnant?
Although pilonidal cysts are much more common in men, pregnant women can get them too. If you’re experiencing pain in your buttocks, it could be a sign of a pilonidal cyst and not just a normal discomfort of pregnancy. It’s usually best in that case to contact your provider and get checked.
Diagnosis and Tests
How is a pilonidal cyst diagnosed?
Your provider will start by giving you a full physical examination. During the exam they’ll check the crease of your buttocks for signs of a pilonidal cyst.
If you have a pilonidal cyst, it should be visible to the naked eye. Your provider might spot what looks like a pimple or oozing cyst. If so, they may also ask you several questions, including:
- Has the cyst changed in appearance?
- Is it draining any fluid?
- Do you have any other symptoms?
Very rarely, your provider may order a CT or MRI to look for any sinus cavities (little holes) which may have formed under the surface of your skin.
Management and Treatment
How is a pilonidal cyst treated?
If you are diagnosed with one or more pilonidal cysts, you will receive a treatment plan that best fits your individual case. This treatment will depend on the answers to several questions such as:
- Have you had a pilonidal cyst before?
- Have you also had any other skin issues (like an abscess or sinus) in the same area?
- How quickly are you recovering?
Depending on the severity of your symptoms, you may or may not need surgery to remove your pilonidal cyst. There are several other treatment methods available besides surgery, including:
- Draining the cyst: This procedure can happen right in your provider’s office. A small incision (cut) will be made to open and drain fluid from your infected cyst.
- Injections: Injections (phenol, an acidic chemical compound) can treat and prevent mild and moderate pilonidal cysts.
- Antibiotics: Antibiotics can treat skin inflammation. However, antibiotics can’t heal pilonidal cysts on their own.
- Laser therapy: Laser therapy can remove hair which otherwise might become ingrown and cause more pilonidal cysts to come back.
While waiting for your treatment, you can try to manage any pain you may feel by using a warm compress on the affected area to soothe your skin. You might also feel less pain when using an inflatable seat or mattress.
Will I need surgery for a pilonidal cyst?
If you have a chronic pilonidal cyst or it has gotten worse and formed a sinus cavity under your skin, it’s a serious case and you may need surgery to excise (remove) the cyst entirely. Afterward, the surgeon might either leave the wound open for packing (inserting gauze) or close the wound with sutures or a skin flap (skin taken from a healthy part of your body).
Whenever you have surgery, it’s important to take good care of your wound so it doesn’t get infected. Your provider will tell you how to keep your wound clean (including shaving the area) and how long you should keep it covered. They’ll also tell you the warning signs of infection and when you should call your provider.
Can a pilonidal cyst go away on its own?
Pilonidal cysts sometimes drain and disappear on their own. If you have chronic pilonidal cysts, your symptoms may come and go over time.
Can a pilonidal cyst be cured?
Pilonidal cysts can sometimes be cured with surgery and your skin might heal fully. However, even after surgery, a pilonidal cyst can remain as a chronic, returning condition. This is true especially if the condition has gotten worse or if pilonidal cysts run in your family.
How can pilonidal cysts be prevented?
There are several steps you can take to help prevent getting pilonidal cysts or to keep them from coming back. These steps include:
- Regularly washing and drying your buttocks (to keep the area clean).
- Losing weight (if you are currently overweight) to lower your risk.
- Avoiding sitting for too long (if your job allows) to keep pressure off the area.
- Shaving the hair around your buttocks (once a week or more). You can also try using a hair removal product to avoid getting ingrown hairs.
Outlook / Prognosis
Is a pilonidal cyst fatal?
A pilonidal cyst is not fatal in itself. Aside from the pain you may feel, though, there’s always a chance that a cyst can pose several long-term health issues. These health risks can include:
- One or more returning cysts can form in the same area (or elsewhere, but typically in the crease of your buttocks). If your cyst comes back, you have chronic pilondial disease.
- Systemic infection (when an infection spreads throughout your body). Body-wide infection can quickly become life-threatening.
- Cancer (specifically squamous cell carcinoma or SCC). SCC is rarely caused by a pilonidal cyst. But this type of skin cancer can sometimes happen if you get a pilonidal cyst. If your provider diagnoses you with a pilonidal cyst, they’ll usually take a pus sample and test it just to be sure it’s not cancerous.
Be sure to see your provider if you develop symptoms of a pilonidal cyst.
Do I need to leave work if I have a pilonidal cyst?
Depending on your symptoms, you might need to take some time off of work if you have a pilonidal cyst. This condition can cause a lot of discomfort especially if you’re sitting for a long period of time. Talk to your provider about ways to be more comfortable at work and treatment options to relieve any pain caused by a pilonidal cyst.
A note from Cleveland Clinic
Although a pilonidal cyst is not life-threatening itself, it can become more difficult to treat and turn into a chronic condition if you don’t quickly seek help. That’s why it’s important to get an exam at the first sign of any symptoms of a pilonidal cyst. Always be open with your healthcare provider about your symptoms and concerns.
90,000 Abscess: Medicines Used in Treatment
Abscess (abscess) – a local accumulation of pus, which appears due to an 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 the penetration of microbes through abrasions, injections, wounds.
A characteristic feature of an 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 the immune system 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.
There is a possibility of an abscess on the skin and on any organ or tissue. Internal organ abscesses are the 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 goes 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.
What can you do with an abscess
An abscess is a surgical disease, therefore, in order to avoid unwanted complications, at the first signs of it, you should consult a doctor.
What a doctor can do
The doctor will make an accurate diagnosis and prescribe the appropriate treatment.
Attention! Symptom chart is for educational purposes only. Do not self-medicate; for all questions regarding the definition of the disease and methods of treatment, contact your doctor.Our site is not responsible for the consequences caused by the use of information posted on the portal.
symptoms, causes, diagnosis, treatment and prevention
An abscess is an accumulation of purulent contents in various tissues. Suppurative inflammation is usually caused by a bacterial infection. In this case, in the process of melting the tissues, a cavity is formed. The appearance of an abscess is due to the ingress of bacteria into the tissues from the outside – through abrasions and injuries or from other infected tissues and organs.This disease differs from other similar diseases by the formation of a capsule that prevents the spread of inflammation.
At the location of the pus, superficial accumulations are isolated in the subcutaneous fat area and deep within organs and deep tissues. Depending on the method of penetration of pathogenic microorganisms, there are exogenous accumulations (from the external environment) and endogenous (migration within the body of one person).
Symptoms and signs
Regardless of the location of the purulent accumulation, the symptoms of an abscess are the same:
- intoxication – fever, chills, weakness, malaise, nausea, vomiting, poor appetite, muscle and joint pain, headaches;
- superficial location – redness and swelling of the skin immediately above the place of accumulation, pain on palpation or during movement;
- disruption of the functioning of the damaged organ or related tissues.
A chronic abscess has no symptoms of an acute inflammatory process. Deeply located clusters have only general signs of intoxication and are detected by instrumental diagnostics. The most common abscess locations:
- inside the bones – the main symptom is pain from physical exertion or when the weather changes;
- abscess of the lung is manifested by shortness of breath and weak breathing. A lung abscess is often confused with pneumonia;
- in the abdominal cavity and liver is accompanied by signs of any disease of this organ;
- in the brain causes seizures and impaired coordination;
- abscess of the prostate gland causes pain when urinating;
- throat abscess causing cough cramps and pain;
- abscess of the Bartholin gland and others.
Cold proceeds without signs of intoxication and appears with immunodeficiencies. The leaky excludes the presence of an inflammatory process in the tissues. Acute abscess has more pronounced symptoms in comparison with other forms.
Do you have symptoms of an abscess?
Only a doctor can accurately diagnose the disease.
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Causes of origin and development
The main cause of an abscess is a bacterial infection trapped in the tissues from the surrounding world.Bacteria enter the body due to microtraumas that violate the integrity of the skin. Such injuries include cuts and minor abrasions / scratches / injuries resulting from shaving or hair cutting, manicure or pedicure, and others. At the same time, in the case of dirt or small particles in the form of a splinter, the likelihood of the formation of a purulent accumulation increases.
The appearance of an accumulation of pus can occur for other reasons of an abscess:
- migration of infection from the primary focus of infection;
- suppurating hematomas and cysts;
- Surgical manipulations – violation of sanitary rules in the form of non-sterile devices;
90,053 violations in the administration of drugs and drugs, for example, impaired concentration during vaccinations.
The abscess develops further under the influence of reduced immunity or circulatory disorders in the area of the abscess.
Forms of the disease and routes of infection
An abscess can be an independent disease, but in the overwhelming majority of cases it acts as a complication of any underlying disease, for example, purulent tonsillitis causes a paratonsillar abscess. Pathogenic microorganisms have a lot of ways to get inside – through damage to the skin as a result of injuries and cuts, from other organs and tissues previously infected, through non-sterile equipment during surgical procedures, and others.
The forms of the disease are classified according to the localization of purulent accumulation:
- retropharyngeal abscess;
- paratonsillar abscess;
- appendicular and others.
90,053 soft tissues;
In the absence of timely and adequate treatment, complications of abscesses are very dangerous for the life and health of the patient:
- internal bleeding of the vessel walls;
- sepsis as a result of a purulent abscess of the appendicular region;
- purulent meningitis and others.
Contacting the clinic
A purulent accumulation is fraught with dangerous consequences, therefore, if the slightest signs of an accumulation of pus in tissues or organs appear, an urgent need to consult a doctor. The ideal solution would be to call an ambulance.
In the center of Moscow in JSC “Medicine” (the clinic of Academician Roitberg) you will be provided with the necessary assistance in treatment. In addition, JSC “Medicine” (the clinic of Academician Roitberg) has the ability to accommodate patients in a round-the-clock hospital and has the function of calling a doctor at home around the clock.
Purulent accumulations located at the surface of the skin are easily diagnosed by external examination by characteristic signs. A throat abscess is detected on examination by an otolaryngologist.
Diagnosis of an abscess located deep inside requires special laboratory and instrumental studies:
- biochemical blood test will show the inflammatory process in the body with an increased content of leukocytes and ESR, as well as shifts in protein fractions;
- Radiography is used to detect subphrenic, intraosseous and pulmonary congestion;
- Ultrasound is aimed at detecting congestion in the abdominal cavity and liver;
- Computed tomography, as an auxiliary method, detects purulent accumulations in the brain, lungs and liver, subphrenic region and inside bones and joints;
- encephalography of various forms (echo-, electro-, pneumo-) is aimed at examining the brain;
- laparoscopy and angihepatography are used as an auxiliary method for examining the liver;
- puncture of an abscess and inoculation of its contents is performed to determine the specific type of pathogen and its sensitivity to certain antibacterial drugs.
Most often, purulent accumulations are caused by streptococci, staphylococci in combination with various kinds of rods, but now other aerobic and anaerobic bacteria are also spreading.
The key to the success of abscess treatment lies in its timely detection. That is why it is so important to see a doctor immediately if you have any symptoms.
- Only superficially located purulent accumulations can be treated at home under the supervision of a physician.All other cases require hospitalization;
- opening and drainage of the area of purulent accumulation is carried out by a surgeon, it is necessary to remove an abscess;
- drug therapy is based on taking the following drugs: antibacterial agents, antipyretics, pain relievers, drugs to reduce intoxication, vitamin complexes, immunomodulators and others;
- balanced nutrition, gentle bed or semi-bed rest, as well as rest;
- Physical therapy, physiotherapy and spa treatment are possible as rehabilitation measures during the recovery phase.
As an aid in the treatment of subcutaneous fatty suppuration, special ointments are used.
Purulent accumulations in the lungs are initially treated with antibiotics of a wide range of effects, and after receiving the results of studies of the culture of the culture medium, the correction of the medications taken is carried out. In severe cases, bronchoalveolar lavage is possible. In the absence of a positive effect of classical therapy, an abscess operation is forced to remove the affected part of the organ.
Treatment of purulent accumulations in the brain is carried out by surgical methods. Contraindications for the removal of clusters, namely, the location in the deep parts of the brain, forces the washing of the purulent contents by puncture. Treatment of purulent accumulations at home with traditional medicine is unacceptable.
Abscess prevention is based on the following guidelines:
- Timeliness of primary treatment of wounds and injuries;
- remediation of foci of infection;
- strengthening the immune system;
- Careful adherence to antiseptic and aseptic measures during surgical procedures that damage the skin.
How to enroll
In JSC “Medicine” (the clinic of Academician Roitberg), experienced specialists are receiving appointments. You can sign up on the website, by phone +7 (495) 775-73-60. Our clinic is located at 10 2nd Tverskoy-Yamskaya lane, Mayakovskaya metro station.
Breast abscess lancing – treatment of breast abscess in Kiev, examination of breast abscess in the clinic
Features of the disease that you need to know
An abscess of mammary tissue occurs in case of lactostasis, damage to the skin (scratches, irritation, cracks, etc.).inadequate adherence to the rules of personal hygiene or against the background of a decrease in immunity.
The cause of purulent mastitis can be breast infiltration, which is characterized by an increased concentration of lymph and blood in the tissues, which increases the volume of the breast and tightens the structure of the organ.
With purulent mastitis, inflammation is accompanied by tissue melting and suppuration. In 8 out of 10 cases, it is often accompanied by regional lymphadenitis (an abscess of lymph nodes located nearby).
In severe cases, gangrenous mastitis may develop if vascular thrombosis or aggressive putrefactive and anaerobic pathogens join the purulent inflammation.
A purulent cyst of the mammary gland is less dangerous, because the process of suppuration is limited – it is restrained by the capsule of the cyst.
Symptoms of purulent mastitis
|Temperature up to 38.5 ° C||Breast augmentation due to edema|
|Reduction of milk|
|Feeling of heat in the mammary gland||Nipple retraction|
|Hypersensitivity||Swelling and tenderness of the lymph nodes|
|Pulsating chest pain General, inability to feed the baby due to discomfort|
Localization of inflammation
Pus in the breast is concentrated in different ways. Depending on this, there are 5 types of abscesses.
Subcutaneous. It is located superficially, so the pus is translucent and easy to see.
Subareolar. Located in the areola. Occurs more often in nursing women.
Intramammary. It arises in the thickness of the glandular tissue of the mammary gland. Can be connected to duct system or not.
Retromammary. It is located in the area between the retromammary fatty tissue and the muscles of the chest. The most dangerous form of the disease, which poses a risk of purulent muscle fusion and abscess breakthrough into the chest cavity.
Intracanalicular. It means inflammation of the ducts, galactophoritis is rarely isolated or purulent. As a rule, it does not need surgical treatment and is an element of other mastitis.
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Diagnosis of an abscess
Superficial forms of the disease are diagnosed early. With deep mastitis (especially retromammary), the symptoms of an abscess appear later.In the process of examination and diagnosis, the mammologist or surgeon collects anamnesis, examines the patient and reveals the characteristic signs of a purulent formation: skin hyperemia (local redness), sensitivity of a certain area, enlarged axillary lymph nodes.
Ultrasound and mammography are of great importance in the diagnosis of breast abscesses. Puncture biopsy of the focus with mandatory examination of the microscopic composition is important. It is carried out to determine the pathogen and its sensitivity to antibiotics.
There are complex clinical cases of purulent mastitis with a predominance of edematous-infiltrative form, which must be distinguished from breast cancer and cancer in the decay stage. Often, the disease is accompanied by erysipelas, hematoma or allergic processes.
Late seeking medical care directly affects the volume of breast lesions and the nature of the course of the disease. Subsequently, it can develop persistent changes in the breast from scar deformity to fibrous mastitis (cirrhosis of the breast).It is especially important to realize that timely diagnosis of inflammatory processes in the mammary gland and proper treatment will shorten the period of illness, prevent gross changes in breast tissue and preserve its aesthetic appearance.
Photo 1. Be attentive to yourself and consult a specialist if you notice even the slightest changes in the breast
Breast abscess: opening, drainage
Treatment of abscess in 99% of cases is surgical. The location of the cavity formed in the tissues of the mammary gland determines not only the clinical manifestation and the difficulty of detecting an abscess, but also the severity of the condition, the nature and volume of surgical treatment, and the choice of anesthesia.Puncture tactics for the treatment of inflammation of the mammary glands is used, as a rule, for abscess formation of breast cysts.
Surgical treatment of a purulent abscess involves general anesthesia. Local anesthesia, which is combined with retromammary blockade, is acceptable. After the incision, the wound is examined, all detected abscesses are opened and combined into one cavity, the pus is removed and the wound is washed with an antiseptic solution. Then drainage is installed and the wound is partially sutured.
The doctor chooses the incision for opening the abscess depending on the place of its localization in the gland.After you have opened up purulent mastitis, antibiotic therapy is prescribed, dressings with rinsing the abscess cavity and replacing the drains.
Expert help from the Specialized Breast Center
Acute mastitis requires a quick diagnosis. In our clinic, mammologists of the highest category work with experience from 10 years and there are doctors of related profiles. We use expert class devices for examination. All this gives us the opportunity to quickly make the same diagnosis and help women maintain their health and beauty.
Surgery to remove an abscess is not performed in the clinic, but, if possible, we solve the problem in another way or give recommendations.
The cost of services of the mammological center is indicated in the section “Prices”. In the section “Profiles of doctors” you can see photos and detailed information about doctors, as well as reviews of other patients.
Surgical treatment of purulent diseases (boils, abscesses, phlegmon)
Most surgical diseases require surgical intervention, especially often with boils, abscesses and phlegmon.The listed pathologies occur with the participation of pathogenic microorganisms and, without treatment, can even lead to the loss of bone tissue.
Causes of occurrence
The main reason for the development of purulent diseases is representatives of pathogenic microflora, in most cases – streptococci and staphylococci. They cause the formation of toxins that help microbes maintain their numbers, penetrate the skin and survive under adverse conditions.
Pathogenic microorganisms can actively and rapidly multiply in cases where human immunity is reduced.This can happen with vitamin deficiency, diabetes mellitus, obesity, concomitant chronic diseases.
Indications and contraindications for surgery
Surgical intervention for purulent diseases is required in cases where conservative therapy does not lead to improvement. The decision on the appropriateness of the surgical intervention is determined by the attending physician.
Purulent pathologies may be accompanied by the following symptoms:
- Pain in the affected area is the main symptom of soft tissue diseases.
- Swelling and hyperemia (redness) of tissues.
- Elevated body temperature.
- General signs of intoxication of the body.
Please note that purulent diseases can proceed in different ways. The clinical picture is not always clearly expressed, which complicates the process of making a diagnosis. Deeply located abscesses cause only general signs of intoxication, which can be characteristic of many ailments. They are detected only by instrumental diagnostics.
It should be noted that purulent diseases progress rapidly, therefore, at the first signs of pathology, you should slowly consult a doctor. In emergency cases, surgical treatment of purulent diseases is carried out immediately – in this case, contraindications do not matter.
Preparation for surgical treatment of purulent diseases includes examination. In most cases, the list of studies is as follows:
- General analysis of blood and urine.
- Blood clotting test.
- Analysis for HIV, hepatitis and syphilis.
- Ultrasound examination, MRI, x-ray to determine the boundaries of the formation in order to gently open the abscess.
- In some cases, a puncture from a purulent focus may be required.
You also need to consult a therapist, and if necessary – and narrow specialists.
The following preparation considerations should also be taken into account:
- If surgery is required under general anesthesia, the patient should avoid food at least 7-8 hours before surgery.
- It is also worth giving up alcohol in a few days.
- Women are not advised to undergo surgery during menstruation.
- If you are afraid or anxious about manipulation, you can take sedatives, but only after consulting a doctor.
- Tell your doctor about any medications you are taking, including birth control pills and vitamins.
How is the operation going
This is how the surgical treatment of purulent diseases occurs:
- Anesthesia is performed first. Local anesthesia or general anesthesia can be used – the doctor chooses the optimal method of anesthesia.
- The doctor then carefully treats the skin in the area of intervention with antiseptic preparations.
- After that, the surgeon makes an incision of the purulent formation so as not to touch the nerve fibers, blood vessels, fascial-muscular sheaths. The incision can be made in various ways: classical surgical, radio wave or laser.
- The next step is to remove pus, treat the cavity with antiseptic agents.
- Install drainage and suture if necessary.
- Upon completion of the manipulation, apply a sterile bandage.
After the operation, it is important to regularly carry out dressings, treat the sutures with antiseptic solutions. In order to prevent relapse, the doctor may prescribe some medications: antibacterial, anti-inflammatory, vitamin complexes, drugs to increase immunity, etc.
The period of the recovery period after surgery is individual, it depends on the characteristics of the pathological process and the state of the patient’s body.
- Elimination of increased physical activity.
- Ban on hot tubs, saunas, baths or swimming pools.
- Alcohol should be avoided during the recovery period.
- You should eat a balanced diet so that the body receives all the necessary vitamins and minerals.
- Observe personal hygiene.
- Be sure to take all medications prescribed by your doctor.
Remember that purulent diseases such as boils, abscesses, phlegmon are very dangerous to treat on their own. This often leads to life-threatening consequences. We recommend that you see a doctor, even with small pustules!
You can find out more detailed information about the surgical treatment of purulent diseases at an in-person appointment with a specialist. Be healthy!
90,000 Abscesses in rabbits
Abscess is a cavity filled with pus resulting from localized acute purulent inflammation (photo 1).If the processes of resorption or excretion of pus are insufficient, a capsule forms around the site of inflammation, which can thicken and the disease acquires a chronic or recurrent course with periodic formation of fistulas and outflow of pus (photo 2). Filling of the abscess cavity with granulation tissue may occur. Abscesses are periodically observed in every rabbit farm and in domestic decorative rabbits.
|Photo 1 – abscess in the lower jaw||Photo 2 – Multiple abscesses on the jaw|
Causes of occurrence
The causes of abscesses in rabbits are summarized in the table.As in other animals, the cause of the development of external abscesses is damage to the skin or mucous membrane as a result of bites, bruises, wounds. The oral mucosa can be damaged by food particles, and head abscesses are often associated with congenital or acquired dental anomalies. An insufficient amount of milk in females and biting of the nipples by rabbits leads to the occurrence of breast abscesses. The spread of bacteria through the blood and penetrating wounds can lead to the formation of abscesses in the internal organs.
Abscesses in rabbits are caused by Pasteurella, Staphylococcus and, less commonly, other microorganisms. The nature of the pus depends on the type of microorganism. In photo 3, the abscess contains a white, creamy exudate characteristic of staphylococci.
|Photo 3 – White, creamy exudate characteristic of Staphylococcus spp.|
Post-injection abscesses have been described.The appearance of abscesses is often promoted by congenital or acquired immunodeficiency states, infection with the myxomatosis virus, helminthiasis, inadequate feeding, crowded housing, violation of veterinary and sanitary rules of feeding, maintenance and care.
Table – Prediction of the outcome of abscesses depending on the cause of occurrence
Place of detection
Superficial swelling in the skin
Cheeks, occiput, neck, back, mammary glands, scrotum
Wounds resulting from fights, bites, punctures by foreign objects, spread through blood
Favorable with adequate treatment
Spread through blood and lymph
Increased stress due to obesity, abrasive, dirty and damp bedding
Cautious, becomes chronic
Subcutaneous swelling involving deep tissues
Cheeks, occiput, neck, back, mammary glands, scrotum, limbs
Wounds resulting from fights, bites, punctures by foreign objects, spread through blood
Favorable with adequate treatment
The chewing surfaces of the lower and upper teeth form sharp edges that injure the cheeks
Favorable for regular tooth grinding
Swelling in the subcutaneous tissue or muscles
Injection of oil preparations of vitamins, antimicrobial preparations of prolonged action, vaccines (more often against dermatomycosis)
Favorable, no treatment required
Large, rapidly developing in combination with skin necrosis
Injuries, foreign objects and improperly growing teeth
Cautious, surgery required, recurrent often
Solid encapsulated swelling involving underlying tissues, may be multiple
More often the ventral surface of the lower jaw
Infection spreading to the roots of the teeth, destruction of bones, loosening of the teeth
Unfavorable, requires surgery, long-term antibiotic therapy and anesthesia, often repeated
Enlarged, painful limbs in combination with lameness
More often pelvic limbs, in combination with ulcerative inflammation of the skin
Spread through the blood from the site of microflora introduction through the skin of the extremities
Unfavorable, becomes chronic, requires long-term antibiotic therapy and pain relief
Bulging, lacrimation and inflammation of the skin around the eye (usually one-sided). Pus secreted from one nostril
Eyes, nose area
Injury of the accessory sinuses and the space behind the eye by the growing roots of the upper molars, bone inflammation
Unfavorable, requires extraction of teeth, sometimes of the eyeball, drainage of the abscess cavity, long-term antibiotic therapy and pain relief
Encapsulated neoplasms of various sizes in the abdominal cavity
Uterus, ovaries, peritoneum, liver, kidneys
Bacteremia, more often with pasteurellosis and staphylococcosis, after surgery
Unfavorable, a surgical operation is required which may be difficult or technically impossible, after a successful operation – long-term antibiotic therapy
Impaired coordination of movements
Middle and inner ear, vestibular apparatus
Penetration of bacteria (often pasteurella) from the nasal cavity
Unfavorable, surgery is required, long-term antibiotic therapy
Encapsulated formations of various sizes in the chest cavity
Bacteremia, more often with pasteurellosis and staphylococcosis, penetrating wounds of the chest
Unfavorable, surgery is required which may be difficult or technically impossible
In many cases, the classic signs of abscesses may be absent: local fever, redness, swelling, pain, fluctuation, swelling of the skin and subcutaneous tissue. Then, for differential diagnosis, it is necessary to conduct a test puncture and aspiration of the contents.
X-ray (photo 5) and ultrasound examination of the animal may be necessary to recognize abscesses in internal organs (photo 4). According to our observations, any abscess, regardless of size, location and etiology, spontaneously almost never opens and does not dissolve.
|Photo 4 – Rabbit lung abscess||Photo 5 – abscess in rabbit lung on radiograph|
The prognosis and treatment methods for a rabbit depend on the type of abscess.With external abscesses of soft tissues, with abscesses on the head caused by trauma to the oral mucosa by foreign objects or improperly growing teeth, trauma to the skin, the prognosis with adequate treatment is favorable or cautious. Abscesses involving the jaw bones, paranasal sinuses and eyes, abscesses of the middle ear, pleural and abdominal cavities often cause euthanasia of rabbits.
Prepared by Ph.D. Melent’ev O.N. based on articles:
- Sokolova L.N. Abscesses in rabbits: etiology and prognosis / Sokolova L.N., Melent’ev O.N. // International veterinary bulletin. – 2011. – No. 2.
- Sokolova L.N. Classification of abscesses in rabbits, treatment and prognosis / Sokolova L.N., Melent’ev O.N. // Rabbit and fur farming. – 2012. – No. 5.
q.v.n. Melent’ev O.N.
Abscess in dogs
An abscess is a delimited purulent inflammation. It can be located on the surface of the skin, in the depths of it, or not in any organ.It has various sizes, on which the severity of the disease depends. Blisters that are too large can press on the surrounding organs of the dog and cause pain.
Causes of abscess and symptoms.
Since it is a purulent disease, it is necessary to have damage to the skin or mucous membrane through which the microorganism enters. A local infection will develop in the wound, which often affects dogs. Also, the development of an abscess can be triggered by poor dog hygiene, bites from other dogs, or accidental injury.
The development of the disease occurs several days after the infection of the animal. Swelling and swelling occurs. It can grow rapidly as microorganisms multiply in it. Their waste products enter the bloodstream, causing symptoms of general intoxication:
- Decreased appetite
- Fever increase.
The lump itself is painful. The animal is restless. The skin is red. Soft to the touch, may burst with strong pressure.This will release the pus that has accumulated in it, but may cause bleeding.
Diagnostics of the disease. A superficial abscess is clearly visible to the naked eye when examining or feeling the dog. Deep can be suspected by the condition of the pet. The exact location of the abscess is determined using an X-ray examination.
Treatment of an abscess.
If the area is small and located on the surface of the body, treatment is to accelerate maturation. The abscess will open and cleanse itself, after applying special ointments and dressings.Vishnevsky ointment or ichthyol ointment helps best. In order to avoid repeated inflammation, I wash the wound with an antiseptic solution, for example, chlorhexidine or hydrogen peroxide. It is important to do this even at the bottom of the wound. Specialists of veterinary clinics in Simferopol provide services for hiding abscesses and their subsequent treatment.
A small, isolated abscess inside can be treated with antibiotics. This must be done under the supervision of a veterinarian, in compliance with all the rules for taking the medicine.
When the deadline is neglected, it is best to deliver the animal to the ABBA veterinary clinic.The abscess should be opened under sterile conditions with anesthesia so that the infection does not spread. Typically, the top shell is simply cut and the contents are discharged to the outside. For deep abscesses, drainage can be placed. This will allow you to monitor the state of the focus of infection.
Antibiotic injections are given to prevent the occurrence of an abscess.
Dogs suffer from abscesses like everyone else. Only taking care of pets will help to quickly cure them and prevent re-infection.
Post-injection abscess – causes, symptoms, diagnosis and treatment
Post-injection abscess is a limited purulent-inflammatory focus at the injection site of the drug. An abscess is characterized by the appearance of local edema and redness of the skin, gradually increasing in the volume of compaction, an increase in pain of a bursting nature, fluctuation. The diagnosis is made on the basis of anamnesis and clinical picture (the appearance of a purulent-inflammatory focus at the site of intramuscular and intravenous injections), ultrasound data, MRI of soft tissues. At the stage of infiltration, conservative treatment is effective. The formed abscess is opened surgically and drained.
Cases of post-injection abscess formation of soft tissues occur in people of all ages, more often in obese, obese patients. Most of the post-injection abscesses develop in the area of the buttocks, since the gluteus muscle is most often used for parenteral administration of drugs. Children have a high proportion of shoulder abscesses as a result of vaccinations.Intravenous drug administration is the most common cause of the formation of a focal point of suppuration in the antecubital fossa. Post-injection abscesses of this localization account for 69% of all cases of purulent-inflammatory processes of soft tissues in drug addicts.
For the formation of a post-injection focus of suppuration, it is not enough just for bacteria to enter the tissues. The human immune system is able to cope with a small number of pathogenic and opportunistic microorganisms that have overcome the protective barrier of the skin.For the development of an abscess, other contributing factors must be present:
- High pathogenicity of microorganisms. Different types of bacteria have different rates of cell division and the ability to resist the immune system. Staphylococcus aureus or Pseudomonas aeruginosa often cause the formation of post-injection abscess than opportunistic species that make up the skin microflora.
- Weakening of the immune system. May be the result of a banal seasonal ARVI or a serious concomitant illness.The likelihood of developing abscesses is higher in patients with diabetes mellitus, severe cardiovascular, endocrine, infectious diseases.
- Local circulatory disorder. This is facilitated by the simultaneous introduction of significant volumes of solution into the muscle (more than 5 ml), the simultaneous introduction of several drugs into one buttock. The first sign of abscess formation is a significant induration at the injection site. The risk of post-injection suppuration increases in bedridden patients, patients with bedsores.
- Local irritating effect of drugs. Not only bacteria, but also chemicals are capable of provoking purulent tissue fusion. Inappropriate intramuscular administration of drugs intended for intravenous or subcutaneous infusion can cause necrosis and inflammation. An individual reaction can be given by a drug that is approved for intramuscular use, but is not suitable for a specific patient.
- Violation of injection technique. Factors in the development of post-injection complications are non-compliance with the rules of asepsis and antiseptics, the use of the wrong solvent, too rapid administration of solutions, incompatibility of different drugs. One of the consequences of improper technique can be damage to vessels of various diameters with a needle. Blood clots are a substrate for the multiplication of microorganisms and the formation of post-injection abscess.
The development of the inflammatory reaction is based on the release of a large number of lysosomal enzymes from damaged and dead cells into the extracellular environment, which change the metabolism in the pathological focus.In the zone of necrosis, the metabolism slows down, and in the areas adjacent to it, it sharply increases, which leads to an increase in oxygen and nutrient consumption, the development of acidosis due to the accumulation of under-oxidized products: lactic, pyruvic and other acids.
The blood supply to the pathological focus changes: blood flow increases and outflow slows down. This explains the redness of the affected area. The blood vessels dilate, and the capillary permeability for blood plasma and cells increases.Leukocytes and macrophages are released into the tissue. Local inflow of fluid leads to the formation of edema. Compression of nerve endings provokes pain. This is the stage of infiltration, when there is still no pus in the focus of inflammation. Under favorable conditions at the stage of infiltration, the changes are reversible.
At the stage of abscess formation, dead tissue and dead cells of the immune system form pus. Post-injection abscess is located in the center of the inflammation focus. Clots of pus are delimited from healthy tissues by a granulation shaft.The pus does not dissolve. It is possible to eliminate inflammation only if conditions are created for the outflow of the contents of the abscess.
Symptoms of post-injection abscess
The pathological focus is formed within several days. The onset of the disease can go unnoticed by the patient due to the mild severity of symptoms. Pain and swelling of the injection sites caused by a physiological reaction to the administration of drugs can mask the first manifestations of developing purulent inflammation.It is possible to distinguish between the formation of an inflammatory infiltrate and a reaction normal for intramuscular injections with a careful attitude to one’s sensations.
The pain after the injection is immediately sharp, bursting, then aching. Its intensity decreases rather quickly. The pain of a maturing abscess is constantly increasing. Normally, the compaction after injections is quite uniform, its temperature does not differ from the temperature of the surrounding areas, the skin over the seal is of a normal color. The addition of an inflammatory reaction is marked by a noticeable local temperature increase.The increase in swelling and pain in the buttock leads to the fact that it is impossible to sit on the affected side. The unpleasant sensations intensify when walking and performing other movements. Pressing on the abscess area is sharply painful, while the usual seal can be felt without provoking pronounced discomfort in the patient.
A post-injection abscess is characterized by fever with an increase in body temperature to 39-40 about C. However, you should not focus only on this symptom. If the inflammatory focus develops against the background of ongoing injections of non-steroidal anti-inflammatory drugs that have analgesic and antipyretic effects, then there is no hyperthermia.
The rapid development of infection in the focus can provoke the formation of pus leaks into the intermuscular spaces. The spread of bacteria in tissues causes the development of extensive phlegmon of the buttocks, thighs, and upper arms. There is a danger of the formation of long-term non-healing soft tissue fistulas and rectal fistulas. A breakthrough of pus into the bloodstream becomes the cause of sepsis, pericarditis, osteomyelitis, disseminated intravascular coagulation syndrome – in these cases, even with the appointment of adequate treatment, the outcome for the patient may be unfavorable.
Diagnosis is straightforward for the consulting surgeon. The characteristic pentad of signs of inflammation (redness, swelling, pain, fever, dysfunction) at the injection site allows you to quickly determine the nature of the pathological process. A positive symptom of fluctuation indicates the presence of fluid in the focus, which is an indication for surgery. To confirm the diagnosis of post-injection abscess in doubtful cases, perform:
- Ultrasound of the abscess. In three cases out of four, the accumulation of pus is localized in the thickness of the muscle and intermuscular spaces and only in 25% of cases in the subcutaneous tissue. The form of the purulent cavity is oval. Its largest radius is parallel to the body axis. Ultrasound of soft tissues allows you to distinguish between infiltration and suppuration with a deep location of the pathological focus in the tissues, to reveal leaks and “pockets” that can go unnoticed during a surgical operation.
- MRI of the affected area. Prescribed in cases where the information content of ultrasound is insufficient to make a correct diagnosis. In the images obtained by the method of magnetic resonance imaging, soft tissues, bones, internal organs of the investigated area are visualized. This allows you to detect pathological changes, carry out differential diagnostics, and identify complications.
- Laboratory tests. In order to select an effective antibacterial drug, sowing of the contents of the abscess on the flora and its sensitivity to antibiotics can be performed.General and biochemical blood tests, general urine analysis are performed without fail to exclude pathology from the internal organs.
Treatment of post-injection abscess
Approaches to the treatment of abscesses at the stages of infiltration and suppuration are fundamentally different. In the first case, conservative therapy is indicated, in the second – a surgical operation. The basic principles of conservative local treatment of infiltrates can be successfully applied for the rapid resorption of post-injection seals without signs of inflammation.
- General treatment. Its volume is determined by the doctor based on the clinical picture. Anti-inflammatory drugs and antibiotics target the inflammatory process. Additionally, infusion therapy can be prescribed to combat intoxication.
- Local therapy. Assumes the application of Vishnevsky ointment to the affected area or the use of compresses with Dimexide. At the initial stages, an iodine grid is allowed.If the condition does not improve within 24 hours, it is advisable to use more effective drugs.
- Physiotherapy. All thermal influences are prohibited. Electrophoresis of anti-inflammatory drugs, diadynamic currents are effective. Physiotherapy procedures are prescribed simultaneously with local and general anti-inflammatory treatment.
- Surgical operation. Opening and drainage of the purulent cavity is carried out under local anesthesia.Under general anesthesia, the operation is performed when the post-injection abscess is located deep in the tissues. In the postoperative period, general and local conservative treatment is carried out, physiotherapy procedures are prescribed.
Prognosis and prevention
The prognosis of post-injection suppuration is favorable, subject to timely medical attention. Otherwise, complications of the disease may develop. Spontaneous opening and emptying of a deep abscess is impossible, and without the evacuation of pus from the cavity, recovery does not occur.Surgical opening of the abscess can solve the problem in one day.
Prevention of post-injection complications involves the administration of drugs parenterally in hospitals by medical personnel, refusal of self-medication. It is advisable to change the places of injection of solutions during the course appointment: if seals have already formed on the buttocks, drugs can be injected into the muscles of the anterior surface of the thigh. Do not inject funds for intravenous infusion into the muscles, even if the veins are thin and brittle.It is advisable to make the injection course as short as possible, continuing the treatment with taking pills.