We all know small abscesses: a larger pimple develops and pus forms. Once the pimple is ripe, you can squeeze it and remove the pus. Unfortunately, this cosmetically unsightly but relatively harmless “abscess” type is not the only one. Read here when and where an abscess can occur anywhere and what the symptoms are.
What is an abscess?
An abscess is a collection of pus in tissue. Under a microscope, you can see that the boil has a connective tissue membrane delineating it so that the pus cannot spread indiscriminately throughout the tissue. The pus is composed of dead cell parts and bacteria. In the skin, the causative bacteria are usually Staphylococcus aureus bacteria.
When an accumulation of pus occurs in a pre-existing body cavity such as a joint capsule or gallbladder, it is referred to as an empyema rather than an abscess.
When does an abscess develop?
Bacteria are usually responsible for the development of an abscess. Since some types of bacteria are part of the normal skin flora, an abscess develops when the bacteria penetrate deeper into the skin and there is no drainage to the outside – for example, when a pore is clogged by sebum or dirt, or when a wound is contaminated and has been tightly closed.
An abscess without bacteria (called a cold or sterile abscess) is much rarer and sometimes occurs without apparent cause after serious, extensive surgery or in tuberculosis.
Where can an abscess occur?
Abscesses can occur in the following places on the body:
- Often, an abscess occurs in the hair follicles and sebaceous or sweat glands, near the surface of the skin. An inflammation of the hair follicles is called folliculitis. It can be recognized by the hair that seems to sprout from the middle of the pimple. As soon as pus is added and the inflammatory process also extends to the surrounding area, it is called a boil – if several hair follicles and their surroundings are affected, a carbuncle.
- The anal glands are also predisposed to abscesses – the perianal abscesses (“peri” is Latin and means “in the surrounding area”) are painful and protracted.
- But there are also abscesses in inflammations that take place inside the body. In chronic intestinal inflammation such as Crohn’s disease, in gall bladder inflammation and tuberculosis abscesses often occur.
- Another category is abscesses, which can occur after injury or surgery. If germs get into the wound, but it is closed without drainage, the pus can not drain and an abscess develops. That is why contaminated deeper wounds are usually not applied so-called primary wound closure, but the wound is treated open – wound secretion can flow off and healing will proceed without abscess.
- Less frequently, abscesses occur in bone: The so-called Brodie abscess refers to an abscess formation in the bone. These abscesses are often very poorly treated with medication and must usually be removed surgically.
In addition, two empyemas are not quite correctly called abscesses in medicine: Perityphlitic abscess is a collection of pus next to the appendix and Douglas abscess is a collection of pus in the pelvis between the vagina and rectum.
Symptoms: What are the symptoms of an abscess?
With a thick pimple, everyone knows the signs: The skin tightens and hurts to the touch, and the surrounding area is red. As soon as a pus plug is visible and the pimple can be squeezed, the feeling of tightness disappears.
In the case of larger abscesses or abscess forms inside the body, fever may be the only symptom, since the abscess is not visible. However, severe courses of the disease with a general feeling of illness, exhaustion or even shock symptoms such as circulatory failure are also possible.
