Classification
Abscesses can occur on all parts of the body, both superficially and in depth. Since both the therapy and the symptoms are always very similar, the individual abscesses are usually not named individually. The abscesses are subdivided according to localisation (liver, skin, brain, lung), or according to other characteristics such as spread or cause (sedimentation abscess, injection abscess, wall abscess).
The editors recommend the article on the causes of an abscess: Causes of an abscessAn anal abscess is an abscess, i.e. abscess formation in the surrounding tissue of the anus. The abscess is the acute form, whereas the anal fistula is by definition the chronic form. Perianal abscesses frequently occur in patients with chronic intestinal disorders (Crohn’s disease).
Furthermore, inflammation of the anal glands in adults is often the reason for abscess formation. In diaper-bearing children, massive deep diaper dermatitis can also lead to abscess formation. An anal abscess can be located in the skin (subcutaneously), in fatty tissue or in muscle.
The typical symptoms of an anal abscess are swelling, redness and pressure pain. Because of the pain and swelling, defecation is often disturbed. Perianal abscesses tend to occur repeatedly and can lead to fistula formation due to inflammation of the rectal mucosa.
The diagnosis is made by inspection, palpation and a rectoscopy. Therapy is always surgical by generously opening the abscess cavity so that the drainage of secretions is guaranteed. This is an ascending inflammation of the sweat glands in the armpit area.
The pathogens causing this abscess are staphylococci. The therapy does not differ from that of other abscesses and therefore also consists of opening and drainage. A boil is a special form of abscess.
It is an inflammation of a hair follicle and the surrounding tissue. Usually this abscess is caused by the bacterium Staphylococcus aureus. This abscess formation mainly affects the chest, neck, groin, armpits, inner thighs and nose.
As a rule, this abscess heals with scarring after the pus has been rejected to the outside. Predisposing factors are immune deficiencies and metabolic diseases, such as diabetes mellitus. A boil is usually first treated with traction ointment and then surgically incised to allow the pus to drain.
On the nose and upper lip, however, surgical intervention is contraindicated, as there is a risk of the pathogen spreading in the incision/incision. This can lead to inflammation of the paranasal sinuses. In exceptional cases, a systemic antibiotic therapy is additionally applied.
Due to sweat production and constant friction from clothing, abscesses can also develop on the legs. Due to the increased hairiness, this affects men more than women. This is an abscess formation within the liver.
A distinction is made between the primary and secondary liver abscess. While a primary liver abscess by definition develops in the liver due to trauma, parasite infection or tumours, the secondary liver abscess develops outside the liver due to changes and inflammation. Bacteria can be transported from the gallbladder, appendix or other inflammatory processes in the abdomen via vessels or bile ducts into the liver, where they cause a secondary abscess.
Symptomatically, with a time lag, fever, right-sided upper abdominal pain, nausea and possibly jaundice (icterus) occur. The inflammation values in the blood increase. The diagnosis is confirmed by imaging procedures such as ultrasound, computer tomography (CT) or magnetic resonance imaging (MRI of the liver).
Abscesses caused by parasites should be treated conservatively with drainage and antibiotics. Multiple abscesses, or non-receding abscesses, should be surgically removed completely. It may be necessary to remove part of the liver completely.
An abscess in the brain is very rare and can have serious consequences. Since the abscess not only spreads, but nerve tissue can be destroyed. Children between the ages of four and seven are most commonly affected.
A distinction is made between brain abscesses that have been passed on, those caused by trauma and those that are haematogenic. Conducted brain abscesses are by far the most common brain abscesses. They are usually caused by an inflammation in the pneumatocrits.
These are directly adjacent to the brain and are closely connected to the brain. Examples are inflammation of the middle ear or sinuses. The traumatic brain abscesses develop after open craniocerebral trauma, whereby pathogens can enter the brain from outside and form abscesses.
The hematogenic brain abscesses often present as multiple abscesses in the brain. They are caused by purulent lung inflammation or inflammation of the heart and are transported into the brain via the bloodstream. Although the patients are seriously ill, they often do not show the typical symptoms of an abscess.
Therefore, the overall picture of the symptoms as well as neurological failures and previous illnesses lead to a suspected diagnosis. In acute cases, the abscess spreads rapidly and leads to headaches, neck stiffness, clouding of consciousness and signs of cerebral pressure. Chronic abscesses, on the other hand, develop slowly and manifest themselves as cerebral seizures and paralysis.
The diagnosis should always be confirmed by imaging procedures (CT, MRT, ultrasound), as well as liquor puncture and an EEG. If a capsule has not yet formed around the abscess, systemic antibiotic therapy is often sufficient. In case of capsule formation, neurosurgical intervention is necessary.
The lethality rate of acute brain abscesses is about 20%, that of chronic abscesses about 10%. The lung abscess often develops on the basis of pneumonia (pneumonia), pulmonary embolism (dislocation of the small blood vessels due to blood clots) or atelectasis (sticking of the small bronchioles). A lung abscess does not usually lead to acute symptoms.
Often subfebrile temperatures and prolonged coughing and a general feeling of weakness or illness are the only indications of an abscess. Bloody or purulent sputum is rare and only occurs when the abscess has spread to the large bronchial tree. If the abscess spreads massively, systemic blood poisoning, a purulent effusion in the pleural gap (pleural empyema) or pulmonary embolism may occur.
The diagnosis is usually made by an x-ray of the thorax. In order to kill the pathogens with the right antibiotics, it is necessary to create a culture of the sputum, the blood or a bronchoscopy. As a rule, antibitoic therapy for at least 6 weeks is sufficient.
If the therapy fails, surgical intervention is essential. The pulmonary abscess is often caused by pneumonia, pulmonary embolism (blood clots in the small blood vessels) or atelectasis (adhesions in the small bronchioles). A lung abscess does not usually lead to acute symptoms.
Often subfebrile temperatures and prolonged coughing and a general feeling of weakness or illness are the only indications of an abscess. Bloody or purulent sputum is rare and only occurs when the abscess has spread to the large bronchial tree. If the abscess spreads massively, systemic blood poisoning, a purulent effusion in the pleural gap (pleural empyema) or pulmonary embolism may occur.
The diagnosis is usually made by an x-ray of the thorax. In order to kill the pathogens with the right antibiotics, it is necessary to create a culture of the sputum, the blood or a bronchoscopy. As a rule, antibitoic therapy for at least 6 weeks is sufficient.
If the therapy fails, surgical intervention is essential. This abscess is caused by mucous membrane damage after bite wounds or tongue piercing. It causes painful swelling and redness of the tongue.
Swallowing difficulties also exist. The therapy of choice consists of opening and drainage into the abscess cavity. If necessary, additional antibiotics should be administered.
