Dermatology-Online

Forms of the abscess

Classification

Abscesses can appear anywhere on the body, both superficially and deeply. Since both the therapy and the symptoms are always very similar, the individual abscesses are usually not named individually. The abscesses are divided according to their location (liver, skin, brain, lungs) or according to other characteristics such as spread or cause (sagging abscess, injection abscess, wall abscess).

The editors recommend the article on the causes of an abscess: Causes of an abscess

1. Abscesses by location

Abscesses can develop on the skin or in organs.

Periproctic abscess (on the buttocks)

This is an anal abscess, i.e. an abscess formation in the surrounding tissue of the anus. The abscess represents the acute form, while the anal fistula, by definition, represents the chronic form. Perianal abscesses are common in patients with chronic bowel disease (Crohn's disease). Furthermore, inflammation of the anal glands in adults is often the reason for abscess formation.
In diaper-wearing children, massive, deep diaper rash can also lead to abscess formation. An anal abscess can occur in the skin (subcutaneous), in adipose tissue or in muscles. The typical symptoms of an anal abscess are swelling, redness, and tenderness.
Defecation disorders often occur due to the pain and swelling. Perianal abscesses tend to recur and can lead to fistula formation due to inflammation of the rectal mucosa. The diagnosis is made through inspection, keys and a rectoscopy. Therapy is always carried out surgically by generously opening the abscess cavity so that secretion can drain away.

Sweat gland abscess

This is a rising inflammation of the sweat glands in the armpit area. The causative agents of this abscess are Staphylococci. The therapy does not differ from that of other abscesses and thus also consists of the opening and drainage insert.

boil

A boil is a special form of the abscess. It is an inflammation of a hair follicle and the surrounding tissue. Mostly this abscess is due to the bacterium Staphylococcus aureus evoked. This abscess formation mainly includes the chest, neck, groin, armpits, inner thighs and nose affected. As a rule, this abscess heals after the pus has been rejected to the outside with scarring. Predisposing factors are Immune deficiencies andMetabolic diseases, such as Diabetes mellitus. A boil is usually first treated with pulling ointment and then surgically incised to allow pus to drain. On the other hand, surgical intervention on the nose and upper lip is contraindicated, as there is a risk of the pathogen spreading at the incision / incision. This can lead to inflammation of the sinuses. In exceptional cases, a systemic Antibiotic therapy scheduled.

Abscess on the leg

Due to sweat production and constant friction from clothing, abscesses can also develop on the legs.
Men than women are more likely to be affected by this - due to the increased hairiness.

Read more on the topic: Abscess on the inside of the thigh

Liver abscess

This is an abscess formation within the liver. A distinction is made between the primary and the secondary liver abscess. While a primary liver abscess is by definition in the liver as a result of trauma, or parasite infestation Tumors the secondary liver abscess is formed by changes and inflammation outside the liver. The bacteria can get from the Gallbladder, the appendix or other inflammatory processes in the abdominal cavity are transported to the liver via vessels or biliary tract and cause a secondary abscess there.
Symptoms are delayed fever, right-sided upper abdominal pain, nausea and possibly for Jaundice (Jaundice). The inflammation levels rise in the blood. The diagnosis is confirmed by imaging methods such as Ultrasonic, Computed Tomography (CT), or Magnetic resonance imaging (MRI of the liver). Abscesses caused by parasites should be treated conservatively with drainage pads and antibiotics. Multiple abscesses, or abscesses that do not regress, should be completely removed surgically. It may be necessary to completely remove part of the liver.

Brain abscess

An abscess in the brain is very rare and can have serious consequences. Since the abscess not only spreads, but nerve tissue can also be destroyed. Children between the ages of four and seven are most commonly affected. A distinction is made between disseminated, traumatic or hematogenic brain abscesses. The brain abscesses carried forward are by far the most common abscesses in the brain. They usually arise due to inflammation in the pneumatization areas. These are directly adjacent to the brain and are closely related to the brain. Examples of this are middle ear infections or sinus infections. The traumatically caused brain abscesses arise after open skull-brain trauma, whereby pathogens from outside can penetrate the brain and form abscesses. The hematogenous brain abscesses often present themselves as multiple abscesses in the brain.
They are caused by purulent inflammation of the lungs or heart inflammation and are transported to the brain via the bloodstream. Although patients are critically 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 quickly and leads to headaches, neck stiffness, clouding of consciousness and signs of intracranial pressure. Chronic abscesses, on the other hand, develop slowly and become noticeable through cerebral seizures and symptoms of paralysis. The diagnosis should always be confirmed by imaging procedures (CT, MRI, ultrasound), as well as CSF puncture and an EEG. If a capsule has not yet formed around the abscess, systemic antibiotic therapy is often sufficient. In the case of capsule formation, neurosurgical intervention is necessary. The lethality of acute brain abscesses is around 20%, that of chronic abscesses around 10%.

Read more on the subject at: Brain abscess.

Lung abscess

The lung abscess often arises on the basis of a lung infection (pneumonia), Pulmonary embolism (Obstruction of small blood vessels by blood clots) or Atelectasis (Adhesion of the small bronchioles).

A lung abscess usually does not lead to acute symptoms. Often the temperatures are subfebrile and prolonged to cough and a general feeling of weakness or illness are the only signs 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 space (Pleural empyema) or pulmonary embolism. The diagnosis is usually made by a X-ray of thorax. In order to kill the pathogens with the right antibiosis, it is necessary to create the pathogen by creating a culture from the sputum, the blood or a bronchoscopy. As a rule, antibiotic therapy is sufficient for at least 6 weeks. If the therapy fails, surgical intervention is essential here too.

Lung abscess

The lung abscess often arises on the basis of a lung infection (pneumonia),Pulmonary embolism (Obstruction of small blood vessels by blood clots) or Atelectasis (Adhesion of the small bronchioles).

Abscessed tongue

This abscess is caused by damage to the mucous membrane Bite wounds or even one Tongue piercing. There is painful swelling and reddening of the tongue. There are also difficulty swallowing. The therapy of choice consists of opening and inserting drainage into the abscess cavity. Antibiotics may also be given.

2. Further classifications and forms

Subsidence abscess

In the case of a subsidence abscess, the abscess spreads along pre-existing anatomical structures following gravity. They arise mainly in the area of the spine. The abscess spreads along the muscle fascia after vertebral body inflammation and can extend into the muscle fascia of the thighs.

Gas abscess

In the case of a gas abscess, not only does a purulent abscess form, but gas-forming bacteria cause gas to form in the abscess cavity. This leads to a significant increase in size and pain in the area of the abscess.

Injection abscess

A syringe abscess is usually iatrogenic, that means medically caused, induced. If the puncture site was not properly disinfected before the vaccination or other injection into the skin, the bacteria of the normal skin flora can be transported through the needle into the subcutaneous tissue and form an abscess there. This also occurs frequently with drug addicts who inject their drugs through syringes and who often do not have clean hygienic conditions.