What is an abscess: general information about the disease
An abscess is a purulent inflammation of the tissues with the formation of a purulent cavity. May occur in muscles, bones, subcutaneous tissue, in organs and between them. An abscess can develop on its own or as a complication of other diseases (injuries, pneumonia, angina).
If a large amount of exudate accumulates, the capsule may burst, which will be followed by the release of pus to the outside. This causes the development of the inflammatory process, which can cause sepsis, purulent fusion of the blood vessel and other equally dangerous consequences. That is why it is necessary to know how to treat an abscess at an early stage.
An abscess is a surgical disease and often requires surgery. Running an abscess can lead to serious complications.
Abscess: causes and factors of development
Like any other purulent disease, an abscess develops due to the violation of the integrity of the skin and the ingestion of pathogenic pyogenic bacteria. Reproduction of purulent bacteria causes the skin to melt and form a capsule, which is filled with purulent masses. It is noteworthy that some bacteria that can cause an abscess, are part of the normal microflora. However, under certain conditions, these bacteria begin to multiply uncontrollably with the formation of purulent masses. A large number of such microorganisms lives on the mucous membranes of the mouth, nasal cavity, genitals, eye mucosa, in the small and large intestines.
Note that it can be quite difficult to identify the pathogenic causative agent of an abscess. But the effectiveness of treatment depends on the exact identification of the microorganism. There are a large number of pathogenic bacteria that can cause a soft tissue abscess. We will consider only those microbes that are most often encountered by doctors in surgical practice:
- Staphylococcus aureus (Staphylococcus aureus). In most cases, the cause of cutaneous abscess is Staphylococcus aureus. According to recent medical studies, Staphylococcus aureus is detected in 28% of skin abscess cases. Almost always Staphylococcus aureus is sown in pure culture, without accompanying microflora. In approximately 47% of cases, abscesses develop in the upper half of the body (abscesses of the neck, face, chest and axillary region), caused by Staphylococcus aureus. Some strains of Staphylococcus aureus are not sensitive to antibiotics, which is difficult to treat such abscesses.
- Proteus mirabilis. This is one of the most common microorganisms that lives in the large intestine and is excreted by microscopic examination of feces. This microorganism is often the cause of the development of abscesses in the lower half of the body.
- E. coli. This is a representative of the normal intestinal microflora. However, in some circumstances, for example, with a decrease in immunity, E. coli can cause serious and even fatal diseases.
- Medications. Some medicines can cause sterile abscesses that look like cellulite of the skin.
- Some diseases. In some cases, some diseases (for example, pharyngitis, paraproctitis, ingrown nail, Crohn’s disease, osteomyelitis, and others) may be complicated by the occurrence of an abscess.
Types of disease: abscess classification
- soft tissue abscess (in adipose tissue, muscles, cold abscess in bone tuberculosis);
- appendicular abscess (as a complication of acute appendicitis);
- Bezold abscess (deep abscess under the neck muscles);
- lung abscess;
- brain abscess;
- pharyngeal abscess;
- small pelvic abscess;
- paratonsillar abscess (a complication of angina);
- liver abscess (bacterial, amebic);
- inter-intestinal abscess (between the intestinal loops and the abdominal wall);
- subphrenic abscess (as a result of surgical interventions, injuries, etc.);
- spinal epidural abscess (damage to the tissue surrounding the spinal cord).
Symptoms of an abscess: how the disease manifests itself
Classical manifestations of acute inflammations are characteristic of superficial abscesses: reddening of the skin, local soreness, local temperature increase, swelling, dysfunction of the organ. Common abscess symptoms are typical for inflammatory processes of any location: headache, general malaise, fever, loss of appetite, weakness.
The outcome of an abscess may be:
- breakthrough with emptying into closed cavities (into the joint cavity, pleural, abdominal, etc.);
- spontaneous dissection with a breakthrough (with mastitis, paraproctitis, abscess of the subcutaneous tissue);
- breakthrough into the lumen of organs that communicate with the external environment (bronchi, intestine, stomach, bladder).
After the opening of the abscess, the emptying cavity, under favorable conditions, subsides and undergoes scarring. In case of incomplete emptying of the abscess cavity or its poor drainage, the inflammatory process can turn into a chronic form with the formation of fistulas. A breakthrough into closed cavities leads to the occurrence of purulent processes in them (pericarditis, pleurisy, arthritis, peritonitis, meningitis, etc.).
As for the abscess symptoms of individual organs, they look as follows:
- Abscess throat. With peritonsillar or pharyngeal abscess of the throat, the patient has a sore throat when swallowing, and with edema, suffocation. This is the most dangerous complication of purulent abscess of the throat. If in this case the patient does not provide medical care in time, then this can be fatal.
- Brain abscess. In the initial stages, brain abscess is accompanied by localized severe pain, which is caused by increased intracranial pressure. More often such painful sensations occur in the morning. In the later stages of the development of the pathological process in humans, the development of delusions and hallucinations is possible. With purulent lesions of the cerebellum, coordination of movements and orientation in space are disturbed.
- Lung abscess. With a lung abscess, the patient has a strong cough, with purulent sputum. The patient’s breathing is very difficult, and pain occurs in the chest. At the initial stages of the pathological process, it is quite difficult to diagnose a lung abscess.
The most common complications are the spread of infection, bacteremia (the ingress of bacteria into the blood), an abscess breakthrough (outward or into the adjacent cavities and tissues), arrosive bleeding. With inadequate drainage of the abscess, a late performed operation, generalization of the infection is possible, the transition of the inflammatory process to the chronic form.
Distant consequences of abscess are dysfunction of vital organs, as well as exhaustion caused by tissue breakdown, anorexia.
Patient’s actions in abscess
If you experience signs of an abscess, you should contact a surgeon. Independent opening of an abscess due to the risk of serious complications is unacceptable.
Treatment of a formed abscess is not complete without surgery. Such a therapeutic event holds the surgeon in the operating room.
A patient can be hospitalized for an indefinite period in stationary conditions in case of a complicated abscess, in case of a relapse of the pathology after the operation, in the presence of a serious background disease, with a high risk of complications. In addition, a person is hospitalized if the abscess is located near a large vessel or nerve trunk.
An abscess can be eliminated by an open or closed method. The closed operation consists of a small incision through which the tumor is removed and a special drainage tube is inserted. After the cavity is washed with a disinfectant and bandaged.
Open surgery is to remove the exudate from the abscess cavity, which is carried out after a wide dissection of the tumor. Also use a drainage tube and change the bandage daily.
In that case, even if the operation did not help eliminate unpleasant symptoms, there may be a generalization of the infection with the development of sepsis. In this case, antibiotic therapy, symptomatic treatment, detoxification therapy.
A physician can easily recognize a superficial abscess, but it is much more difficult to diagnose a deep abscess. In the diagnosis used blood test (there is a shift of the formula to the left, an increase in the number of leukocytes and ESR). To determine the location and size of the abscess, can assign x-ray, ultrasound, computed tomography or magnetic resonance imaging.
Differential diagnosis of abscess is carried out with cellulitis, characterized by the absence of limitations. Also, hematoma, cysts and tumor-like formations with associated infection have similar symptoms. To clarify the diagnosis, a puncture of the content is carried out, which allows not only to establish the nature of education, but also the pathogen, and this greatly facilitates further treatment.
When an abscess occurs, surgical treatment is indicated, the purpose of which is to open a purulent cavity, emptying it, followed by drainage. Opening of small superficial abscesses can be performed on an outpatient basis.
An alternative to surgical intervention in the case of small localized abscesses of subcutaneous fat is the use of ointment Ilon k. The tool should be applied under a sterile dressing or patch once or twice a day. When used correctly, the ointment contributes to the maturation and subsequent opening of the abscess, while the purulent contents are completely eliminated, which prevents the encapsulation of the purulent foci of infection and the recurrence of the inflammatory process. Ointment Ilon K you can find in pharmacies.
In case of abscesses of the internal organs, urgent hospitalization is necessary in a surgical hospital. Some types of abscess (for example, lungs, liver) are treated by puncture with aspiration of pus and the introduction of antibiotics, enzyme preparations into the abscess cavity.
Resection of the affected organ (eg, lung), together with an abscess, is indicated for chronic course. After the abscess is opened, patients are provided with a balanced diet and detoxification therapy is performed. Antibacterial agents are prescribed taking into account the sensitivity of the inoculated microflora to them.
Early on apply cold treatment (compresses), which contributes to the resorption of purulent mass. With the inefficiency of such and the absence of negative changes (for example, an increase in the cavity or pronounced suppuration) use thermal compresses (heating pad, etc.).
In the treatment of ulcers use antibacterial drugs in the form of tablets, ointments, or in the form of injections into the affected area. Before the appointment of the drug make sowing of purulent mass, which helps to identify the type of pathogen and its sensitivity to drugs. Penicillins are used in most cases. This may be Cefalexin, Amoxicillin, which is prescribed in a daily dosage of 250-500 mg four times a day. The approximate duration of therapy is 10 days.
In the treatment of boils You can use local drugs. For example, if an abscess has formed in a child, Bepanten’s ointment, which quickly deals with the inflammatory process and accelerates wound healing, will be an effective remedy.
For an adult, ointments such as Levomekol, Vishnevsky, Ihtiolovaya are perfect. The first (Levomekol) has a powerful anti-inflammatory effect, as well as antiseptic. The advantage of the drug is the elimination of both the symptoms of the abscess and its causes. The side effects of the ointment are few.
Vishnevsky ointment is used in the treatment of abscesses, as well as carbuncles and furuncles, trophic and varicose ulcers. The only contraindication is hypersensitivity to the components of the drug. Other contraindications are absent, as well as side effects from the application.
It is possible to cure abscess of soft tissues with the help of traditional medicine, but only if the pathology proceeds at the initial stage. Aloe vera is a plant that is used for holding compresses and lotions on the affected area. In aloe juice moisten gauze segment, applied to the abscess and incubated for a day, after replacing with a new one.
You can use rye bread, which is pre-steamed and applied to an abscess. On top of the compress fix cabbage leaf and bandaged. Hold for a day, after replacing the compress with a new one.
Onions are also effective, a compress from which helps to accelerate the maturation of the abscess and its breakthrough to the outside. Fresh onion rubbed on a grater, gruel spread on a gauze cut, after – on the boil, keeping for 5 hours. The onion can be boiled in milk, then applied to the wound and bandaged.
Healing properties of ointment from propolis. Prepare it like this: melt animal fat (100 g), add chopped propolis (10 g), then for another 7 minutes. Next, remove from heat, cool and strain through a gauze filter. Ready means to use as a compress, keeping for 2 hours. The procedure is carried out three times a day.
Another useful product of beekeeping is honey. An ointment is prepared from it: it is mixed in the same volume with Vishnevsky ointment and alcohol, so that a uniform consistency is obtained. The finished product spread on the gauze, after – on the abscess, soaking until the morning. The procedure is carried out at night.