An abscess is a collection of pus caused by a bacterial infection. It is characterized by inflammation, swelling, pain, and the presence of dead and live bacteria, white blood cells, and tissue debris. Abscesses are usually caused by Staphylococcus aureus infections and can occur anywhere in the body. They are diagnosed based on symptoms, physical exam, and imaging tests. Treatment involves antibiotics, analgesics, and sometimes surgical drainage of the pus. Complications can include sepsis, organ damage, and tissue destruction if not properly treated.

1. ABSCESS
Group C
Odoi joseph
Ocung Emmanuel
Ongwen Emmanuel
Nabukenya Victoria

2. Definition
An abscess is a circumscribed area of inflammation that contains pus.
The process of pus formation is called suppuration
pus contains;
- dead and alive leukocytes
- Dead and alive bacteria
- Tissue debris

3. .

4. Etiology
• Different causes of abscesses include;
-infections by microorganisms. Numerous organisms cause abscesses
but the most common is staphylococcus aureus
- Autoimmune
- Neoplastic (benign and malignant)
- Trauma
- Congenital
- Idiopathic
- iatrogenic

5. Predisposing factors
• Impaired host defense mechanisms like in HIV
• Presence of foreign bodies within the tissue
• Tissue ischemia or necrosis
• Hematoma or excessive fluid accumulation in tissue
• Trauma

6. Sites of abscess
External;
• Fingers , hands, neck, axilla, breast, foot, thigh etc.
Internal;
• Retroperitoneal,
• lung abscess,
• brain,
• periphrenic,
• abdominal(pelvic, phrenic, paracolic, liver abscess, splenic abscess)

7. Classification of abscess
Based on duration of occurrence;
• Acute abscess(hot abscess)- inflammatory symptoms more active
• Chronic abscess(cold abscess)- inflammatory symptoms are less
active, soft with liquid and has a thin wall
Based on location;
• Superficial abscess
• Deep abscess

8. Types of abscess
• There are 3 types;
• Pyogenic
• Pyaemic
• Cold
• Pyogenic abscess; is a collection of pus resulting from infection by
pyogenic organisms.
• Entry of organisms is through direct infection from outside due to
penetrating wound, local extension from adjacent focus of an
infection, through the lymphatics and the
bloodstream(hematogenous)

9. Cont.
• Features of acute inflammation are present that is calor, rubor,dolor
and tumor.
• There’s also fever
• Presence of pus elicited by fluctuation in the abscess area.
• These pyogenic abscesses may be located anywhere in the body.

10. Pyaemic abscess
This is caused by infective emboli in cases of pyaemia
Pyaemia is a condition in which the infected emboli containing clumps
of microorganisms, infected clots or vegetation circulate in the blood
stream. For example in conditions like acute osteomyelitis

11. Cold abscess
• It is called so because it is not accompanied by the classical signs of
inflammation- heat, redness, pain, fever, swelling which are usually
found with pyogenic abscess
• More commonly a sequelae of tubercular infection elsewhere in the
body, commonly in the lymph nodes and bone.
• Other causes can be ;
• - leprosy,
• fungal infections like blastomycosis

12. Cold abscess

13. pathophysiology
• An abscess occurs when tissue is invaded by microorganisms and
multiplication occurs.
• An immune response follows resulting into the formation of pus.
• In response to injury the tissue releases cytokines like TNF, IL-1, IL-6
and chemokines. These attract nearby white blood cells
• Cytokines also cause dilation of nearby capillaries bringing more
blood to the affected site and also cause the capillaries to become
leaky leading to diffusion of more inflammatory cells to the affected
site.
• Neutrophils are the first cells to be attracted to the infection site.

14. Cont.
• Neutrophils release chemicals and enzymes which kill bacteria and
dissolve pieces of dead cells creating a pool of dead material
• This is called suppurative inflammation
• Sometimes called liquefactive necrosis because area of dead tissue
turns into a liquid.
• Some immune cells die too and become part of the pool.
• Around this area of pus a wall of fibrinogen forms and hardens to
form a barrier.
• There is still plenty of live bacteria within the pus that makes it highly
infectious. The most common being staphylococcus aureus

15. Cont.
• Staphylococcus aureus produces coagulase which speeds up process
of building the fibrinogen wall.
• Abscesses also occur deep in the body in areas that are already
walled off

16. pathophysiology

17. Diagnosis
• Largely based on history taking and physical examination

18. Clinical features of an abscess
• Fevers with chills and rigors
• Smooth, soft fluctuant Localized swelling
• Visible or pointing pus
• Tenderness in the affected part
• Redness and warmth of the abscess area
•

19. Investigations
• Hematological
• Complete blood count
• Culture and sensitivity
• ESR
• CRP
• Blood sugar to rule out diabetes
• Radiological
• X-ray radiograph
• Ultrasound
• CT Scan
• Angiography
• Endoscopy
• MRI

20. Management
• Can be operative and non operative
Non operative-
• use of antibiotics to treat the underlying infection
• use of analgesics for pain management
Operative management through surgical drainage

22. Complications of abscess
• Bacteremia/septicemia
• Multiple abscess formation
• Metastatic abscess
• Tissue destruction
• Sinus and fistula formation
• Destruction of adjacent blood vessels leading to hemorrhage
• Organ failure for example hepatic failure due to liver abscess,
neurological deficit due to brain abscess
• Un-healing ulcers

23. Differential diagnosis
• Soft tissue tumors
• Hematoma
• Aneurysm
• Lipoma
• Cyst