Abscesses are encapsulated pus bumps. Depending on their size and location, they are harmless, painful or even life-threatening. More about symptoms, causes and treatment.

Synonyms

Pus blister, pus bulge, pus accumulation

Definition

Medical experts describe encapsulated collections of pus as an abscess. Abscesses can appear anywhere in the body. They are usually the result of an infection. But they also form when the body encases a foreign body and in response to injections or surgery.

Ultimately, abscess formation is a protective function of the body. Because pus collections are surrounded by an impermeable layer of tissue, the germs they contain cannot spread into the organism. However, the protective effect is limited: If the covering of an abscess becomes permeable (perforated), the contents pour outwards through the skin or inside the body. Depending on the location of the abscess, this can have life-threatening consequences. If, for example, a pus blister bursts in the abdomen, an acute abdomen quickly develops, which in turn can lead to blood poisoning.

A special form of the abscess are infections of the hair follicle. These collections of pus are called boils or carbuncles.

Symptoms

The symptoms of abscesses depend on the location and size of the pus. Some abscesses inside the body often go unnoticed for a long time. For example, they only cause pain when they become very large and put pressure on neighboring nerves or organs.

Most pus blisters, however, arise near the surface. These abscesses are often initially noticeable through a barely perceptible foreign body sensation. But pain soon arises, which intensifies particularly when the abscess is pressed. Redness and swelling are other visible symptoms of near-surface abscesses.

Such abscesses are particularly common in the genital area, on the anus or buttocks, as well as in the armpits, the joints and on the thighs. Large and deep abscesses often cause flu-like symptoms with fatigue, fever, and body aches or headaches. The pain of liver abscesses, for example, sometimes radiates into the shoulder or into the pelvis and back.

Causes

Abscesses near the surface are almost always caused by bacteria. As a rule, the germs get into the deeper layers of the skin through the smallest skin injuries. There they multiply and trigger an inflammatory process. This inflammation is fought by the immune system. Pus can form as a waste product of this control. The greater the inflammation, the greater the accumulation of pus.

In the case of a syringe abscess, the bacteria enter the body from the skin surface with the cannula. Peak abscesses occur especially when the injection site is not carefully disinfected or infected injection equipment is used (especially common among drug addicts).

But there are also rare causes of abscesses. For example, parasites can enter the body with food, spread and cause infections.

Non-bacterial causes of abscesses are, for example, Crohn’s disease and tuberculosis. In Crohn’s disease, abscesses form primarily in the intestine, in the case of tuberculosis in the lungs. Non-bacterial abscesses are also called cold abscesses.

Treatment

Treating abscesses is always in the hands of trained personnel. These can be nurses or doctors. Under no circumstances should you express or even cut open abscesses yourself. Even with superficial abscesses, there is a considerable risk that bacteria will get deeper into the organism. This can have serious consequences, including life-threatening blood poisoning (sepsis).

The only way to completely remove larger abscesses is by surgery. The severity of this intervention depends on the location and size of the pus. Abscesses close to the surface can often be done during an outpatient procedure in the doctor’s office, if necessary with local anesthesia. Deep or overgrown abscesses, on the other hand, often require inpatient hospital treatment with surgery under general anesthesia.

Surgical treatment is often followed by drug therapy with antibiotics such as flucloxacillin, cefalexin, clindamycin or tetracycline. This antibiosis is intended to ensure that any bacteria that have not been removed cause a new infection with abscess formation.

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