Editing Abscess (section)

{{short description|Localized collection of pus that has built up within the tissue of the body}}
{{About|the medical condition|the death metal band|Abscess (band)}}
{{cs1 config|name-list-style=vanc}}
{{Infobox medical condition (new)
| name = Abscess
| synonyms = {{Langx|la|Abscessus}}
| image = Five day old Abscess Extra Low Contrast B.jpg
| alt = 
| caption = Five-day-old inflamed epidermal inclusion cyst. The black spot is a keratin plug which connects with the underlying cyst.
| field = [[General surgery]], [[infectious disease (medical specialty)|infectious disease]], [[dermatology]]
| symptoms = Redness, pain, swelling<ref name=NEJM2014/>
| duration = 
| causes = [[Bacterial infection]] (often [[MRSA]])<ref name=NEJM2014/>
| risks = [[Intravenous drug use]]<ref name=Langrod2007/>
| diagnosis = [[Ultrasound]], [[CT scan]]<ref name=NEJM2014/><ref name=Rosen2014Chp137/>
| differential = [[Cellulitis]], [[sebaceous cyst]], [[necrotising fasciitis]]<ref name=Rosen2014Chp137/>
| treatment = [[Incision and drainage]], [[Antibiotics]]<ref name="ACEPfive"/>
| medication = 
| frequency = ~1% per year (United States)<ref name=Taira2009/>
| onset = Rapid
| deaths = 
}}

An '''abscess''' is a collection of [[pus]] that has built up within the [[tissue (biology)|tissue]] of the body, usually caused by bacterial infection.<ref>{{Cite web |title=Abscess |url=https://my.clevelandclinic.org/health/diseases/22876-abscess |access-date=2025-01-02 |website=[[Cleveland Clinic]] |quote=An abscess is a buildup of a pus that can affect any part of your body.}}</ref><ref>{{Cite web |last=Bush |first=Larry M. |date=Jul 2024 |title=Abscesses |url=https://www.msdmanuals.com/professional/infectious-diseases/biology-of-infectious-disease/abscesses |access-date=2025-01-02 |website=[[MSD Manual]] |quote=Abscesses are collections of pus in confined tissue spaces, usually caused by bacterial infection.}}</ref> Signs and symptoms of abscesses include redness, pain, warmth, and swelling.<ref name=NEJM2014/> The swelling may feel fluid-filled when pressed.<ref name=NEJM2014/> The area of redness often extends beyond the swelling.<ref name=El2009>{{cite book| vauthors = Elston DM |title=Infectious Diseases of the Skin.|date=2009|publisher=Manson Pub. |location=London |isbn=978-1-84076-514-4 |page=12 |url= https://books.google.com/books?id=esPkuOxZajYC&pg=PA12|url-status=live |archive-url=https://web.archive.org/web/20170906120647/https://books.google.com/books?id=esPkuOxZajYC&pg=PA12|archive-date=2017-09-06}}</ref> [[Carbuncle]]s and [[boil]]s are types of abscess that often involve [[hair follicle]]s, with carbuncles being larger.<ref name=Rosen2014Chp120>{{cite book| vauthors = Marx JA |title=Rosen's emergency medicine : concepts and clinical practice|date=2014|publisher=Elsevier/Saunders|location=Philadelphia, PA|isbn=978-1-900151-96-2 |pages=Chapter 120|edition=8th |chapter=Dermatologic Presentations}}</ref> A [[cyst]] is related to an abscess, but it contains a material other than pus, and a cyst has a clearly defined wall. Abscesses can also form internally on internal organs and after surgery.

They are usually caused by a [[bacterial infection]].<ref name=Cox2007>{{cite book| vauthors = Cox C, Turkington JS, Birck D |title=The encyclopedia of skin and skin disorders |date=2007 |publisher=Facts on File|location=New York, NY |isbn=978-0-8160-7509-6 |page=1 |url= https://books.google.com/books?id=GKVPHoIs8uIC&pg=PA1 |edition=3rd|url-status=live|archive-url=https://web.archive.org/web/20170906120647/https://books.google.com/books?id=GKVPHoIs8uIC&pg=PA1|archive-date=2017-09-06}}</ref> Often many different types of bacteria are involved in a single infection.<ref name=El2009/> In many areas of the world, the most common bacteria present is ''[[methicillin-resistant Staphylococcus aureus]]''.<ref name=NEJM2014/> Rarely, [[parasites]] can cause abscesses; this is more common in the [[developing world]].<ref name=Rosen2014Chp137/> Diagnosis of a skin abscess is usually made based on what it looks like and is confirmed by cutting it open.<ref name=NEJM2014/> [[Ultrasound]] imaging may be useful in cases in which the diagnosis is not clear.<ref name=NEJM2014/> In abscesses around the [[anus]], [[computer tomography]] (CT) may be important to look for deeper infection.<ref name=Rosen2014Chp137>{{cite book| vauthors = Marx JA |title=Rosen's emergency medicine : concepts and clinical practice|date=2014|publisher=Elsevier/Saunders|location=Philadelphia, PA|isbn=978-1-4557-0605-1 |pages=Chapter 137|edition=8th |chapter=Skin and Soft Tissue Infections}}</ref>

Standard treatment for most skin or soft tissue abscesses is cutting it open and drainage.<ref name="ACEPfive">{{Citation |author1 = American College of Emergency Physicians |author1-link = American College of Emergency Physicians |title = Five Things Physicians and Patients Should Question |publisher = American College of Emergency Physicians |work = [[Choosing Wisely]]: an initiative of the [[ABIM Foundation]] |url = http://www.choosingwisely.org/doctor-patient-lists/american-college-of-emergency-physicians/ |access-date = January 24, 2014 |url-status = live |archive-url = https://web.archive.org/web/20140307012443/http://www.choosingwisely.org/doctor-patient-lists/american-college-of-emergency-physicians/ |archive-date = March 7, 2014 }}</ref> There appears to be some benefit from also using [[antibiotic]]s.<ref>{{cite journal | vauthors = Vermandere M, Aertgeerts B, Agoritsas T, Liu C, Burgers J, Merglen A, Okwen PM, Lytvyn L, Chua S, Vandvik PO, Guyatt GH, Beltran-Arroyave C, Lavergne V, Speeckaert R, Steen FE, Arteaga V, Sender R, McLeod S, Sun X, Wang W, Siemieniuk RA | display-authors = 6 | title = Antibiotics after incision and drainage for uncomplicated skin abscesses: a clinical practice guideline | journal = BMJ | volume = 360 | pages = k243 | date = February 2018 | pmid = 29437651 | pmc = 5799894 | doi = 10.1136/bmj.k243 }}</ref> A small amount of evidence supports not packing the cavity that remains with [[Gauze sponge|gauze]] after drainage.<ref name=NEJM2014>{{cite journal | vauthors = Singer AJ, Talan DA | title = Management of skin abscesses in the era of methicillin-resistant Staphylococcus aureus | journal = The New England Journal of Medicine | volume = 370 | issue = 11 | pages = 1039–1047 | date = March 2014 | pmid = 24620867 | doi = 10.1056/NEJMra1212788 | url = http://enotes.us/SkinAbscess2014.pdf | url-status = dead | access-date = 2014-09-24 | archive-url = https://web.archive.org/web/20141030065311/http://enotes.us/SkinAbscess2014.pdf | archive-date = 2014-10-30 }}</ref> Closing this cavity right after draining it rather than leaving it open may speed healing without increasing the risk of the abscess returning.<ref name=Singer2011>{{cite journal | vauthors = Singer AJ, Thode HC, Chale S, Taira BR, Lee C | title = Primary closure of cutaneous abscesses: a systematic review | journal = The American Journal of Emergency Medicine | volume = 29 | issue = 4 | pages = 361–366 | date = May 2011 | pmid = 20825801 | doi = 10.1016/j.ajem.2009.10.004 | url = http://www.emottawa.ca/assets_secure/journal_club/Sept%2011_2_Singer%202011%20Am%20J%20of%20Emerg%20Med%20Primary%20closure%20of%20cutaneous%20abscesses.pdf | url-status = dead | archive-url = https://web.archive.org/web/20150722040008/http://www.emottawa.ca/assets_secure/journal_club/Sept%2011_2_Singer%202011%20Am%20J%20of%20Emerg%20Med%20Primary%20closure%20of%20cutaneous%20abscesses.pdf | archive-date = 2015-07-22 }}</ref> Sucking out the pus with a needle is often not sufficient.<ref name=NEJM2014/>

Skin abscesses are common and have become more common in recent years.<ref name=NEJM2014/> Risk factors include [[intravenous drug use]], with rates reported as high as 65% among users.<ref name=Langrod2007>{{cite book| vauthors = Ruiz P, Strain EC, Langrod J |title=The substance abuse handbook|date=2007|publisher=Wolters Kluwer Health/Lippincott Williams & Wilkins|location=Philadelphia|isbn=978-0-7817-6045-4 |page=373|url=https://books.google.com/books?id=6LkNShsAw78C&pg=PA373|url-status=live|archive-url=https://web.archive.org/web/20170906120647/https://books.google.com/books?id=6LkNShsAw78C&pg=PA373|archive-date=2017-09-06}}</ref> In 2005, 3.2 million people went to American emergency departments for abscesses.<ref name=Taira2009>{{cite journal | vauthors = Taira BR, Singer AJ, Thode HC, Lee CC | title = National epidemiology of cutaneous abscesses: 1996 to 2005 | journal = The American Journal of Emergency Medicine | volume = 27 | issue = 3 | pages = 289–292 | date = March 2009 | pmid = 19328372 | doi = 10.1016/j.ajem.2008.02.027 }}</ref> In Australia, around 13,000 people were hospitalized in 2008 with the condition.<ref name=Vas2012>{{cite journal | vauthors = Vaska VL, Nimmo GR, Jones M, Grimwood K, Paterson DL | title = Increases in Australian cutaneous abscess hospitalisations: 1999-2008 | journal = European Journal of Clinical Microbiology & Infectious Diseases | volume = 31 | issue = 1 | pages = 93–96 | date = January 2012 | pmid = 21553298 | doi = 10.1007/s10096-011-1281-3 | s2cid = 20376537 }}</ref>
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