Abscess

Jump to: navigation, search
Title

Abscess Main page

Patient Information

Overview

Causes

Classification

Anal Abscess
Appendicular Abscess
Brain Abscess
Breast Abscess
Colon Abscess
Cutaneous Abscess
Liver Abscess
Lung Abscess
Pancreatic Abscess
Retropharyngeal Abscess
Splenic Abscess
Tonsillar and Peritonsillar Abscess

Differential Diagnosis

For patient information click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]:Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]

Overview

Abscess is defined as collection of pus in a specific part of body. Abscess can form in any tissues secondary to initial inflammation or trauma. Skin is the most common site for abscess formation. Abscess may be classified based on pathogen. Pathogen is varied depending on abscess' location however, Staphylococcus aureus is the leading cause of abscesses. Secondary to local inflammation and cytokine release, polymorphonuclear cells (PMNs) are the first and the most important responding cells in abscess formation.[1] Neutrophils, are responsible for phagocytosis. Once the pathogen is opsonized by complement system, it will be recognized by neutrophils and the phagocytosis process will begin. After phagocytosis the bactricidal process will begin by producing superoxide radicals and other reactive oxygen species (ROS).[2] Conditions that may result in immunosuppresion, such as chronic steroid therapy, chemotherapy, diabetes, cancer, and AIDS are predisposing factors for abscess formation. Diagnosis is based on clinical features, laboratory, and imaging findings. Treatment depends on location and etiology and it is mostly drainage and antibiotics.

Causes

Abscesses are caused by many different pathogens based on their anatomical location. The following table summarizes pathogenic causes of abscesses.[3][4][5][6][7][8][9][3][10][11][12]

Anatomical location Common causes Less common causes Comments
Brain abscess
  • Causes of brain abscess depends on the source of infection.
  • To see a complete list of brain abscesses's causes, click here.
Tonsillar and peritonsillar abscess --
Retropharyngeal abscess
  • Retropharyngeal abscess are usually caused by polymicrobial flora.
  • To see a complete list of retropharyngeal abscess' causes, click here.
Lung Abscess
Breast Abscess --
Liver abscess Pyogenic To see a complete list of pyogenic liver abscess' causes, click here.
Amoebic -- --
Fungal -- --
Splenic abscess To see a complete list of splenic abscess' causes, click here.
Pancreatic abscess --
Appendicular abscess --
Colonic abscess --
Anal abscess -- --
Cutaneous abscess



Classification

Abscesses may be classified based on their location. These are listed below.


Differential diagnosis

The following table summarizes differential diagnosis list for different abscesses.

Abscess Common disease Less common disease
Anal abscess
Appendicular abscess
Brain abscess
Breast Abscess
Colonic abscess
Cutaneous abscess
Liver abscess --
Lung Abscess
Pancreatic abscess
  • Infected necrotic pancreas
Retropharyngeal abscess
Splenic abscess
Tonsillar and peritonsillar abscess


References

  1. Kolaczkowska E, Kubes P (2013). "Neutrophil recruitment and function in health and inflammation". Nat. Rev. Immunol. 13 (3): 159–75. PMID 23435331. doi:10.1038/nri3399. 
  2. Quinn MT, Gauss KA (2004). "Structure and regulation of the neutrophil respiratory burst oxidase: comparison with nonphagocyte oxidases". J. Leukoc. Biol. 76 (4): 760–81. PMID 15240752. doi:10.1189/jlb.0404216. 
  3. 3.0 3.1 Brook I (2004). "Microbiology and management of peritonsillar, retropharyngeal, and parapharyngeal abscesses.". J Oral Maxillofac Surg. 62 (12): 1545–50. PMID 15573356. 
  4. Megalamani SB, Suria G, Manickam U, Balasubramanian D, Jothimahalingam S (2008). "Changing trends in bacteriology of peritonsillar abscess.". J Laryngol Otol. 122 (9): 928–30. PMID 18039418. doi:10.1017/S0022215107001144. 
  5. Snow DG, Campbell JB, Morgan DW (1991). "The microbiology of peritonsillar sepsis.". J Laryngol Otol. 105 (7): 553–5. PMID 1875138. 
  6. Matsuda A, Tanaka H, Kanaya T, Kamata K, Hasegawa M (2002). "Peritonsillar abscess: a study of 724 cases in Japan.". Ear Nose Throat J. 81 (6): 384–9. PMID 12092281. 
  7. Asmar BI (1990). "Bacteriology of retropharyngeal abscess in children.". Pediatr Infect Dis J. 9 (8): 595–7. PMID 2235179. 
  8. McClay JE, Murray AD, Booth T (2003). "Intravenous antibiotic therapy for deep neck abscesses defined by computed tomography.". Arch Otolaryngol Head Neck Surg. 129 (11): 1207–12. PMID 14623752. doi:10.1001/archotol.129.11.1207. 
  9. Wright CT, Stocks RM, Armstrong DL, Arnold SR, Gould HJ (2008). "Pediatric mediastinitis as a complication of methicillin-resistant Staphylococcus aureus retropharyngeal abscess.". Arch Otolaryngol Head Neck Surg. 134 (4): 408–13. PMID 18427007. doi:10.1001/archotol.134.4.408. 
  10. Inman JC, Rowe M, Ghostine M, Fleck T (2008). "Pediatric neck abscesses: changing organisms and empiric therapies.". Laryngoscope. 118 (12): 2111–4. PMID 18948832. doi:10.1097/MLG.0b013e318182a4fb. 
  11. Abdel-Haq N, Quezada M, Asmar BI (2012). "Retropharyngeal abscess in children: the rising incidence of methicillin-resistant Staphylococcus aureus.". Pediatr Infect Dis J. 31 (7): 696–9. PMID 22481424. doi:10.1097/INF.0b013e318256fff0. 
  12. Cheng J, Elden L (2013). "Children with deep space neck infections: our experience with 178 children.". Otolaryngol Head Neck Surg. 148 (6): 1037–42. PMID 23520072. doi:10.1177/0194599813482292. 
  13. Cesar L, Gonzalez C, Calia FM (1975). "Bacteriologic flora of aspiration-induced pulmonary infections". Arch. Intern. Med. 135 (5): 711–4. PMID 28705. 
  14. Bartlett JG (2012). "Anaerobic bacterial infection of the lung". Anaerobe. 18 (2): 235–9. PMID 22209937. doi:10.1016/j.anaerobe.2011.12.004. 
  15. Wang JL, Chen KY, Fang CT, Hsueh PR, Yang PC, Chang SC (2005). "Changing bacteriology of adult community-acquired lung abscess in Taiwan: Klebsiella pneumoniae versus anaerobes". Clin. Infect. Dis. 40 (7): 915–22. PMID 15824979. doi:10.1086/428574. 

Linked-in.jpg