Abscess

	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

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

Overview

Causes

Abscesses are caused by many different pathogens based on their anatomical location. The following table summarizes pathogenic causes of abscesses.^[1]^[2]^[3]^[4]^[5]^[6]^[7]^[1]^[8]^[9]^[10]

Anatomical location		Common causes	Less common causes	Comments
Brain abscess		Staphylococcus aureus Streptococcus spp Cryptococcus neoformans Cysticercosis Toxoplasma gondii	Pseudomonas aeruginosa Enterobacter spp Haemophilus spp	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		Streptococcus pyogenes Fusobacterium necrophorum Streptococcus milleri Staphylococci Haemophilus Prevotella Acinetobacter	Candida albicans Peptostreptococcus spp Pseudomonas spp Enterobacter spp Klebsiella Porphyromonas	--
Retropharyngeal abscess		Beta-hemolytic streptococcus Streptococcus pyogenes (group A streptococcus [GAS]) Staphylococcus aureus (including methicillin-resistant S. aureus [MRSA])	Haemophilus Influenzae Haemophilus parainfluenzae Neisseria species Bacteroides Fusobacterium	Retropharyngeal abscess are usually caused by polymicrobial flora. To see a complete list of retropharyngeal abscess' causes, click here.
Lung Abscess		Bacteroides Fusobacterium Peptostreptococcus Prevotella Streptococcus milleri	Legionella Lemierre's syndrome Listeriosis Melioidosis	About 90% of the lung abscess is caused by polymicrobial infection.^[11] ^[12] Anaerobes are the predominant pathogens involved in primary lung abscess, followed by Streptococcus pneumoniae. Klebsiella pneumoniae is the more commonly seen in alcoholics.^[13] To see a complete list of lung abscess' causes, click here.
Breast Abscess		Staphylococcus aureus Streptococcus pyogenes Lactobacillus Clostridium	Bacteroides spp Enterobacteria	--
Liver abscess	Pyogenic	Streptococcus sp Staphylococcus aureus Staphylococcus epidermidis Escherichia coli Salmonella typhi Yersinia enterocolitica Bacteroids sp Fusobacterium	Mycobacterium tuberculosis Actinomyces sp Enterococcus sp Streptococcus milleri K.pneumonia Pseudomonas sp	To see a complete list of pyogenic liver abscess' causes, click here.
	Amoebic	Entamoeba histolytica	--	--
	Fungal	Candida species Aspergillus species	--	--
Splenic abscess		Staphylococcus species Streptococcal species Bacteroides Actinomyces Candida albicans Entamoeba histolytica	Aureobasidium pullulans Bacillus cereus Brucella Citrobacter freundii Cryptococcus neoformans	To see a complete list of splenic abscess' causes, click here.
Pancreatic abscess		Enterococcus Escherichia coli Klebsiella pneumoniae Bacteroides fragilis Candida albicans Entamoeba histolytica	Pseudomonas aeruginosa Staphylococcus aureus Proteus Clostridium perfringens Candida tropicalis	--
Appendicular abscess		Enterococcus Escherichia coli Staphylococcus aureus Bacteroides fragilis Clostridium perfringens	Klebsiella pneumoniae Pseudomonas aeruginosa Proteus	--
Colonic abscess		Enterococcus Escherichia coli Staphylococcus aureus Bacteroides fragilis Clostridium perfringen	Klebsiella pneumoniae Pseudomonas aeruginosa Proteus	--
Anal abscess		E.coli Staphylococcus aureus MRSA	--	--
Cutaneous abscess		S. aureus (either methicillin-susceptible or methicillin-resistant S. aureus) Mixed flora (including S. aureus together with S. pyogenes and gram-negative bacilli with anaerobes) Anaerobes	Nontuberculous mycobacteria Blastomycosis Nocardiosis Cryptococcosis

Classification

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

3

Differential diagnosis

The following table summarizes differential diagnosis list for different abscesses.

References

↑ ^1.0 ^1.1 Brook I (2004). "Microbiology and management of peritonsillar, retropharyngeal, and parapharyngeal abscesses". J Oral Maxillofac Surg. 62 (12): 1545–50. PMID 15573356.
↑ 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. doi:10.1017/S0022215107001144. PMID 18039418.
↑ Snow DG, Campbell JB, Morgan DW (1991). "The microbiology of peritonsillar sepsis". J Laryngol Otol. 105 (7): 553–5. PMID 1875138.
↑ 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.
↑ Asmar BI (1990). "Bacteriology of retropharyngeal abscess in children". Pediatr Infect Dis J. 9 (8): 595–7. PMID 2235179.
↑ 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. doi:10.1001/archotol.129.11.1207. PMID 14623752.
↑ 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. doi:10.1001/archotol.134.4.408. PMID 18427007.
↑ Inman JC, Rowe M, Ghostine M, Fleck T (2008). "Pediatric neck abscesses: changing organisms and empiric therapies". Laryngoscope. 118 (12): 2111–4. doi:10.1097/MLG.0b013e318182a4fb. PMID 18948832.
↑ 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. doi:10.1097/INF.0b013e318256fff0. PMID 22481424.
↑ Cheng J, Elden L (2013). "Children with deep space neck infections: our experience with 178 children". Otolaryngol Head Neck Surg. 148 (6): 1037–42. doi:10.1177/0194599813482292. PMID 23520072.
↑ Cesar L, Gonzalez C, Calia FM (1975). "Bacteriologic flora of aspiration-induced pulmonary infections". Arch. Intern. Med. 135 (5): 711–4. PMID 28705.
↑ Bartlett JG (2012). "Anaerobic bacterial infection of the lung". Anaerobe. 18 (2): 235–9. doi:10.1016/j.anaerobe.2011.12.004. PMID 22209937.
↑ 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. doi:10.1086/428574. PMID 15824979.

[pmid15573356-1] 1.0 ^1.1 Brook I (2004). "Microbiology and management of peritonsillar, retropharyngeal, and parapharyngeal abscesses". J Oral Maxillofac Surg. 62 (12): 1545–50. PMID 15573356.

[pmid18039418-2] 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. doi:10.1017/S0022215107001144. PMID 18039418.

[pmid1875138-3] Snow DG, Campbell JB, Morgan DW (1991). "The microbiology of peritonsillar sepsis". J Laryngol Otol. 105 (7): 553–5. PMID 1875138.

[pmid12092281-4] 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.

[pmid2235179-5] Asmar BI (1990). "Bacteriology of retropharyngeal abscess in children". Pediatr Infect Dis J. 9 (8): 595–7. PMID 2235179.

[pmid14623752-6] 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. doi:10.1001/archotol.129.11.1207. PMID 14623752.

[pmid18427007-7] 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. doi:10.1001/archotol.134.4.408. PMID 18427007.

[pmid18948832-8] Inman JC, Rowe M, Ghostine M, Fleck T (2008). "Pediatric neck abscesses: changing organisms and empiric therapies". Laryngoscope. 118 (12): 2111–4. doi:10.1097/MLG.0b013e318182a4fb. PMID 18948832.

[pmid22481424-9] 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. doi:10.1097/INF.0b013e318256fff0. PMID 22481424.

[pmid23520072-10] Cheng J, Elden L (2013). "Children with deep space neck infections: our experience with 178 children". Otolaryngol Head Neck Surg. 148 (6): 1037–42. doi:10.1177/0194599813482292. PMID 23520072.

[pmid28705-11] Cesar L, Gonzalez C, Calia FM (1975). "Bacteriologic flora of aspiration-induced pulmonary infections". Arch. Intern. Med. 135 (5): 711–4. PMID 28705.

[pmid22209937-12] Bartlett JG (2012). "Anaerobic bacterial infection of the lung". Anaerobe. 18 (2): 235–9. doi:10.1016/j.anaerobe.2011.12.004. PMID 22209937.

[pmid15824979-13] 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. doi:10.1086/428574. PMID 15824979.

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