This action might not be possible to undo. Are you sure you want to continue?
New Brunswick, New Jersey: Rutgers University Press, 1997. Zaret, Barry L., ed. The Patient’s Guide to Medical Tests. Boston: Houghton Mifflin Company, 1997.
There are two types of abscesses, septic and sterile. Most abscesses are septic, which means that they are the result of an infection. Septic abscesses can occur anywhere in the body. Only bacteria and the body’s immune response are required. In response to the invading bacteria, white blood cells gather at the infected site and begin producing chemicals called enzymes that attack the bacteria by first marking and then digesting it. These enzymes kill the bacteria and break them down into small pieces that can travel in the circulatory system prior to being eliminated from the body. Unfortunately, these chemicals also digest body tissues. In most cases, bacteria produce similar chemicals. The result is a thick, yellow liquid—pus—containing dead bacteria, digested tissue, white blood cells, and enzymes. An abscess is the last stage of a tissue infection that begins with a process called inflammation. Initially, as invading bacteria activate the body’s immune system, several events occur: • Blood flow to the area increases. • The temperature of the area increases due to the increased blood supply. • The area swells due to the accumulation of water, blood, and other liquids. • It turns red. • It hurts, due to irritation from the swelling and the chemical activity. These four signs—heat, swelling, redness, and pain—characterize inflammation. As the process progresses, the tissue begins to turn to liquid, and an abscess forms. It is the nature of an abscess to spread as the chemical digestion liquefies more and more tissue. Furthermore, the spreading follows the path of least resistance, commonly, the tissue that is most easily digested. A good example is an abscess just beneath the skin. It most easily continues along immediately beneath the surface rather than traveling up through the outermost layer or down through deeper structures where it could drain its toxic contents. The contents of an abscess can also leak into the general circulation and produce symptoms just like any other infection. These include chills, fever, aching, and general discomfort. Sterile abscesses are sometimes a milder form of the same process caused not by bacteria but by non-living irritants such as drugs. If an injected drug such as penicillin is not absorbed, it stays where it is injected and may cause enough irritation to generate a sterile abscess. Such an abscess is sterile because there is no infection involved. Sterile abscesses are quite likely to turn into
Freundlich, Naomi. “Ultrasound: What’s Wrong with this Picture?” Business Week (15 September 1997): 84-85. Kuhn, M., Bonnin, R.L.L., Davey, M.J., Rowland, J.L., Langlois, S. “Emergency Department Ultrasound Scanning for Abdodminal Aortic Aneurysm: Accessible, Accurate, Advantageous. Annals of Emergency Medicine. (September 2000) 36(3):219-223. Sisk, Jennifer. “Ultrasound in the Emergency Department: Toward a Standard of Care.” Radiology Today (June 4, 2001) 2(1):8-10.
American College of Radiology. 1891 Preston White Drive, Reston, VA 20191-4397. (800)227-5463. <http://www.acr.org>. American Institute of Ultrasound in Medicine. 14750 Sweitzer Lane, Suite 100, Laurel, MD 20707-5906. (301) 4984100. <http://www.aium.org>. American Registry of Diagnostic Medical Sonographers. 600 Jefferson Plaza, Suite 360, Rockville, MD 20852-1150. (800) 541-9754. <http://www.ardms.org>. American Society of Radiologic Technologists (ASRT). 15000 Central Avenue SE, Albuquerque, NM 87123-2778. (800) 444-2778. <http://www.asrt.org>. Radiological Society of North America. 820 Jorie Boulevard, Oak Brook, IL 60523-2251. (630) 571-2670. <http://www.rsna.org>. Society of Diagnostic Medical Sonography. 12770 Coit Road, Suite 708, Dallas, TX 75251-1319. (972) 239-7367. <http://www.sdms.org>.
Jennifer E. Sisk, M.A.
ABO blood typing see Type and screen Abrasions see Wounds Abruptio placentae see Placental abruption
An abscess is an enclosed collection of liquefied tissue, known as pus, somewhere in the body. It is the result of the body’s defensive reaction to foreign material.
G A L E E N C Y C L O P E D I A O F N U R S I N G A N D A L L I E D H E A LT H
Enzyme—Any of a number of protein chemicals that can initiate chemical reactions at body temperature. • Retropharyngeal. Many people have as a birth defect a tiny opening in the skin just above the anus. redness. Acne is a similar condition involving sebaceous glands on the face and back. which is a very common cause of abscesses under the skin. Sinus—A tubular channel connecting one body part with another or with the outside. swelling. Streptococcus. amoebae. Usually something in the initial evaluation directs the search. tuberculosis. Staphocococcus. Pyogenic—Capable of generating pus. An abscess can develop in one of these muscles. of tissue due to Listed below are some of the more common and important abscesses. Septicemia—The spread of an infectious agent throughout the body by means of the blood stream. G A L E E N C Y C L O P E D I A O F N U R S I N G A N D A L L I E D H E A LT H . If they become plugged. As a result of throat infections such as strep throat and tonsillitis. for instance seizures or altered bowel function. If an individual’s symptoms and the results of a physical examination do not help. These abscesses can compromise swallowing and even breathing. or other bacteria. The most common are the pus-forming (pyogenic) bacteria such as Staphylococcus aureus. bacteria can invade the deeper tissues of the throat and cause an abscess. peritonsillar abscess. may provide the clue. fungi. and pain—easily identify superficial abscesses. Abscesses in other parts of the body are caused by organisms that normally inhabit nearby structures or that infect them. Dysfunction of an organ or system. Flora—Living inhabitants of a region or area. rather than remaining pockets of pus. Brain abscesses and liver abscesses can be caused by any organism that can travel there through the blood stream. particularly around the anus. Causes and symptoms Many different agents cause abscesses. A sterile abscess may cause only a painful lump deep in the buttock where a shot was given. • Psoas abscess. sebum collects inside and forms a nurturing place for germs to grow. and bowel bacteria are the primary pyogenic organisms. and certain fungi can travel in this fashion. hard. on either side of the lumbar spine. Fecal bacteria can enter this opening. abscesses can develop as a complication. usually when it spreads from the appendix. may be caused by any of the numerous bacteria found within the large bowel. Deep in the back of the abdomen. Sebaceous glands—Tiny structures in the skin that produce oil (sebum). During or after pneumonia. • Lung abscess. lie the psoas muscles.Abscess Specific types of abscesses KEY TERMS Cellulitis—Inflammation infection. whether it’s due to bacteria [common pneumonia]. Abscesses in other places may produce only generalized symptoms such as fever and discomfort. Sometimes a deep abscess will eat a small channel (sinus) to the surface and begin leaking pus. They flex the hips. or the fallopian tubes. a physician may have to resort to a battery of tests to locate the site of an abscess. Recent or chronic disease in an organ suggests it may be the site of an abscess. Some common causes of specific abscesses are: • skin abscesses by normal skin flora • dental and throat abscesses by mouth flora • lung abscesses by normal airway flora. bacteria that cause pneumonia or tuberculosis • abdominal and anal abscesses by normal bowel flora 6 Diagnosis The common findings of inflammation—heat. Pain and tenderness on physical examination are common findings. parasites. Bacteria or amoeba from the intestines can spread through the blood to the liver and cause abscesses. Abscesses near the large bowel. Bacteria. • Carbuncles and other boils. parapharyngeal. the large bowel. Skin oil glands (sebaceous glands) on the back or the back of the neck are the ones usually infected. Fallopian tubes—Part of the internal female anatomy that carries eggs from the ovaries to the uterus. • Pilonidal cyst. The most commonly involved bacteria is Staphylococcus aureus. solid lumps as they scar. causing an infection and subsequent abscess. • Liver abscess.
an abscess ruptures into neighboring areas or permits the infectious agent to spill into the bloodstream. Bites are the most dangerous of all. and educate patients about caring for the resulting wound. 2000. “Brain abscess. Health care team roles First aid providers may unknowingly initiate an abscess by using inappropriate or incorrect techniques. it acts as a barrier. The surgeon determines when the abscess is ready for drainage and opens a path to the outside. Russell W. the result is life threatening. surgeon. Alternative treatment If an abscess is directly beneath the skin. 1857-1858. can also help assist the body in resorption of the abscess... In either case. physician’s assistant. (Phototake NYC. Chesney.Abscess Treatment Since skin is very resistant to the spread of infection. Silica and Hepar sulphuris. There are two homeopathic remedies that work to rebalance the body in relation to abscess formation. trunk. Since chemicals work faster at higher temperatures. the pus must be drained from the abscess by a physician. sometimes with the help of antibiotics or other drugs. allowing the pus to escape. 1212.) Of special note. 16th ed. the prognosis is excellent for the condition itself. A physician. Thus. Occasionally. In cases of septic abscesses. William. Nurses provide supportive care. or nurse practitioner usually drains an abscess. 16th ed. edited by Richard E. ears. Blood poisoning is a term commonly used to describe an infection that has spilled into the blood stream and spread throughout the body from a localized origin. a physical therapist may be needed to recover lost function. face. and back of the neck.. even more so because they often occur on the hand. applications of hot compresses to the skin over the abscess will hasten the digestion of the skin and eventually result in its break down and spontaneous release of pus. Blood poisoning. it will be slowly working its way through the skin as it is more rapidly working its way elsewhere. alternating hot and cold compresses. Behrman et al. Radiologists and laboratory personnel may assist in the process of establishing a diagnosis. on the other hand. 7 G A L E E N C Y C L O P E D I A O F N U R S I N G A N D A L L I E D H E A LT H . Abscesses within an abdominal organ such as the liver may rupture into the abdominal cavity. known to physicians as septicemia. Prognosis Once an abscess is properly drained. Contrast hydrotherapy. abscesses in the hand are more serious than they might appear. “Liver abscess. The surgeon may leave a drain (a piece of cloth or rubber) in the abscess cavity to prevent it from closing before all the pus has drained out. often keeping the toxic chemicals of an abscess from escaping the body on their own. any hand infection must be treated promptly and competently. serious or fatal consequences are likely.” In Nelson Textbook of Pediatrics. Saunders. Behrman et al. Abscesses in and around the nasal sinuses. It will “ripen” them. Philadelphia. physician’s assistant. 2000. dress the wound. or nurse practitioner usually diagnoses the presence of an abscess. edited by Richard E. the body handles the remaining infection. Philadelphia. It is even better to avoid infections altogether by taking prompt care of open injuries. This treatment is best reserved for smaller abscesses in less sensitive areas of the body such as limbs. Prevention Infections that are treated early with heat (if superficial) or antibiotics will often resolve without the formation of an abscess. Saunders.” In Nelson Textbook of Pediatrics. Due to the intricate structure and the overriding importance of the hand. particularly puncture wounds. The reason for the abscess (other diseases an individual has) will determine the overall outcome. Reproduced by permission. and scalp may work their way into the brain. bentonite clay packs (bentonite clay and a small amount of Hydrastis powder) can be used to draw an infection from the area. An amoebic abscess caused by Entameoba histolytica. If. is also life threatening. It is also useful for all superficial abscesses in their very early stages. Ordinarily. Resources BOOKS Balistreri. A physician.. surgeon.
and magnesium. 1266-1267. (312) 738-1336.” In Nelson Textbook of Pediatrics. Saunders. American Academy of Family Physicians. Philadelphia.” In Cecil Textbook of Medicine. Jr. which help prevent rapid changes in body fluid pH over short periods of time. South Bank University. 11400 Tomahawk Creek Parkway. info@ascp. Michael. 16th ed. Northfield.Net.” Lancet 357. and electrolyte concentration are maintained within a narrow range.html>. <http://www. “Imaging of soft tissue infections.org. 2000. MD..org/index.fascrs. Claude.html>. Behrman et al. “Submasseteric abscess. F. is frequently defined as a substance that combines with a proton to form a chemical bond. The chemical composition of food in the diet can have an effect on the body’s acid-base production. “Acute and chronic paronychia. Cells and body fluids contain acid-base buffers.merck. Base solutions have a bitter taste and a slippery feel. Sydney M. Schwartz. <http://www.Principles of Surgery.edu/remedies/abcess. Behrman et al. “Bacterial meningitis. <http://www.html>.43. hydrochloric acid is secreted by the stomach to assist with digestion.uk/ROADS/ subject-listing/abcess. edited by Richard E. diet. Peter G. Ho SG. American Society of Clinical Pathologists.” Radiology Clinics of North America 39. 14th ed. <http://www. University of Kansas Medical Center. Saunders. Saunders. and environmental factors. Stern. no.. Lee and Bennett. W. “Clinical picture: paravertebral abscess.” Journal of Laryngology and Otology 115. 7th ed. Fleming Fallon.tuberculosis. “Lung abscess. Acid solutions have a sour taste and produce a burning sensation with skin contact. 2000. no. “Psoas abscess: a primer for the internist. “Pulmonary abscess.brisbio. Kloutsos GM. <http://www. 439-442.” In Harrison’s Principles of Internal Medicine. College of American Pathologists. IL 60093. also known as an alkali. no. DrPH Achromatopsia see Color blindness Acid-base balance Definition Acid-base balance can be defined as homeostasis of the body fluids at a normal arterial blood pH ranging between 7. <http://www. 16th ed. 16th ed. 2001.htm>. In contrast. PERIODICALS University of California-San Diego: <http://burn.” Southern Medical Journal 94. Struk DW.kumc.cap. Korres S. The partial pressure of carbon dioxide gas (PCO2) in the pulmonary system can be measured with a blood sample and American Society of Colon and Rectal Surgeons. Scheld. Munk PL. a base. Herendeen.” In Nelson Textbook of Pediatrics. 1 (2001): 2-5. Shires. 2100 West Harrison Street. et al. Protopapas D. L.. Tuberculosis. 2 (2001): 277-303. (913) 9066000. Fauci. 1 (2001): 68-70. 9251 (2001): 168-70. chloride.ac. potassium. Robert C. Components that affect acid-base balance include protein.. firstname.lastname@example.org/~dirt/ museum/p6-216. Philadelphia. sodium.. Neil E and Szilagy. Merck Manual. The kidneys and pulmonary system then work to maintain acid-base balance through excretion in the urine or respiration.ucsd. 6 (2001): 1113-6. 2000. University of Bristol.html>. Balatsouras DG. KS 66211-2672. and other suppurative intracranial infections. phosphorus.Acid-base balance Finegold. the body’s acidbase balance.sbu. fluid volume. Tom and Spencer. OTHER Function Many naturally occurring acids are necessary for life. Chua. For example.htm>. New York: McGraw-Hill. the rate at which nutrients are absorbed in the intestine will alter acid-base balance. 8 G A L E E N C Y C L O P E D I A O F N U R S I N G A N D A L L I E D H E A LT H . Lee MJ. Courtney M. no. 1309-1310. 1998. Rockwell PG. Seymour. calcium. edited by Anthony S. <http://www. Economou C. ORGANIZATIONS Description An acid is a substance that acts as a proton donor. edited by Goldman. 325 Waukegan Road. New York.37 and 7.ascp. no. Taiwo B.net/imagesof/ rulcavity. Leawood.aafp. J. Despite variations in metabolism. 21st ed. Philadelphia. Worsley DF.edu/instruction/medicine/pathology/ed /ch_28/c28_s24.asp>.” American Family Physician 63..com/pubs/mmanual/ section3/chapter35/35d.org. McGraw Hill.html>. Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. <http://www. until the kidneys pulmonary systems can make appropriate adjustments. 2419-2434. A base is any chemical compound that produces hydroxide ions when dissolved in water. Townsend. edited by Richard E.org/brochures/anal-abscess..B. Philadelphia: W. 1998. <http://www. Frank C. Saunders.ac. brain abscess. In addition.org/>. “Peritonsillar abscess.org/>. (800) 323-4040. Chicago IL 60612.