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Abscess and Boil Types and Treatments

An abscess is a collection of pus in the body that can be caused by bacteria entering through a wound, neighboring structures, lymph vessels, or bloodstream. There are three main types: pyogenic, pyaemic, and cold. Pyogenic abscesses are most common and caused by bacteria, while pyaemic abscesses develop from infected emboli leading to multiple abscesses. Cold abscesses are always a sequel to tuberculosis and form from caseated lymph nodes. Treatment involves drainage of localized pus, taking cultures and antibiotics, and improving overall health.

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139 views16 pages

Abscess and Boil Types and Treatments

An abscess is a collection of pus in the body that can be caused by bacteria entering through a wound, neighboring structures, lymph vessels, or bloodstream. There are three main types: pyogenic, pyaemic, and cold. Pyogenic abscesses are most common and caused by bacteria, while pyaemic abscesses develop from infected emboli leading to multiple abscesses. Cold abscesses are always a sequel to tuberculosis and form from caseated lymph nodes. Treatment involves drainage of localized pus, taking cultures and antibiotics, and improving overall health.

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Plày Game
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Abscess and boil

Dr. Archana
What is abscess
• Collection of pus in the body.
Types
I. Pyogenic
II. Pyaemic
III. cold abscess
Pyogenic abscess
• Commonest variety
• Causative organism- bacteria
• Mode of entry----
direct from penetrating wound
Local extension from neighboring structures
Lymph
blood
Clinical features
• All signs of acute inflammation
Rubor
Tumor
Calor
Dolor
Impairment of function
Others signs are fever, brawny induration, fluctuation positive.
Investigations
• Complete blood count
• Conventional radiology
• Isotope scanning
• USG
Treatment
• In initial stage- conservative treatment should be given like
rest, antibiotics etc.
• When pus is localized- it should be drained.
• Drainage of pus –
A. By free or liberal incision
B. By Hilton’s method
• Pus should be sent for culture and sensitivity
• Suitable antibiotic should be started.
• Vitamin C for healing in all cases.
Cruciate
incision

Hilton’s
method
Pyaemic abscess
• Development of multiple abscess from infected emboli.
Terms related to pyaemia
• Bacteremia- bacteria circulating in blood.
• Eg in tooth extraction
• It is usually transient and get rapidly destroyed.
• Septicemia- bacteria in circulation as well as development of
clinical manifestations by the liberation of toxins in circulation.
• Features of septicemia are pyrexia, rigors, hypotension ,
petechial hemorrhages, intravascular coagulation defects.
• Toxemia- presence of toxins either chemical or bacterial , in
circulation.
Clinical features of pyaemic
abscess
• Generally multiple
• Commonly in sub- fascial plane
• Signs of acuteness are generally abscent
• Some systemic fetures are present- high grade fever,
hypotension, rigors, toxemia etc
• May occur in visceras and death may be caused.
Treatment
• Localizing the source of infection
• Proper antibiotics after C/S test
• Drainage of superficial abscess
Cold abscess
• Non- reacting in nature
• Always sequel to tuberculosis.
• Common sites are neck and axilla.
• Abscess is formed by the caseation of lymph node.
• Treatment- anti-tubercular drugs.
• Abscess should be drained obliquely through normal
surrounding skin through needle not from the most
prominent part of abscess.
Boil
• Acute staphylococcal infection of hair follicle with peri-
folliculitis.
• Sites – back and neck most commonly, furuncle of E.A.M, stye,
perianal folliculitis.
• c/f- initially painful swelling around hair follicle then
softening at center, appearance of pustule.
• Pustules bursts discharging greenish slough.
• A deep cavity develops after, that heals by granulation.
• Treatment- application of iodine helps in draining out the pus.
• If pus not drained, removal of affected hair should be done.
• Antibiotics in case of multiple boils.
Carbuncle
• Infective gangrene of SC tissue due to staphylococcal infection.
• Found in diabetic patients.
• Sites- common site is back , nape of neck, shoulder, cheeks.
• c/f- affected group- diabetic patients above 40 yr of age.
 starts with painful and stiff swelling which spreads rapidly.
Multiple vesicles appears with central softening.
Vesicles transforms in pustules, they burst leaving sieve like or
cribriform appearance of skin.
• T/T- improvement of general health
• Proper antibiotics
• If surface openings are not formed yet, paste of anhydrous Mg
sulphate and glycerine should be applied.
• In case of large carbuncle, pus should be drained through cruciate
incision.

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