User:Mr. Ibrahem/Abscess
| Abscess | |
|---|---|
| Other names | Latin: Abscessus |
 | |
| Five-day-old infected epidermal inclusion cyst. The black spot is a keratin plug which connects with the underlying cyst. | |
| Specialty | General surgery, infectious disease, dermatology |
| Symptoms | Redness, pain, swelling[1] |
| Usual onset | Rapid |
| Causes | Bacterial infection (often MRSA)[1] |
| Risk factors | Intravenous drug use[2] |
| Diagnostic method | Ultrasound, CT scan[1][3] |
| Differential diagnosis | Cellulitis, sebaceous cyst, necrotising fasciitis[3] |
| Treatment | Incision and drainage[4] |
| Frequency | ~1% per year (United States)[5] |
An abscess is a collection of pus that has built up within the tissue of the body.[1] Signs and symptoms of abscesses include redness, pain, warmth, and swelling.[1] The swelling may feel fluid-filled when pressed.[1] The area of redness often extends beyond the swelling.[6] Carbuncles and boils are types of abscess that often involve hair follicles, with carbuncles being larger.[7]
They are usually caused by a bacterial infection.[8] Often many different types of bacteria are involved in a single infection.[6] In the United States and many other areas of the world the most common bacteria present is methicillin-resistant Staphylococcus aureus.[1] Rarely, parasites can cause abscesses; this is more common in the developing world.[3] Diagnosis is usually made based on what it looks like and is confirmed by cutting it open.[1] Ultrasound imaging may be useful in cases in which the diagnosis is not clear.[1] In abscesses around the anus, computer tomography (CT) may be important to look for deeper infection.[3]
Standard treatment for most skin or soft tissue abscesses is cutting it open and drainage.[4] There appears to be some benefit from also using antibiotics; though such use is associated with side effects.[9][10] A small amount of evidence supports not packing the cavity that remains with gauze after drainage.[1] Closing this cavity right after draining it rather than leaving it open may speed healing without increasing the risk of the abscess returning.[11] Sucking out the pus with a needle is often not sufficient.[1]
Skin abscesses are common and have become more common in recent years.[1] Risk factors include intravenous drug use, with rates reported as high as 65% among users.[2] In 2005 in the United States, 3.2 million people went to the emergency department for an abscess.[5] In Australia, around 13,000 people were hospitalized in 2008 with the condition.[12]
References[edit]
- ^ a b c d e f g h i j k l Singer, Adam J.; Talan, David A. (Mar 13, 2014). "Management of skin abscesses in the era of methicillin-resistant Staphylococcus aureus" (PDF). The New England Journal of Medicine. 370 (11): 1039–47. doi:10.1056/NEJMra1212788. PMID 24620867. Archived from the original (PDF) on 2014-10-30. Retrieved 2014-09-24.
- ^ a b Langrod, Pedro Ruiz, Eric C. Strain, John G. (2007). The substance abuse handbook. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. p. 373. ISBN 9780781760454. Archived from the original on 2017-09-06.
{{cite book}}: CS1 maint: multiple names: authors list (link) - ^ a b c d Marx, John A. Marx (2014). "Skin and Soft Tissue Infections". Rosen's emergency medicine : concepts and clinical practice (8th ed.). Philadelphia, PA: Elsevier/Saunders. pp. Chapter 137. ISBN 1455706051.
- ^ a b American College of Emergency Physicians, "Five Things Physicians and Patients Should Question", Choosing Wisely: an initiative of the ABIM Foundation, American College of Emergency Physicians, archived from the original on March 7, 2014, retrieved January 24, 2014
- ^ a b Taira, BR; Singer, AJ; Thode HC, Jr; Lee, CC (Mar 2009). "National epidemiology of cutaneous abscesses: 1996 to 2005". The American Journal of Emergency Medicine. 27 (3): 289–92. doi:10.1016/j.ajem.2008.02.027. PMID 19328372.
- ^ a b Elston, Dirk M. (2009). Infectious Diseases of the Skin. London: Manson Pub. p. 12. ISBN 9781840765144. Archived from the original on 2017-09-06.
- ^ Marx, John A. Marx (2014). "Dermatologic Presentations". Rosen's emergency medicine : concepts and clinical practice (8th ed.). Philadelphia, PA: Elsevier/Saunders. pp. Chapter 120. ISBN 1455706051.
- ^ Cox, Carol Turkington, Jeffrey S. Dover; medical illustrations, Birck (2007). The encyclopedia of skin and skin disorders (3rd ed.). New York, NY: Facts on File. p. 1. ISBN 9780816075096. Archived from the original on 2017-09-06.
{{cite book}}: CS1 maint: multiple names: authors list (link) - ^ 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, RAC (6 February 2018). "Antibiotics after incision and drainage for uncomplicated skin abscesses: a clinical practice guideline". BMJ (Clinical research ed.). 360: k243. doi:10.1136/bmj.k243. PMC 5799894. PMID 29437651.
- ^ Ton, Joey (21 January 2019). "#227 There's Pus About, So Are Antibiotics In or Out? Adding antibiotics for abscess management". CFPCLearn. Archived from the original on 25 March 2023. Retrieved 16 June 2023.
- ^ Singer, Adam J.; Thode, Henry C., Jr; Chale, Stuart; Taira, Breena R.; Lee, Christopher (May 2011). "Primary closure of cutaneous abscesses: a systematic review" (PDF). The American Journal of Emergency Medicine. 29 (4): 361–66. doi:10.1016/j.ajem.2009.10.004. PMID 20825801. Archived from the original (PDF) on 2015-07-22.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ Vaska, VL; Nimmo, GR; Jones, M; Grimwood, K; Paterson, DL (Jan 2012). "Increases in Australian cutaneous abscess hospitalisations: 1999-2008". European Journal of Clinical Microbiology & Infectious Diseases. 31 (1): 93–96. doi:10.1007/s10096-011-1281-3. PMID 21553298.