Etiology, Features, and Management of Abscess

Introduction

An abscess is a localized collection of pus due to infection or tissue necrosis. It can occur in various organs and tissues, causing significant morbidity if left untreated.

Etiology of Abscess

Abscess formation is primarily caused by bacterial invasion, commonly Staphylococcus aureus and Streptococcus species. Other factors include foreign body penetration, trauma, or obstruction of normal drainage pathways.

Gross and Microscopic Features

• Gross Features: Typically, an abscess appears as a swollen, red, and tender area with fluctuance indicating pus accumulation.
• Microscopic Features: Histopathological examination reveals central liquefactive necrosis surrounded by neutrophilic infiltration and fibrin deposition.

Complications of Abscess

• Systemic spread leading to sepsis
• Rupture causing fistula formation
• Chronic abscess leading to fibrosis
• Adjacent tissue damage

Treatment Modalities

Management involves drainage, antibiotic therapy, and supportive care:

• Incision and Drainage: The primary treatment for most abscesses.
• Antibiotics: Targeted antimicrobial therapy based on culture results.
• Supportive Care: Pain management and wound care.

Conclusion

Early identification and proper management of abscesses are crucial to prevent complications. Surgical drainage combined with appropriate antimicrobial therapy remains the cornerstone of treatment.