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Abscess Health Article

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Table of Contents
Author Info: L. Fleming Fallon Jr., MD, DrPH, The Gale Group Inc., Gale, Detroit, Gale Encyclopedia of Nursing and Allied Health, 2002
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Diagnosis

The common findings of inflammation—heat, redness, swelling, and pain—easily identify superficial abscesses. Abscesses in other places may produce only generalized symptoms such as fever and discomfort. If an individual's symptoms and the results of a physical examination do not help, a physician may have to resort to a battery of tests to locate the site of an abscess. Usually something in the initial evaluation directs the search. Recent or chronic disease in an organ suggests it may be the site of an abscess. Dysfunction of an organ or system, for instance seizures or altered bowel function, may provide the clue. Pain and tenderness on physical examination are common findings. Sometimes a deep abscess will eat a small channel (sinus) to the surface and begin leaking pus. A sterile abscess may cause only a painful lump deep in the buttock where a shot was given.

Treatment

Since skin is very resistant to the spread of infection, it acts as a barrier, often keeping the toxic chemicals of an abscess from escaping the body on their own. Thus, the pus must be drained from the abscess by a physician. The surgeon determines when the abscess is ready for drainage and opens a path to the outside, allowing the pus to escape. Ordinarily, the body handles the remaining infection, sometimes with the help of antibiotics or other drugs. 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.

Alternative treatment

If an abscess is directly beneath the skin, it will be slowly working its way through the skin as it is more rapidly working its way elsewhere. Since chemicals work faster at higher temperatures, 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. This treatment is best reserved for smaller abscesses in less sensitive areas of the body such as limbs, trunk, and back of the neck. It is also useful for all superficial abscesses in their very early stages. It will "ripen" them.

Contrast hydrotherapy, alternating hot and cold compresses, can also help assist the body in resorption of the abscess. There are two homeopathic remedies that work to rebalance the body in relation to abscess formation, Silica and Hepar sulphuris. In cases of septic abscesses, bentonite clay packs (bentonite clay and a small amount of Hydrastis powder) can be used to draw an infection from the area.

Prognosis

Once an abscess is properly drained, the prognosis is excellent for the condition itself. The reason for the abscess (other diseases an individual has) will determine the overall outcome. If, on the other hand, an abscess ruptures into neighboring areas or permits the infectious agent to spill into the bloodstream, serious or fatal consequences are likely. Abscesses in and around the nasal sinuses, face, ears, and scalp may work their way into the brain. Abscesses within an abdominal organ such as the liver may rupture into the abdominal cavity. In either case, the result is life threatening. 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. Blood poisoning, known to physicians as septicemia, is also life threatening.

Of special note, abscesses in the hand are more serious than they might appear. Due to the intricate structure and the overriding importance of the hand, any hand infection must be treated promptly and competently.

Health care team roles

First aid providers may unknowingly initiate an abscess by using inappropriate or incorrect techniques. A physician, surgeon, physician's assistant, or nurse practitioner usually diagnoses the presence of an abscess. Radiologists and laboratory personnel may assist in the process of establishing a diagnosis. A physician, surgeon, physician's assistant, or nurse practitioner usually drains an abscess. Nurses provide supportive care, dress the wound, and educate patients about caring for the resulting wound. Occasionally, a physical therapist may be needed to recover lost function.

Prevention

Infections that are treated early with heat (if superficial) or antibiotics will often resolve without the formation of an abscess. It is even better to avoid infections altogether by taking prompt care of open injuries, particularly puncture wounds. Bites are the most dangerous of all, even more so because they often occur on the hand.


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