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Primary Care Mar 2022An abscess is a localized collection of purulent material surrounded by inflammation and granulation in response to an infectious source. Most simple abscesses can be... (Review)
Review
An abscess is a localized collection of purulent material surrounded by inflammation and granulation in response to an infectious source. Most simple abscesses can be diagnosed upon clinical examination and safely be managed in the ambulatory office with incision and drainage. Wound culture and antibiotics do not improve healing, but packing wounds larger than 5 cm may reduce recurrence and complications.
Topics: Abscess; Anti-Bacterial Agents; Anus Diseases; Drainage; Humans
PubMed: 35125157
DOI: 10.1016/j.pop.2021.10.002 -
The Surgical Clinics of North America Dec 2022Peripheral nonlactational abscesses behave like other soft tissue abscesses and resolve with drainage and antibiotics. Subareolar abscesses tend to recur or develop... (Review)
Review
Peripheral nonlactational abscesses behave like other soft tissue abscesses and resolve with drainage and antibiotics. Subareolar abscesses tend to recur or develop fistulae between obstructed ducts and the border of the areola and are usually seen in women in their thirties who have a history of smoking or a congenitally cleft nipple. The underlying cause of subareolar abscesses and fistulae is the obstruction of terminal ducts due to keratin plugging caused by squamous metaplasia of the ducts. Successful resolution of the problem requires excision of the terminal ducts in and just below the nipple along with the correction of nipple deformity, if present.
Topics: Female; Humans; Abscess; Mastitis; Breast Diseases; Nipples; Fistula
PubMed: 36335928
DOI: 10.1016/j.suc.2022.06.007 -
Journal of the Medical Association of... Mar 2002Salmonella neck abscesses have rarely been reported in the world literature. Two patients with underlying diabetes mellitus developed deep neck abscesses which did not... (Review)
Review
Salmonella neck abscesses have rarely been reported in the world literature. Two patients with underlying diabetes mellitus developed deep neck abscesses which did not respond to empirical antimicrobials. Diagnosis of salmonella infection was made by culture of the discharge. Successful treatment was obtained by prescribing appropriate antibiotics and proper drainage.
Topics: Abscess; Anti-Bacterial Agents; Diabetes Complications; Drug Therapy, Combination; Humans; Male; Middle Aged; Neck; Salmonella Infections
PubMed: 12117032
DOI: No ID Found -
Annals of Emergency Medicine May 1995To review clinical features of perirectal abscesses and to determine appropriate management.
STUDY OBJECTIVE
To review clinical features of perirectal abscesses and to determine appropriate management.
DESIGN
Retrospective analysis of medical records.
SETTING
Urban teaching hospital.
PARTICIPANTS
Ninety-two patients with the discharge diagnosis of perirectal abscess over a 4-year period.
RESULTS
Perirectal pain was the most common presenting symptom, being present in 98.9% of cases. External perianal and digital rectal examination identified an abscess in 94.6% of patients. A variety of aerobic and anaerobic bacteria from skin, bowel, and, rarely, vagina were identified as causative agents, with mixed infections common. The major complications of perirectal abscesses included formation of extensive abscesses and urine retention. Abscess resolution occurred in all patients after adequate drainage. Antibiotics appeared to be useful only as adjunct therapy.
CONCLUSION
Effective management of perirectal abscess involves early, adequate drainage, with antibiotics in an adjunct role.
Topics: Abscess; Adolescent; Adult; Aged; Anti-Bacterial Agents; Causality; Combined Modality Therapy; Diagnosis, Differential; Drainage; Female; Humans; Male; Medical Records; Middle Aged; Rectal Diseases; Retrospective Studies
PubMed: 7741334
DOI: 10.1016/s0196-0644(95)70170-2 -
Seminars in Dialysis May 2021Peritoneal dialysis (PD)-related peritonitis is sometimes complicated with other infections; however, few cases of splenic abscess have been reported. We present the... (Review)
Review
Peritoneal dialysis (PD)-related peritonitis is sometimes complicated with other infections; however, few cases of splenic abscess have been reported. We present the case of a 64-year-old PD patient with complicated splenic abscesses diagnosed following relapsing sterile peritonitis. After PD induction, he presented with turbid peritoneal fluid and was diagnosed with PD-related peritonitis. A plain abdominal computed tomography (CT) did not reveal any intra-abdominal focus of infection. After empiric intravenous antibiotics, the peritoneal dialysate was initially cleared, with a decrease in dialysate white blood cells (WBC) to 20/µL. However, WBC and C-reactive protein (CRP) levels remained elevated. A contrast-enhanced abdominal CT showed two areas of low-density fluid with no enhancement in a mildly enlarged spleen, making it difficult to distinguish abscesses from cysts. Due to relapsing sterile peritonitis, we performed an abdominal ultrasonography, and suspected splenic abscesses due to rapid increase in size. Repeated imaging tests were useful in establishing a diagnosis of splenic abscesses. Considering the persistent elevation of WBC and CRP levels, imaging findings, and episodes of relapsing peritonitis, we comprehensively formed the diagnosis, and performed a splenectomy as a rescue therapy. We should consider the possibility of other infectious foci with persistent inflammation after resolving PD-related peritonitis.
Topics: Abscess; Humans; Male; Middle Aged; Peritoneal Dialysis; Peritonitis; Renal Dialysis; Splenic Diseases
PubMed: 33609413
DOI: 10.1111/sdi.12953 -
International Journal of Colorectal... Jun 2012The incidence of anal abscess is relatively high, and the condition is most common in young men. (Review)
Review
BACKGROUND
The incidence of anal abscess is relatively high, and the condition is most common in young men.
METHODS
A systematic review of the literature was undertaken.
RESULTS
This abscess usually originates in the proctodeal glands of the intersphincteric space. A distinction is made between subanodermal, intersphincteric, ischioanal, and supralevator abscesses. The patient history and clinical examination are diagnostically sufficient to establish the indication for surgery. Further examinations (endosonography, MRI) should be considered in recurrent abscesses or supralevator abscesses. The timing of the surgical intervention is primarily determined by the patient's symptoms, and acute abscess is generally an indication for emergency treatment. Anal abscesses are treated surgically. The type of access (transrectal or perianal) depends on the abscess location. The goal of surgery is thorough drainage of the focus of infection while preserving the sphincter muscles. The wound should be rinsed regularly (using tap water). The use of local antiseptics is associated with a risk of cytotoxicity. Antibiotic treatment is only necessary in exceptional cases. Intraoperative fistula exploration should be conducted with extreme care if at all; no requirement to detect fistula should be imposed. The risk of abscess recurrence or secondary fistula formation is low overall, but they can result from insufficient drainage. Primary fistulotomy should only be performed in case of superficial fistulas and by experienced surgeons. In case of unclear findings or high fistulas, repair should take place in a second procedure.
CONCLUSION
In this clinical S3 guideline, instructions for diagnosis and treatment of anal abscess are described for the first time in Germany.
Topics: Abscess; Anus Diseases; Germany; Humans; Male; Postoperative Complications; Rectal Fistula
PubMed: 22362468
DOI: 10.1007/s00384-012-1430-x -
Otolaryngology--head and Neck Surgery :... 1981Primary thyroid abscess arising from acute suppurative thyroiditis is an unusual type of head and neck infection. Only 39 cases of thyroid abscess have been reported in...
Primary thyroid abscess arising from acute suppurative thyroiditis is an unusual type of head and neck infection. Only 39 cases of thyroid abscess have been reported in the medical literature since 1950. Sixteen of these cases (41%) were in children. This presentation reports in detail two additional adult patients with thyroid abscesses. In addition, the incidence, etiology, signs and symptoms, complications, aids to diagnosis, and management are reviewed. Systemic antimicrobials combined with prompt surgical intervention will prevent the serious complications possible with this disease.
Topics: Abscess; Adult; Anti-Bacterial Agents; Drainage; Female; Humans; Male; Thyroid Diseases; Thyroiditis
PubMed: 6787517
DOI: 10.1177/019459988108900216 -
Clinical Infectious Diseases : An... Jan 1993Tongue abscesses are extremely rare infections despite the relatively frequent exposure of the tongue to bite trauma during mastication and seizures. We describe a case... (Review)
Review
Tongue abscesses are extremely rare infections despite the relatively frequent exposure of the tongue to bite trauma during mastication and seizures. We describe a case of tongue abscess in a 40-year-old man and discuss the pathophysiology, diagnosis, and treatment of this entity.
Topics: Abscess; Adult; Humans; Male; Tongue Diseases
PubMed: 8448289
DOI: 10.1093/clinids/16.1.133 -
Journal of Spinal Disorders Apr 1999Despite advances in neuroimaging and neurosurgical treatment, spinal epidural abscess (SEA) remains a challenging problem for the practicing physician. Early diagnosis... (Review)
Review
Despite advances in neuroimaging and neurosurgical treatment, spinal epidural abscess (SEA) remains a challenging problem for the practicing physician. Early diagnosis is often elusive, and treatment is delayed. The optimal management of SEA is not clearly defined, and morbidity and mortality remain significant. In this review article, we discuss contemporary issues surrounding SEA. In addition, we shed light on the epidemiology of this potentially devastating disease and outline current diagnostic and therapeutic guidelines. We find the frequency of diagnosis of SEA is increasing. To prevent serious morbidity and mortality, early diagnosis and prompt treatment are essential. Patients who are at high risk for developing such abscesses should have an immediate magnetic resonance scan with contrast enhancement. Surgical drainage and prolonged antibiotic use are the cornerstones of treatment, although selected patients may be treated nonsurgically with very vigilant medical follow-up.
Topics: Abscess; Epidural Space; Humans; Incidence; Spinal Diseases
PubMed: 10229519
DOI: No ID Found -
Current Opinion in Otolaryngology &... Dec 2011Orbital cellulitis and abscess formation in pediatric patients usually arises as a complication of acute sinusitis and if untreated may cause visual loss or... (Review)
Review
PURPOSE OF REVIEW
Orbital cellulitis and abscess formation in pediatric patients usually arises as a complication of acute sinusitis and if untreated may cause visual loss or life-threatening intracranial complications. This review describes the current evaluation and management of this condition.
RECENT FINDINGS
Computed tomography with contrast remains the optimal imaging study for orbital inflammation. Orbital inflammation is still classified by Chandler's original description as preseptal or postseptal and nearly all cases of preseptal cellulitis are managed with oral antibiotics. Most cases of postseptal cellulitis are managed with intravenous antibiotics, although surgical therapy is required for some abscesses, particularly large ones. Patients under 9 years respond to medical management more frequently than older patients but recent studies confirm that even children over 9 with small or moderate-sized abscesses and normal vision deserve a medical trial before surgical intervention. Medial subperiosteal abscesses that fail medical therapy are usually drained endoscopically, whereas lateral or intraconal abscesses require an open procedure.
SUMMARY
Periorbital complications of sinusitis in pediatric patients often respond to medical therapy but may require surgical intervention to prevent serious complications. Continuous in-house evaluation of patients is necessary to observe for progression of symptoms and to optimize outcome.
Topics: Abscess; Anti-Bacterial Agents; Child; Combined Modality Therapy; Contrast Media; Humans; Orbital Cellulitis; Sinusitis; Tomography, X-Ray Computed
PubMed: 22001661
DOI: 10.1097/MOO.0b013e32834cd54a