We all know small abscesses: A larger pimple is formed and pus is formed. Once the pimple is ripe, you can express it and remove the pus. Unfortunately, this cosmetically unsightly but relatively harmless "abscess" type is not the only one. An abscess is a collection of pus in the tissue. Under the microscope, it can be seen that the purulent epithelium delimits a connective tissue membrane, so that the pus can not be distributed indiscriminately in the tissue. The pus is composed of dead cells and bacteria. In the skin, the causative agents are mostly Staphylococcus aureus bacteria. When a pus builds up in an existing body cavity, such as an articular capsule or gallbladder, it is not called an abscess, but an empyema.
When does an abscess arise?
Bacteria are usually responsible for the development of an abscess. Since some types of bacteria belong to the normal skin flora, an abscess arises when the bacteria penetrate deeper into the skin and no outflow is ensured - for example, if a pore is clogged by sebum or dirt or if a wound is contaminated and tightly closed has been.
An abscess without bacteria (a so-called cold or sterile abscess) is much rarer and sometimes occurs without obvious cause after severe, prolonged surgery or tuberculosis.
Where can an abscess occur?
- Often an abscess develops in the hair follicles and sebaceous or sweat glands, ie near the skin surface. A hair follicle inflammation is called folliculitis, it can be recognized by the hair that seems to sprout in the middle of the pimple. As soon as pus is added and the inflammatory process also spreads to the environment, it is called a boil - if several hair follicles and their environment are affected - by a carbuncle.
- Also the anal glands are predestined for abscesses - the Perianalabszesse ("peri" is Latin and means "in the environment") are painful and tedious.
- But there are also abscesses in inflammation, which take place inside the body. In chronic inflammatory bowel diseases such as Crohn's disease, gallbladder inflammation and tuberculosis often occur abscesses.
- Another category is abscesses that can result from injury or surgery. If germs get into the wound and it is closed without drainage, the pus can not drain and an abscess arises. Therefore, in the case of contaminated deeper wounds, usually no so-called primary wound closure is applied, but the wound is treated openly - wound secretions can drain away and healing will proceed without abscess.
- Abscesses occur more rarely in bones: the so-called Brodie abscess refers to an abscess formation in the bone. These abscesses are medically often very bad to treat and usually have to be surgically removed.
Also, in medicine, two empyema are not properly called abscesses: the perityphlitic abscess is a pus buildup next to the cecum, and the Douglas abscess is a pus buildup in the pelvis between vagina and rectum.
Symptoms: How does an abscess express itself?
With a thick pimple everyone knows the signs: The skin tightens and hurts when touched, the environment is red. As soon as an earplug is visible and the pimple can be expressed, the feeling of tension disappears.
For larger abscesses or abscess forms inside the body fever may be the only symptom since the abscess is not visible. But even severe disease courses with general malady, fatigue or even shock symptoms such as circulatory failure are possible.