An abscess is a localized collection of pus resulting from the disintegration of tissue in the dermis and deeper skin tissues.
About
- An abscess is a localized collection of pus
Aetiology
- Diabetes: increased risk, Immunocompromised: increased risk
- IV DU : groin abscess, get USS to look for false aneurysm
Clinical/Types
- Skin abscess, Pilonidal, Psoas, Perianal, Groin - IVDU
- Signs of Sepsis Fever, Tachycardia, Tachypnea, Leukocytosis
Investigations
- FBC, U&E, LFT, CRP Glucose HbA1c
- Blood cultures. HIV tests
- Aspirate and drain and culture
- Ultrasound: is recommended to confirm the fluid collection, determine its size and nature
- CT scan can also help identify an abscess
Mirobiology
-
Skin and soft tissue infections most frequently are caused by Staphylococcus aureus or Streptococcus pyogenes, together accounting for more than 90% of cases.
- Community-acquired methicillin-resistant S. aureus (CA-MRSA) varies by location, race, and age, and is the most common offending agent in many communities, even in patients with no apparent risk factors.
- Enteric bacteria and anaerobic and Gram-negative organisms are not uncommon depending on the anatomic location
Management
- Analgesia, Incise and drain as possible as soon as possible. Antibiotics alone not effective usually. Manage diabetes. Manage anticoagulation . Treat any systemic sepsis. take advce if immunocompromised.
- Breast abscess : refer breast team
- IV DU : groin abscess needs USS can look for a false aneurysm
References