Abscess

Abscess (Latin abscessus – abscess ) is a local accumulation of pus, limited by a capsule and arising due to purulent inflammation of tissues. It is characterized by the presence of a pyogenic membrane, which isolates the focus from healthy tissues and prevents the spread of infection.

An abscess is a form of localized purulent inflammation in which the body creates a barrier around the focus of infection. This protective capsule (pyogenic membrane) consists of granulation and fibrous tissue, it not only limits the process but also produces purulent exudate.

Etiology and pathophysiology

The main cause is the penetration of pathogenic bacteria, most often Staphylococcus aureus, into the tissues. In response to invasion, an inflammatory reaction develops with a massive influx of neutrophils. Enzymes secreted by them and bacteria cause lysis (melting) of tissues, forming a cavity filled with pus.

Clinical significance

Clinically, an abscess is manifested by local signs of inflammation (pain, swelling, hyperemia, local temperature rise) and, when mature, by the symptom of fluctuation (sensation of wave-like movement on palpation), which is a key diagnostic criterion. Ultrasound or CT scanning is used to diagnose deep abscesses.

The main principle of treatment is surgical: opening, drainage and sanitation of the purulent cavity (“Ubi pus, ibi evacua”). Antibiotic therapy is of an auxiliary nature. Timely treatment provides a favorable prognosis; otherwise, there is a high risk of pus breakthrough, phlegmon or sepsis.

Differential diagnostic aspects

Abscess should be distinguished from phlegmona – spilt purulent inflammation without clear boundaries and capsule. It is also differentiated from empyema, which is an accumulation of pus in a pre-existing anatomical cavity (e.g., pleural cavity).