An abscess can form anywhere in the body, such as abscess on buttocks, groin, genital area, or organs. You can read everything about the causes and treatment of the painful accumulation of pus here.
An abscess is a cavity in the tissue filled with pus that can develop in many different parts of the body – abscess on buttocks, on the neck, on the gums or in organs such as the intestines. In order to treat the painful boils, the doctor usually opens them.
Definition: What is an abscess?
An abscess is a collection of pus in a newly formed cavity in the tissue. The triggers are usually bacteria that have penetrated the body, multiply there and are therefore fought by the immune system. This leads to an inflammatory reaction, as a result of which the abscess forms.
Whether on the nose, gums, throat or in internal organs such as the intestines, kidneys and liver – an abscess can basically develop anywhere in the body. Most often, however, the reddened, painful pus bumps appear under the skin and here especially in hairy regions such as the genital area, the armpits or, in men, on the face and neck.
If the abscess starts at the hair roots or, more precisely, at the so-called hair follicles, doctors call it a furuncle. An abscess also sometimes forms in places that are constantly exposed to friction – for example abscess on buttocks, in the woman’s intimate area, such as the labia or in the groin.
Typically, such superficial abscesses become noticeable by the fact that the affected area is warm to the touch, red and swollen and causes pain, especially when pressure is applied. In the case of abscess forms inside the body, fever and a general feeling of illness are often the first symptoms.
Types of abscesses
There are two main types of abscesses, although there are also others that will depend on their morphology and location, these are:
- Superficial or external abscess: these are formed under the skin, they are distinguished because they are a firm dough, that is about to break. It almost always hurts, but only on contact with the skin and inflamed. This mass is surrounded by a red color, sometimes with a yellowish-white appearance due to the presence of pus under it (looking like a point), and sometimes ooze fluids and may increase in size. When they are on the surface of the skin you see like a grain and if it’s under it it looks like a lump. The places where these appear frequently are the groin, near the coccyx, around the anus, in the vaginal area, in the gums or in the armpits mainly.
- Deep or internal abscess: these form in the internal organs or in the spaces between them and produce local pain and pain to the touch. appear when there health problems of the patient and may indicate that an organ is malfunctioning. For example, a liver infection can cause a liver abscess, or a lung infection can cause a lung abscess…etc.
Causes of abscesses
The main cause of abscesses is a bacteria infection such as Staphylococcus aureus and Streptococcus pyogenes, and other germs that enter the body and form the infection. To combat it, the immune system sends white blood cells and these, along with other waste substances, accumulate in the wound and form pus, that is, an abscess, which sometimes may not drain and begin to hurt.
It is also common for abscesses to be associated with difficulties with the immune system. In addition, they may become infected by exposure to a dirty environment and also by having poor circulation.
A boil is often the result of an external injury. In healthy people, the skin provides natural protection against pathogens. However, with deeper injuries, such as cuts or animal bites, bacteria can enter the body and cause an abscess. This risk is all the greater, the more contaminated the wound is.
Operations can also give pathogens access to the body. If there is a particularly high risk of infection, the surgeon often places a drain. Through them, all liquids can drain away immediately. This will prevent pus from building up. Patients at risk also receive an antibiotic to nip possible sources of infection in the bud.
Other tissue damage
Tissue that has already been damaged in other ways is particularly susceptible to infection. Examples include parts of the body that have poor blood flow due to diabetes or blood clots, or overgrowth as in cancer.
Weakened immune system
A weakened immune system also makes one susceptible to an abscess. Such an immune deficiency can be the result of an HIV infection, but also of any other infection. Chemotherapy for cancer also weakens the immune system.
Common places of abscesses
An abscess can form anywhere in the body. However, certain areas are particularly frequently affected by boils. Because some parts of the body can easily be attacked by bacteria or other pathogens. Other abscesses form because an artificial entry point for germs is created as a result of injuries or during an operation.
Abscess in the abdomen
Abdominal abscesses are often the result of injuries or operations on the intestines. Countless bacteria live in the intestines, which play an important role in digestion (intestinal flora). In a healthy intestine, the wall is impermeable to germs.
In diseases such as a ruptured appendix or injuries to the intestine, however, bacteria can penetrate the abdominal cavity. The peritoneum often becomes inflamed. However, abscesses can also form.
A collection of pus can develop especially under the diaphragm (subphrenic abscess), under the liver (subhepatic abscess), directly on the intestinal loops or between the rectum and bladder/vagina (Douglas abscess).
Abscess in the intestine
Diverticulitis is often behind an abscess in the intestine . In this disease, which is particularly common among older people, protuberances in the intestinal wall – so-called diverticula – form and become inflamed. Inflammatory bowel diseases such as Crohn’s disease can also lead to an abscess in the intestine.
Abscesses of the internal organs
Abscesses in organs such as the liver are also caused by pathogens that have been able to get deep into an organ via the bloodstream. Organs with a high blood supply, such as the liver and spleen, are therefore particularly often affected. For example, parasites such as the fox or dog tapeworm and amoebas tend to form abscesses in the liver, since this organ can be easily reached via the blood from the intestine.
Abscess on buttocks and anus
As a result of contact with the stool, which is heavily infested with bacteria, abscesses (perianal abscess or periproctic abscess) form particularly frequently on the anus. In addition, in addition to hair and sebum follicles, anal glands are also located directly in the anal canal and secrete secretions – good conditions for bacterial infections.
An abscess on buttocks can also be an early sign of an inflammatory bowel disease like Crohn’s disease. Men between the ages of 30 and 50 are particularly likely to develop an abscess on the anus.
Abscess on the face
A facial abscess often forms with severe acne. When bacteria invade the sebum and thickened sebum blocks the exit of the sebum, a pimple develops. If the bacteria get deeper into the tissue, different foci of inflammation can merge and form a boil in the facial skin.
Abscess of face and ear
Facial abscesses in men are often caused by shaving injuries and ingrown facial hairs. Other possible causes that can affect both sexes are acne and chronic skin diseases such as neurodermatitis. Abscesses on or in the nose and in the ear are mostly boils, behind which there is a bacterial infection in the area of the hair root.
Abscesses in the mouth
The oral cavity is also heavily colonized with bacteria. Damage to teeth and mucous membranes allows them to penetrate deep into tissues, causing inflammation. When the inflammatory response shuts off, a painful abscess forms in the mucosa. Depending on how deep the boil is in the tissue, one speaks of mucous or submucous abscesses.
Abscess on the tooth and on the tonsils
The oral cavity and pharynx are heavily colonized with bacteria and are therefore prone to abscesses. The often very painful abscesses on the tooth or in the gums can be caused, for example, by an inflamed tooth root or gum inflammation (periodontitis). Gum abscesses are best treated by a dentist or oral surgeon.
If the abscess occurs on the tonsils, the palate and the tissue surrounding them, doctors speak of a tonsillar abscess. The condition, which occurs most commonly in adolescents and young adults, causes fever, difficulty swallowing and a severe sore throat. The harbinger of an abscess of the tonsils is usually a cold with a sore throat.
Abscess on the coccyx
An abscess on the coccyx often occurs as part of a coccyx fistula (pilonidal sinus, pilonidal cyst): If a hair grows into the skin of the buttock fold, a channel forms to the skin surface (fistula). Bacteria can enter the tissue through this portal and cause inflammation with subsequent abscess formation. Overweight middle-aged men are particularly often affected.
Abscess at a hair root (boil)
An abscess in the area of a hair root is called a boil. These abscesses thus appear on hairy parts of the body, armpit, scalp and genital area. A painful, tight knot forms. If several hair follicles are affected, it is called a carbuncle.
Abscess of the breast
In women, an abscess can also develop in the breast. For example, when breastfeeding or nipple piercing, bacteria get into the glandular ducts. Then the mammary gland can become inflamed. Through encapsulation, this develops into a pus-filled lump in the chest.
Abscess in the intimate area and groin
Due to the trend towards shaving the intimate area, abscesses on the labia and vagina, on the scrotum and in the groin region are becoming more common. Shaving causes small injuries that are an entry point for bacteria. Tight, abrasive clothing and poor hygiene also promote the development of abscesses in this area. The same applies to acne inversa, a form of the skin disease acne, which can be very stressful for those affected.
Abscess under the armpit
Because of the increased perspiration and poor ventilation, the armpit offers good growth conditions for bacteria. Similar to the intimate area, the often very painful abscesses under the armpits are caused by shaving and abrasive clothing.
Abscesses from injections
If a syringe is not sufficiently disinfected, bacteria can penetrate deeper tissue layers with the needle (syringe abscess). For example, a so-called gluteal abscess is caused by a needle prick in the buttocks muscle (gluteus).
Symptoms of an abscess
The symptoms of an abscess can be very diverse. Since an abscess is associated with inflammation, general signs of inflammation are found:
- Functional limitation of the affected area.
The type of pus, its smell, and color vary depending on which bacteria caused the infection.
Pain and fever are often the only symptoms of an abscess in the abdomen. The inflammation can also bring bowel function to a standstill (constipation or even bowel obstruction). If the digestion no longer works, the patient vomits and there is no bowel movement. Since the large intestine in particular is colonized by bacteria, further sources of infection can form there in the abdomen.
Abscess: investigations and diagnosis
If the doctor suspects an abscess, he first looks for the typical signs of inflammation. The dysfunction of the affected body part or organ may also be noticed. For example, if there is inflammation in the brain, nerve failures may occur. This can manifest itself as tingling, pain or paralysis.
Liver function is impaired in liver abscesses. This is reflected in deteriorated liver values.
Other blood values can also indicate an inflammatory process. Elevated levels of white blood cells and C-reactive protein (CRP for short ) usually indicate inflammation in the body.
With an ultrasound machine or computer tomograph (CT), the doctor can also detect a boil inside the body. It appears as a rounded structure in otherwise inconspicuous tissue. The wall of the pus bump appears lighter on ultrasound than the pus inside.
Normally, the immune system gets rid of dead body cells and pathogens. However, a boil is difficult for the immune cells to reach. So that it can heal, it should be opened and emptied from the outside as quickly as possible.
During an abscess operation, the doctor opens an abscess as gently as possible and ideally removes the entire contents. Depending on the extent and severity of the abscess, the procedure is performed by the general practitioner or by a surgeon.
Sometimes the pus cannot be completely removed during abscess surgery. Then a drain is inserted. It serves as a drain for newly formed pus.
For some abscesses, puncturing them is sufficient. This applies, for example, to very superficial abscesses of the skin. In the case of larger or deeper abscesses, on the other hand, the doctor must ensure that the pus cavity is completely drained and that the abscess cavity does not close again so that the abscess can heal.
Abscess treatment with antibiotics
Antibiotics help fight the bacterial infection. The choice of the remedy depends, among other things, on the pathogen. The location of the abscess and the color and smell of the pus provide an indication of the type of germ. Based on these factors, the doctor can estimate the possible pathogens relatively well.
A bacterium can be clearly identified by analyzing sample material from the abscess that the doctor obtains during the abscess operation. This analysis takes a few days.
Commonly used antibiotics in abscess treatment are clindamycin, penicillins, cephalosporins, doxycycline or vancomycin. In seriously ill patients, therapy with carbapenems or linezolid can be extended.
In rare cases, abscesses are not caused by bacteria but by parasites such as amoebas. Other drugs are then used to treat the abscess, such as metronidazole or paromomycin.
Never open abscesses yourself!
You should never open an abscess yourself. The danger of tissue being injured and the infection spreading further is too great.
Waiting is the wrong strategy for an abscess. See a doctor as soon as possible so that he can open the abscess. The longer you wait, the more severe the infection will be.
Abscess: course of the disease and prognosis
It is unlikely that an abscess will heal on its own. However, if the boil is recognized and emptied early, it usually heals without consequences.
It becomes problematic when the abscess affects organs that are difficult to regenerate, such as the brain. Destroyed nerve cells are not easily replaced. Since certain regions of the brain specifically control individual areas of the body, depending on the location of the boil, failures, paralysis, memory gaps or paraesthesia can occur.
If an abscess is left untreated, the infection can spread to the entire body – life-threatening sepsis (“blood poisoning”) develops.
The prognosis for an abscess also depends on the overall condition of the patient. The weaker the patient and his immune system, the more difficult it is to fight the boil.
In people with a powerful immune system, on the other hand, bacteria have a hard time. A good body defense is the best protection against abscesses.