Abscesses are caused by the collection of pus in body tissue due to infection. White blood cells migrate to the infected area and form a cavity, which is separated from healthy tissue by an abscess wall. Treatment involves antibiotics and surgical drainage.
An abscess results from the collection of pus in body tissue that has formed a cavity due to an infection. The pathophysiology of an abscess is a series of immune responses that begin with the migration of white blood cells to the infection and the separation of a fluid-filled cavity from surrounding healthy tissue. Some abscesses result from blocked ducts in the glands, while others are caused by infected lesions, often with the Staphylococcus aureus bacterium.
The pathophysiology of abscesses begins in damaged tissue when the immune system prevents the spread of foreign substances and potentially harmful microorganisms. During infection, large numbers of white blood cells, particularly neutrophils, migrate to compromised tissue. They do this by following cytokine signals that warn them of cell death and damage. Pus, the mixture of dead cells and chemical mediators of the immune response, fills the area around the site, which is separated from healthy tissue by the formation of an abscess wall. The pathophysiology of an abscess can cause life-threatening consequences if cavities form in organs such as the liver.
In an epidural abscess, pus builds up on top of the outer dural membrane covering the brain and spine, swelling against the skull or spine. These rare infections are more likely along the spinal cord than in the skull. The pathophysiology of an abscess in the skull or spine is often complicated by damage done to neural tissue by fluid pressure as swelling increases. A tooth abscess results from a local infection in the jaw around the nerve that makes up the tooth root. It causes severe pain and, if broken, can send bacteria into the bloodstream, risking a systemic infection.
Blockage of the glands can seal off an area of tissue which allows for an abscess to form if infected. Several microorganisms can trigger the pathophysiology of Bartholin’s abscess, a painful swelling in a Bartholin’s gland in the vagina. If the glands responsible for healthy vaginal secretions develop a blocked duct, fluid can build up over time. The bacteria can then infect the swollen gland to the point where it becomes very sensitive. Similarly, skin abscesses or boils can result from a blocked sweat gland that has become infected.
Differences in the pathophysiology of an abscess do not greatly affect the underlying treatment. Because Staphylococcus aureus commonly causes abscesses, traditional antibiotic treatments have accompanied surgery as the two mainstays of medical care. But as this organism evolved into methicillin-resistant Staphylococcus aureas (MRSA), the range of antibiotics used to reduce complications has been increased. Many abscesses, especially larger ones, require surgical treatment to drain existing pus from the wound for proper healing. This is often true regardless of the specific cause of the infection.
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