Cold abscesses form slowly without inflammation or heat, and can range in size from a pimple to a baseball. They are caused by infections, often tuberculosis, and can result in bone damage and compression of nearby organs. Treatment may involve drainage and antibiotics.
A cold abscess is a specific type of abscess that forms without the heat or inflammation typically associated with standard abscesses. It usually forms gradually over time, which results in less irritation or inflammation. Pain generally only occurs when pressure is applied. These swellings can be chronic, persisting after the initial growth without any signs of healing or getting worse. Abscesses are caused by an infection at the site of the swelling, and these abscesses are usually associated with tuberculosis bacterial infections.
When a cold abscess forms, the infected area fills with pus that can harden over time. Abscesses can range in size from the size of a pimple to a baseball or larger. In patients with tuberculosis they can form in multiple areas, but are more common in the spinal region, pelvic area, groin or lymph nodes. A common site for this condition is the psoas muscles, in which case the abscess is known as a psoas abscess.
An abscess can be identified by physical examination. In the case of a cold abscess, a doctor may use an MRI, CT scan, or other type of scan to check that the abscess isn’t another form of noninflammatory swelling, such as a tumor. In some cases, this condition can form without a TB infection, such as when skin abscesses form due to a staph infection. Persistent cold abscesses from staph infections are known as MRSA abscesses. Cold abscesses can also form in the psoas region in patients with inflammatory bowel disease or in patients with specific types of gunshot wounds.
In the case of tuberculosis, a cold abscess may be accompanied by bone damage at the infected site. Depending on the size and location of the abscess, nearby organs may also experience compression as the abscess expands and presses against them. If it continues to grow without drainage, bones and organs can suffer permanent damage from compression or the spread of infection.
While some abscesses swell and disappear on their own, most of these abscesses require drainage via percutaneous catheter or surgical methods, such as drainage incisions. Small abscesses can be treated without surgery or other invasive methods. Hot and cold compress treatments can help dissolve or drain the abscess. Absorption techniques may also work to reduce swelling and drain pus, but they may not be as successful. Antibiotic treatments after the drainage can reduce the risk of repeat infections.
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