What Are Abscesses?
An abscess is defined as an accumulation of pus in an infected cavity of the body, usually surrounded by inflamed tissue. Abscesses are associated with tissue destruction, so the word is taken from the Latin abscessus, which means “a going away.” Abscesses are a signal from the body that it is trying to rid itself of impurities. They can appear just about anywhere in the body, either internally or externally. Abscesses can form in just about any type of body tissue, including bone. They can be acute, springing up in a few hours, or chronic, developing over a period of time. The acute ones are generally respond better to treatment.
The pus that fills abscesses is a response of the immune system to infection. Pus is composed of dead tissue cells, white blood cells, and both live and dead bacteria, assuming the infection is bacterial, which most are. General symptoms of abscesses include swelling, warm to the touch, redness, and tenderness in the area of the abscess. A fever, chills, and fatigue may also be present. Some symptoms are more specific to the area of the body in which the abscess forms. Perhaps it would be helpful to base our discussion of abscesses on the different types that form throughout the body. We will take a more in depth look at some of the most common forms of abscesses.
Abscesses of the skin are quite common. They are also known as boils. They most often form as the result of a bacterial infection from staphylococcus (staph for short). They may be found anywhere on the body, and equally affect folks of all ages.
Skin abscesses are infections that form in the deeper layers of the skin. Once the immune system responds to the area, pus begins to form and fill up the cavity. The infection typically forms a head, which is the usual form that boils take. Once it reaches this stage, it can be lanced, either at home, being careful to keep the environment sterile and clean, or in a health care provider’s office. If the boil is not too painful, and not in a sensitive area, it may be left to run its course, which usually takes several weeks. It will normally dry up and dissipate on its own. If you choose to not treat the boil, just watch it and make sure that it is not showing signs of worsening infection. Any infection, including a simple boil, can lead to more serious systematic infections if it is allowed to spread to surrounding areas. Be especially careful with any infection that is bad enough to cause a fever.
Most skin abscesses respond very well to treatment with a warm, moist dressing. This will often keep it from worsening, and may help to drain it and heal it faster without lancing it. Doctors will often prescribe antibiotics for boils, but they are not always necessary, and may not even be effective, as they can have trouble penetrating the abscess wall. Be careful about indiscriminately using antibiotics. If they are used to often, bacteria can become resistant to them. They can also have some undesirable side effects, such as a greater susceptibility to yeast infections.
An abscessed tooth can be very painful. This occurs when the center of the tooth (the pulp) becomes infected typically with a bacterial agent. These most often occur when a cavity is left untreated, or when dental trauma exposes areas of the teeth and gums so that they are more easily open to infection.
Dental abscesses can be particularly dangerous because once the root of the tooth is infected, it can easily be spread to adjacent areas such as the gums and jaws, and eventually may enter the blood stream and cause a dangerous systemic infection. Blood poisoning or infections of major organs can occur, and these can be very serious and even life threatening in some cases.
The best course of treatment and prevention of dental abscesses is good dental hygiene practices, including prompt attention for any cavities that may form in the mouth. No one likes to go to the dentist, at least no body I know, but putting it off can quickly make matters much worse.
An abscess of the brain is potentially one of the most critically dangerous types. Infection, typically of bacterial, fungal, or viral origin, can reach the brain through a number of avenues. It may spread from an infection in adjacent areas, such as the ears, or it may travel to the brain via the bloodstream. In an attempt to isolate the infection and protect itself, the immune system forms a membrane to hem in the infection. However, sometimes the plan backfires, and swelling in the enclosed area does more harm than good.
A brain abscess is a serious medical emergency. Symptoms of a brain abscess may include the following:
- Stiffness in the head, shoulders, and/or back
- Cognitive changes, such as confusion, slurred speech, inability to concentrate, slowed thought processes, and decreasing responsiveness.
- Coma, in extreme cases.
- Loss of coordination
- Loss of muscular control and function
- Vision dysfunction
- Complications can lead to epilepsy, meningitis, and permanent neurological damage.
Any one with a brain abscess should be hospitalized until treatment has gotten it under control. Pressure within the brain or skull can be fatal if left untreated. Medication, usually antibiotics, will be given. Surgery may be called for if medication does not reduce the infection and swelling, but surgery is not always an option if the abscess is located too deeply in the brain, or near sensitive neurological centers of the brain.
These are another very serious type of abscess. They involve the area between the bones of the skull or spine, and the meninges, which are the membranes that cover the brain and spinal chord. Staph is the bacterial agent responsible for most epidural abscesses, but in rare cases the infections may be fungal in nature. The infectious agents can be spread through the blood, but in many cases the source of the germs is never identified.
Certain factors can increase the risk of an epidural abscess forming. These include:
- Recent neurosurgery
- Ear infections, especially chronic
- Head trauma or injury
- Chronic sinusitis
Symptoms of an epidural abscess include:
- Infection or pain at a recent surgical site
- Nausea and/or vomiting
- Fatigue and lethargy
- Depending on the location of the abscess, other symptoms may occur including paralysis, muscle weakness, and a decrease or loss of sensation in certain areas of the body.
Potential complications from an epidural abscess include:
- Brain abscess
- Spinal chord abscess
- Permanent neurological damage
The most common form of treatment for this potentially life-threatening form of abscess is the use of intravenous antibiotics for 4-6 weeks. The goal of treatment is twofold: to heal the infection, and to keep it from spreading to other sensitive areas of the body.
These pus-filled areas within the liver are often contracted from other abdominal infections such as appendicitis, a perforated bowel, or diverticulitis. Trauma to the liver can also predispose someone to liver abscesses. This type of abscess is almost exclusively caused by bacteria, including staph and others.
In addition to the usual fever, chills, and nausea/vomiting, symptoms of a liver abscess include:
- Pain in the upper right quadrant of the abdomen
- Jaundice (yellow skin)
- Loss of appetite
- Dark urine
- Chalky-colored stools
Liver abscesses can be very serious. Blood poisoning may potentially occur, and be life-threatening. 10-30% of all patients with a liver abscess will die, with the percentages even higher if there are multiple abscesses.
This type of abscess is found in the area of the tonsils, and is very common amongst older children and adolescents who have been plagued with tonsillitis. It is not quite as common as it once was, due to the treatment of tonsillitis with antibiotic therapy.
Symptoms may include:
- Severe sore throat
- Sore glands
- Facial swelling
- Difficulty opening the mouth, often accompanied by pain.
The most serious potential complication of a peritonsillar abscess is blockage of the airway due to swelling, which is a true emergency. Surgical removal of the tonsils and the abscess(es) is often called for. Other less common complications may include pneumonia, pericarditis (inflammation of the sac surrounding the heart), or pleural effusion (fluid accumulation in or near the lungs).
Abscesses in the area of the anus and rectum are caused by a number of factors, including sexually transmitted diseases (STDs), infected anal fissures, and as a complication of intestinal conditions such as Crohn disease or diverticulitis, diabetes, or engaging in anal sexual relations. Typical symptoms include:
- Painful bowel movements
- Discharge of pus from the rectum
- Swollen, red nodules that are painful, found near the edge of the anus
- Hardened, painful perianal tissue
Drainage of the abscess(es) is usually performed. Soaking in a tub of warm water (sitz bath) seems to be helpful for many patients to relieve pain and encourage drainage.
Infants and babies may sometimes contract anorectal abscesses if they have anal fissures, especially if diaper changes are not performed promptly.
These abscesses occur in the Bartholin’s glands that are located on both sides of the vagina. This type of abscess can be extremely painful, and they are often found in women with an STD such as gonorrhea. Intercourse is painful and often impossible, and even walking or sitting may lead to intense pain.
Treatment is often accomplished through the use of sitz baths. However, it often may take several weeks for the abscesses to drain and heal up. Recurring infections and abscesses are often a problem.
As we have seen, abscesses can be more than just a painful and annoying area of skin. Internal abscesses can be especially dangerous. Keeping your immune system strong can help avoid abscesses and many other infections, but this is something that must be practiced consistently over time. Natural alternatives to harmful antibiotics include garlic, onion, and topical application of honey to external abscesses. The application of tea tree oil is also a very effective alternative.
Loretta Lanphier, ND, CN, HHP, CH is a Naturopathic Physician, Clinical Nutritionist, Holistic Health Practitioner and Clinical Herbalist in Houston, TX and Founder / CEO of Oasis Advanced Wellness. Under her leadership, Oasis Advanced Wellness is known and respected as one of the leading companies in providing safe, non-toxic, hi-tech natural health and wellness solutions along with cutting-edge health programs. Dr. Lanphier is the author of five health and wellness e-books including Optimum Health Strategies…Doing What Works. Lanphier is Editor and contributor to the worldwide Free E-newsletterAdvanced Health & Wellness We invite you to visit us at Oasis Advanced Wellness, the PMS-Progesterone-Menopause Resource Center, the Acne Resource Center, the Skin Care Resource Center, the Glyconutrient Resource Center, the Allergy-Asthma-Sinus Relief Resource Center andwww.oasisserene.com