What is the pathophysiology of an abscess?

An abscess results from the accumulation of pus in body tissue that has formed a cavity due to 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 the surrounding healthy tissue. Some abscesses result from blocked ducts in the glands, while others are caused by infected lesions, frequently by the bacteria Staphylococcus aureus .

The pathophysiology of an abscess 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 the compromised tissue. They do this by following signals from cytokines that alert them to cell death and injury. Pus, the mixture of dead cells and the 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 collects above the outer dural membrane that covers the brain and spinal column, swelling against the skull or spinal column. 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 to neural tissue caused by fluid pressure as swelling increases. A dental abscess comes from a local infection in the jaw, around the nerve that forms the tooth root. It causes severe pain and, if it breaks, can send bacteria into the bloodstream, risking systemic infection.

Blocking the glands can seal off an area of ​​tissue allowing an abscess to form if infected. Different microorganisms can trigger the pathophysiology of Bartholin's abscess, a painful swelling of the Bartholin's gland in the vagina. If the glands, responsible for healthy vaginal secretions, develop a blocked duct, fluid can build up over time. Bacteria can infect the swollen gland to the point that it becomes very tender. Similarly, skin abscesses or boils can arise from a blocked sweat gland that has become infected.

Differences in the pathophysiology of an abscess do not greatly influence basic treatment. Given the Staphylococcus aureus commonly causes abscesses, traditional antibiotic treatments have accompanied surgery as the two mainstays of medical care. But as this organism has become Staphylococcus aureas resistant to methicillin (MRSA), the range of antibiotics used to reduce complications has increased. Many abscesses, particularly larger ones, will require surgical treatment to drain existing pus from the wound for proper healing. This is usually true regardless of the specific cause of the infection.

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