Abscess: Types

There can be various types of abscess. These are briefed below:

1. Acute/Warm abscess: An abscess associated with significant inflammation, producing intense heat, redness, swelling, and throbbing pain. The tissue over the abscess becomes elevated, soft, and eventually unstable (fluctuant) and discolored as the abscess comes to a head (points). An abscess can rupture spontaneously or be drained via an incision. If it is left untreated , the pathogens may spread to adjacent tissues or to other parts of the body via the bloodstream. Appearance of or increase in fever may indicate sepsis.

2. Alveolar abscess: Abscess about the root of a tooth in the alveolar cavity. It is usually the result of necrosis and infection of dental pulp following dental caries.

3. Amebic abscess: An abscess caused by Entamoeba histolytica. It is also known as endamebic abscess.

4. Anorectal abscess: Abscess in the ischiorectal fossa. It is also known as ischiorectal abscess.

5. Apical abscess: It is the abscess at the apex of the lung. It is also known as periapical abscess.

6. Appendicular abscess: Pus formation around an inflamed vermiform appendix.

7. Bartholin abscess: Abscess of Bartholin's gland.

8. Bicameral abscess: Abscess with two pockets.

9. Bile duct abscess: Abscess of the bile duct. It is also known as Cholangitic abscess.

10. Biliary abscess: Abscess of the gallbladder.

11. Bone abscess: It is also known as Brodie's abscess. It refers to the suppuration of the articular end of a bone, especially the tibia.

12. Brain abscess: An intracranial abscess involving the brain or its membranes. It is seldom primary but usually occurs secondary to infections of the middle ear, nasal sinuses, face , or skull or from contamination from penetrating wounds or skull fractures. It may also have a metastatic origin arising from septic foci in the lungs (bronchiectasis, empyema, lung abscess), in bone (osteomyelitis), or in the heart (endocarditis). Infection of nerve tissue by the invading organism results in necrosis and liquefaction of the tissue, with edema of surrounding tissues. Brain abscesses may be acute, subacute, or chronic. Their clinical manifestations depend on the part of the brain involved, the size of the abscess, the virulence of the infecting organism, and other factors. It is also known as cerebral abscess and also intracranial abscess.

Symptoms: Headache, fever, malaise, vomiting, nausea, irritability, seizures or paralysis.

Treatment: The usual treatment is chemotherapy. Surgical intervention may be required.

13. Breast abscess: It is also known as a mammary abscess. It is formed in the female breast, especially one involving the glandular tissue. It usually occurs during lactation or weaning.

14. Bursal abscess: Abscess in a bursa.

15. Canalicular abscess: Breast abscess that discharges into the milk ducts.

16. Caseous abscess: Abscess in which the pus has a cheesy appearance.

17. Chronic abscess: Abscess with pus but without signs of inflammation. It usually develops slowly as a result of liquefaction of tuberculous tissue. It may occur anywhere in or on the body but occurs more frequently in the spine, hips, genitourinary tract, and lymph glands. Symptoms may be very mild. Pain when present is caused by pressure on surrounding parts; tenderness is often absent. Chronic septic changes accompanied by afternoon fever may occur. Amyloid disease may develop if the abscess persists for a prolonged period. It is also known as cold abscess.

18. Circumtonsillar abscess: It is also known as peritonsillar abscess. It is the abscess of the tissue around the tonsillar capsule. Needle aspiration of the abscess, with subsequent antibiotic therapy, is an effective treatment in 90% of cases.

19. Collar-button abscess: Two pus-containing cavities, one larger than the other, connected by a narrow channel.

20. Dental abscess: Acute inflammatory infection within the maxilla or mandible. Infections are classified as periapical or periodontal.

21. Dentoalveolar abscess: Abscess in the alveolar process surrounding the root of a tooth.

22. Diffuse abscess: A collection of pus not circumscribed by a well-defined capsule.

23. Dry abscess: Abscess that disappears without pointing or breaking.

24. Embolic abscess: Abscess due to movement of infectious material from the site of an infection to the other.

25. Emphysematous/Gas abscess: Abscess containing air or gas, produced by organisms such as Clostridium perfringens. It is also known as tympanitic abscess.

26. Epidural / Extradural abscess: It is an abscess on the dura mater.

27. Fecal abscess: Abscess containing faeces.

28. Filarial abscess: Abscess caused by filaria.

29. Follicular abscess: Abscess in a follicle.

30. Fungal abscess: Abscess caused by a fungus.

31. Gingival abscess: Abscess of the gum.

32. Helminthic /Worm/Verminous abscess: An abscess caused by or containing insect larvae, worms or other animal parasites.

33. Hemorrhagic abscess: Abscess containing blood.

34. Hepatic abscess: Abscess of the liver, either a pyrogenic or amebic abscess.

35. Hypostatic/ Wandering abscess: Abscess at a distance from  the focus of disease with pus along fascial sheaths of muscles.

36. Idiopathic abscess: It is an abscess due to an unknown cause.

37. Iliac abscess: It is an abscess in the iliac region.

38. Iliopsoas abscess: It is an abscess in the psoas and iliacus muscles.

39. Intradural abscess: It is an abscess within the layers of the dura mater.

40. Intraperitoneal/Peritoneal abscess: It is an abscess within the peritoneal cavity usually following peritonitis.

41. Kidney abscess/Renal abscess: It refers to one or more abscesses arising in the kidney, typically following pyelonephritis or a blood-borne infection. The most common causative organisms are gram-negative bacteria from the lower urinary tract that spread to the kidneys and Staphylococcus aureus from a blood-borne infection. Immunocompromised patients may develop abscesses caused by Nocardia, Candida, or Aspergillus. Occasionally, mycobacterium tuberculosis and Echinococcus are responsible agents.
Treatment: Antimicrobial agents are used in combination with surgical drainage. Occasionally, nephrectomy or retroperitoneal exploration are required.

42. Lacrimal abscess: Suppuration of a lacrimal gland or in a lacrimal duct.

43. Lateral alveolar abscess: Abscess in periodontal tissue.

44. Lumbar abscess: Abscess in the lumbar region.

45. Lung/Pulmonary abscess/Empyema: Abscess of the lungs; suppuration of lung tissue with one or more localized areas of necrosis, resulting in pulmonary cavitation.

46. Lymphatic abscess: Abscess of a lymph node.

47. Mastoid abscess: Suppuration of the mastoid portion of the temporal bone.

48. Metastatic abscess: Secondary abscess at a distance from the focus of infection.

49. Miliary abscess: Multiple small embolic abscesses.

50. Milk abscess: Mammary abscess during lactation.

51. Mycotic abscess: Abscess caused by fungi.

52. Nocardial abscess: Abscess caused by Nocardia.

53. Orbital abscess: Suppuration in the orbit.

54. Palatal abscess: Abscess in a maxillary tooth erupting towards the palate.

55. Palmar abscess: Purulent effusion into the tissues of the palm of the hand.

56. Pancreatic abscess: Abscess of pancreatic tissue, usually as a complication of acute pancreatitis or abdominal surgery.

57. Parafrenal abscess: Abscess on the side of the frenulum of the penis. It usually involves Tyson's gland.

58. Parametric abscess: Abscess between the folds of the broad ligaments of the uterus.

59. Paranephric abscess: Abscess in the tissues around the kidney.

60. Parapancreatic abscess: Abscess in the tissues adjacent to the pancreas.

61. Parietal abscess: Periodontal abscess arising in the periodontal tissue other than the orifice through which the vascular supply enters the dental pulp.

62. Parotid abscess: Abscess of the parotid gland

63. Pelvic abscess: Abscess of the pelvic peritoneum, esp. in Douglas' pouch.

64. Perianal abscess: Abscess of the skin around the anus.

65. Periapical/Apical/Root abscess: An accumulation of  acute inflammatory cells at the apex of a tooth, usually resulting from dental caries or tooth trauma. It may be classified further as an acute periapical abscess, a chronic periapical abscess, a periapical granuloma, or a radicular cyst.

66. Pericemental abscess: Alveolar abscess not involving the apex of a tooth.

67. Pericoronal abscess: Abscess around the crown of an unerupted molar tooth.

68. Peridental abscess: Abscess of periodontal tissue.

69. Perinephric abscess: Abscess in tissue around the kidney.

70. Periodontal abscess: A localized area of acute or chronic inflammation with pus formation found in the gingiva, periodontal pockets, or periodontal ligament.

71. Peripleuretic abscess: Abscess in the tissue surrounding the parietal pleura.

72. Periproctic abscess: Abscess in the areolar tissue about the anus.

73. Periureteral abscess: Abscess in the area around a ureter.

74. Periurethral abscess: Abscess in tissue surrounding the urethra.

75. Perivesical abscess: Abscess in tissue around the urinary bladder.

76. Pneumococcic abscess: Abscess due to infection with pneumococci.

77. Prelacrimal abscess: Abscess of the lacrimal bone producing a swelling at the inner canthus of the eye.

78. Premammary abscess: Subcutaneous or subareolar abscess of the mammary gland.

79. Prostatic abscess: Abscess within the prostate gland.

80. Protozoal abscess: Abscess caused by a protozoon.

81. Psoas abscess: Abscess with pus descending in the sheath of the psoas muscle due to vertebral disease, usually of tuberculous origin.

82. Pulp abscess: 1. A cavity discharging pus formed in the pulp of a tooth. 2. Abscess of the tissues of the pulp of a finger.

83. Pyemic abscess: A metastatic abscess , usually multiple, due to pyogenic organisms.

84. Rectal abscess : Abscess in the rectum.

85. Retrocecal abscess: An abscess located behind the cecum.

86. Retromammary abscess: Abscess between the mammary gland and the chest wall.

87. Retroperitoneal abscess: Abscess located between the peritoneum and the posterior abdominal wall.

88. Retropharyngeal abscess: Abscess of the lymph nodes in the walls of the pharynx. It sometimes stimulates diphtheritic pharyngitis.

ETIOLOGY: Staphylococcus aureus and group A hemolytic streptococcus are the most common pathogens.

SYMPTOMS: Typically, a history of pharyngitis is elicited. This is followed by high fever, dysphagia, and refusal to eat. The condition progresses to respiratory distress with hyperextension of the head ("sniffing position"), tachypnea, labored breathing, and drooling. An exquisitely tender bulge in the pharyngeal wall is usually evident.

TREATMENT: A retropharyngeal abscess, if fluctuant, should be treated with incision and drainage. If recognized before it becomes fluctuant, the abscess should be treated with  antibiotics, intravenously administered if the patient is unable to swallow.

89. Retrovesical abscess: Abscess behind the bladder.

90. Sacrococcygeal abscess: Abscess over the sacrum and coccyx.

91. Septicemic abscess: Abscess resulting from septicemia.

92. Spermatic abscess: Abscess of the seminiferous tubules.

93. Spinal abscess: Abscess due to necrosis of a vertebra.

94. Splenic abscess: Abscess of the spleen.

95. Sterile abscess: Abscess from which microorganisms cannot be cultivated.

96. Stitch abscess: Abscess formed about a stitch or suture.

97. Streptococcal abscess: Abscess caused by streptococci.

98. Subaponeurotic abscess: Abscess beneath an aponeurosis or fascia.

99. Subarachnoid abscess: Abscess of the mid -layer of the covering of the brain and spinal cord.

100. Subareolar abscess: Abscess underneath the areolar of the mammary gland, sometimes draining through the nipple.

101. Subdiaphragmatic abscess/ Subphrenic abscess: Abscess beneath the diaphragm.

102. Subdural abscess: Abscess beneath the dura of the brain or spinal cord.

103. Subfascial abscess: Abscess beneath the fascia.

104. Subgaleal abscess: Abscess beneath the galea aponeurotica (i.e.,  the epicranial aponeurosis).

105. Subpectoral abscess: Abscess beneath the pectoral muscles.

106. Subperiosteal abscess: Bone abscess below the peritoneum.

107. Subperitoneal abscess: Abscess between the parietal peritoneum and the abdominal wall.

108. Subscapular abscess: Abscess between the serratus anterior and the posterior thoracic wall.

109. Subungual abscess: Abscess beneath the fingernail. It may follow injury from a pin, needle, or splinter.

110. Sudoriparous abscess: Abscess of a sweat gland.

111. Suprahepatic abscess: Abscess in the suspensory ligament between the liver and the diaphragm.

112. Syphilitic abscess: Abscess occurring in the tertiary stage of syphilis, esp. in bone.

113. Thecal abscess: Abscess in a tendon sheath.

114. Thymus abscess: Abscess of the thymus.

115. Tonsillar abscess: Acute suppurative tonsillitis.

116. Tropical abscess: Amebic abscess of the liver.

117. Tubo-ovarian abscess: Abscess involving both the fallopian tube and the ovary.

118. Tympanocervical abscess: Abscess arising in the tympanum and extending to the neck.

119. Tympanomastoid abscess: A combined abscess of the tympanum and mastoid.

120. Urethral abscess: Abscess in the urethra.

121. Urinary abscess: Abscess that contains pus and urine.