Abscess (boil)

Usually a clearly delineated accumulation of pus forming a cavity within inflamed tissue. On or near the surface of the skin an abscess is usually referred to as a boil. Pus is a fluid consisting of dead tissue, white blood corpuscles and bacteria. Whenever tissue is damaged, for whatever reason, the body reacts with inflammation of the affected area, in order to limit the damage and repair it as soon as possible. Sometimes the inflammation can cause further damage. The most important characteristics of inflammation are redness, hotness, swelling, pain and functional disturbances of the inflamed area, phenomena caused by substances released from the blood and damaged tissue. During inflammation reactions, particularly when they are caused by bacterial infection, large numbers of white blood corpuscles are attracted to the affected area by decomposition products of the bacteria and the damaged tissue in the blood. The white corpuscles move along the wall of a blood vessel towards the infected area. There bacteria are enfolded and digested (phagocytosis), a process which kills many blood corpuscles, forming pus along with the dead tissue and bacteria. The accumulation of pus pushes the surrounding tissue aside, thus causing the abscess, around which inflammation continues to increase, forming the abscess wall, and while living bacteria are present the quantity of pus increases. The abscess is a round swelling, red, hot, and painful if subjected to pressure. It ceases to spread when it bursts through the skin or a hollow organ (intestine or bladder, for example). When the pus has been evacuated and all the bacteria have been removed, the affected area scars over. ‘Wherever pus forms, it must be removed’ is a common saying in medical circles. Most abscesses are the result of skin infection. The doctor can release the pus by lancing the abscess, and the remaining matter is removed with a wet dressing, or by gentle washing. Connective and scar tissue then form by the natural healing process. Antibiotics, which can penetrate into the abscess only with difficulty, are seldom prescribed unless there are signs, such as fever, that infection is still spreading. Sometimes abscesses occur deeper inside the body, for example in the lung or the intestine, when surgery may be needed to reach and drain them. Occasionally it is necessary to remove the whole abscess and the surrounding tissue.

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