Abscess Treatment: Best Remedies for Pyogenic, Cold & Pyaemic Abscesses

byBHMS.STUDENT -
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An abscess is a localized collection of pus within tissue, caused by bacterial infection. It results from the body’s immune response to infection, leading to inflammation, tissue necrosis, and pus formation.

Incidence

  • Common in skin and soft tissues, but can also occur in internal organs.
  • More frequent in diabetics, immunocompromised individuals, and post-surgical cases.
  • Can develop due to poor hygiene, trauma, or foreign bodies.

Definition

An abscess is a circumscribed collection of pus caused by bacterial infection, leading to inflammation, swelling, and pain.

Types of Abscesses

1. Pyogenic Abscess (Acute Abscess)

  • Caused by bacterial infection (Staphylococcus, Streptococcus, E. coli, etc.).
  • Painful, red, swollen lump with pus.
  • Fever, tenderness, and warmth present.
  • Example: Skin boils, furuncles, carbuncles.

2. Cold Abscess (Tuberculous Abscess)

  • Caused by Mycobacterium tuberculosis.
  • Slow-growing, painless swelling, often in lymph nodes or bones.
  • No redness or heat (hence called "cold").
  • Example: Tuberculous lymphadenitis (Scrofula), Pott’s abscess (spinal TB).

3. Pyaemic Abscess (Septic Abscess)

  • Multiple small abscesses formed due to bacteria spreading via blood (septicemia).
  • Caused by Staphylococcus, Streptococcus, or Gram-negative bacteria.
  • Seen in infective endocarditis, osteomyelitis, or IV drug abuse.
  • Can lead to multiple organ abscesses.

4. Internal Organ Abscess

  • Abscesses inside lungs, liver, brain, kidneys.
  • Symptoms depend on the organ involved.
  • Example: Liver abscess (Amoebic or Pyogenic), Brain abscess.

Pathogenesis of Abscess Formation (Mnemonic: PUS)

  1. P – Penetration of bacteria into tissue.
  2. U – Ulceration & breakdown of local tissue due to bacterial toxins.
  3. S – Suppuration (pus formation) due to WBC response.

Clinical Features (Mnemonic: PAINS)

  1. P – Pain (throbbing, localized).
  2. A – Abscess formation (swelling with pus).
  3. I – Inflammation (redness, warmth).
  4. N – Necrosis (tissue destruction in advanced cases).
  5. S – Systemic signs (fever, chills in severe infections).

Signs & Symptoms

Superficial Abscess

  • Swelling with tenderness.
  • Red, warm skin over the lump.
  • Fluctuation test positive (fluid-filled swelling).
  • Pus discharge when ruptured.

Deep Abscess (Internal Organs)

  • Fever with chills.
  • Pain over the affected organ.
  • Weakness, weight loss (if chronic).
  • Jaundice in liver abscess, cough in lung abscess.

Laboratory Investigations

  1. Complete Blood Count (CBC) – Shows high WBC count (leukocytosis).
  2. CRP (C-Reactive Protein) – Elevated in infections.
  3. Blood Culture – Identifies bacteria in systemic infections.
  4. Pus Culture & Sensitivity – Determines causative organism & antibiotic choice.
  5. Ultrasound / CT Scan – Locates deep abscesses (liver, brain, lungs).
  6. AFB Staining & TB PCR – Confirms tuberculous abscess.

Management of Abscesses

General Measures (Mnemonic: DRAIN)

  1. D – Drainage of pus (Incision & Drainage - I&D).
  2. R – Rest & Warm compress to promote healing.
  3. A – Antibiotics for infection control.
  4. I – Immune support (nutrition, hydration).
  5. N – Necrotic tissue removal (debridement).

Allopathic Treatment (Mnemonic: ABCDE)

  1. A – Antibiotics (Amoxicillin-Clavulanic Acid, Cephalosporins).
  2. B – Broad-spectrum coverage for severe infections.
  3. C – Complete drainage to prevent recurrence.
  4. D – Debridement of necrotic tissue.
  5. E – Empirical therapy based on culture report.

Surgical Treatment

  • Incision & Drainage (I&D) – Standard treatment for superficial abscesses.
  • Aspiration – For deep abscesses (liver, brain, lungs).
  • Surgical excision – For chronic abscesses or non-healing TB abscesses.

Homeopathic Treatment

  1. Hepar Sulphuris
    • Abscess with extreme tenderness and sensitivity.
    • Pus is thick, yellow, and offensive.
    • Pain worsens from cold air and slightest touch.
    • Promotes suppuration (pus formation & drainage).
    • Best for abscesses in glands (lymph nodes, tonsils, boils).
  2. Silicea
    • For deep-seated abscesses that heal slowly.
    • Pus is foul-smelling and persistent.
    • Weak immunity, prone to recurrent abscesses.
    • Chronic fistula, boils, and post-surgical wounds.
    • Abscesses that do not heal completely.
  3. Calendula Officinalis
    • Best as an antiseptic wound healer.
    • Prevents secondary infections.
    • Used for post-surgical wounds and open abscesses.
    • Reduces inflammation and promotes rapid healing.
    • External application speeds up healing (Calendula lotion).
  4. Lachesis
    • Abscesses with bluish or purplish discoloration.
    • Septicemia, blood poisoning from infected wounds.
    • Intolerance to tight clothing.
    • Symptoms worse after sleep.
    • Prevents the spread of septic infections.
  5. Mercurius Solubilis
    • Painful, pus-filled abscess with excessive salivation.
    • Pus has a metallic, offensive smell.
    • Worse at night, increased sweating.
    • Tongue has a thick, dirty coating (common in dental abscesses).
    • Useful for abscesses in throat, gums, and oral infections.

Mnemonic for Homeopathic Treatment (SHaLL-M)

  • S – Silicea (Slow-healing abscesses).
  • H – Hepar Sulph (Painful, sensitive abscesses).
  • L – Lachesis (Septic, bluish-purple abscesses).
  • L – Calendula (External healing, prevents infection).
  • M – Mercurius Sol (Pus with foul breath, oral abscesses).



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