Abscess and Its Complications

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Questions and Answers

What is one of the main characteristics of granulation tissue?

It is bluish in color

It does not bleed on touch

It is composed of newly formed capillaries (correct)

It is sensitive to touch

What is a common complication associated with wound healing?

Decreased inflammation

Formation of keloids (correct)

Increased sensitivity in the scar area

Accelerated healing

What is the final outcome of healing after an abscess has been evacuated?

Granulation tissue forms (correct)

Only scar tissue remains

The cavity fills with pus

The epidermis completely regenerates without scars

Which of the following best describes 'contracture' in the context of wound healing?

Shortening of collagen bundles causing cosmetic disturbances Signup and view all the answers

Which process is NOT a consequence of localized suppuration?

Infection spreading through the bloodstream Signup and view all the answers

What characterizes suppurative inflammation?

Formation of pus Signup and view all the answers

What is the primary causative organism associated with localized suppurative inflammation such as abscess formation?

Staphylococcus aureus Signup and view all the answers

What is the fate of an abscess if it is not evacuated?

Rupture at the point of least mechanical resistance Signup and view all the answers

Which component is NOT part of the pus in suppurative inflammation?

Lymphocytes only Signup and view all the answers

In the pathology of an abscess, which zone is formed from liquefied necrotic tissue?

Abscess cavity Signup and view all the answers

What is a complication of an abscess formation?

Spread of infection to surrounding tissues Signup and view all the answers

What causes the necrosis of tissue in the formation of pus?

Bacterial toxins Signup and view all the answers

Which of the following is NOT a type of suppurative inflammation?

Acute serous inflammation Signup and view all the answers

What characterizes a carbuncle?

Multiple loculi containing pus opening through multiple sinuses Signup and view all the answers

Which of the following best describes phlegmonous inflammation?

A diffuse form of acute inflammation in subcutaneous tissues Signup and view all the answers

What is the main complication associated with an untreated abscess?

Spread of infection leading to systemic complications Signup and view all the answers

In what condition does suppuration occur if the infection is not initially suppurative?

Diffuse suppuration Signup and view all the answers

What is a major cause of the spread of infection from an abscess?

Spread via lymphatics and blood Signup and view all the answers

Which of the following is NOT considered a complication of healing from an abscess?

Complete regeneration of tissue Signup and view all the answers

What type of localized suppuration occurs in hair follicles?

Furuncle Signup and view all the answers

Which enzyme is known to facilitate the spread of streptococcal infection in phlegmonous inflammation?

Hyaluronidase Signup and view all the answers

Study Notes

Abscess

A localized area of suppurative inflammation
Caused by pyogenic microorganisms, particularly staphylococci which produce coagulase enzymes
Coagulase enzymes result in fibrin threads which surround and localize the area of inflammation
Abscesses are characterized by three zones:
- A central core of necrotic tissue that liquefies due to proteolytic enzymes released from dead polymorphs
- An abscess cavity containing pus in the middle
- A pyogenic membrane surrounding the cavity infiltrated with a large number of polymorphs
If an abscess is not evacuated it will rupture at the point of least mechanical resistance
If an abscess is evacuated, the swelling subsides, the cavity collapses, and healing occurs by granulation tissue

Complications of Abscess

Ulcer: an area of epithelial discontinuity
Sinus: a blind-ended tract opening to the surface that discharges pus
Fistula: a tract with two openings (e.g., one to the surface and one to a mucous membrane)
Chronicity: occurs if the abscess is not completely drained
Spread of Infection
- Lymphatics causing lymphangitis and lymphadenitis
- Blood causing toxaemia or septicaemia
- Septic thrombophlebitis causing pyaemia

Boil or Furuncle

A localized suppuration in a hair follicle or sebaceous gland

Carbuncle

A type of localized suppuration in the subcutaneous tissue, particularly in the region of the back
Characterized by the formation of multiple loculi containing pus that open on the surface by multiple openings (sinuses)
A serious condition that often occurs in diabetic patients

Diffuse Suppurative Inflammation: Phlegmonous Inflammation

A diffuse form of acute inflammation that occurs in the subcutaneous tissues (cellulitis) and mucous membranes (e.g., the appendix)
Caused by streptococcal infection which produces spreading factors (hyaluronidase and fibrinolysin) that dissolve fibrin, aiding in the spread of infection

Sequels of Acute Inflammation

Resolution: occurs if the inflammation is mild and the individual's resistance is good
Healing: by regeneration or organization
Spread of Infection:
- Direct Spread
- Lymphatics causing lymphangitis and lymphadenitis
- Blood causing toxaemia or septicaemia
- Septic thrombophlebitis causing pyaemia
Suppuration: if the infection is not suppurative from the beginning
Chronicity: due to persistence of the causative agent

Serofibrinous Inflammation

Exudate is rich in serous fluid and fibrin
Occurs in serous sacs

Haemorrhagic Inflammation

Exudate is rich in blood
Caused by virulent organisms that damage blood vessels, as in cases of smallpox

Allergic Inflammation

Characterized by exudation of abundant fluid containing eosinophils (e.g., urticaria)
Caused by antigen-antibody reactions

Suppurative Inflammation

A severe type of acute inflammation characterized by pus formation
Can be primary or complicate other types of inflammation

Causative Organisms for Suppurative Inflammation

Staphylococci
Streptococci
Gonococci
Meningococci

Pathogenesis of Pus Formation

Bacterial toxins cause tissue necrosis, particularly in the center
Causative bacteria are strongly chemotactic, attracting a large umber of polymorphs
Some polymorphs are killed in the battle against the microorganism, becoming pus cells (dead polymorphs)
Dead polymorphs and bacteria release proteolytic enzymes that liquefy necrotic tissues, resulting in pus formation

Composition of Pus

Living and dead microorganisms
Living and dead polymorphs
Liquefied necrotic tissues
Some blood cells and globules of fat
Inflammatory exudate

Types of Suppurative Inflammation

A- Localized Suppurative Inflammation

1- Abscess

2- Boil or Furuncle

3- Carbuncle

B- Diffuse Suppurative Inflammation

Phlegmonous Inflammation

Healing by Secondary Intention

After evacuation of pus, the cavity becomes filled with exudate
Formation of granulation tissue
Regeneration of the epidermis
Formation of scar tissue

Complications of Wound Healing

Contracture: Shortening of collagen bundles leading to cosmetic disturbances (e.g., following healing of burns)
Keloid: Excessive formation of collagen
Delayed Healing:
Secondary Infection:
Chronic Ulcer:
Sinus:
Fistula:
Inclusion Epidermoid Cyst Formation:

Healing of Serofibrinous Exudate

The fluid is slowly absorbed
Granulation tissue is formed and transformed into fibrous tissue
Mesothelial cells proliferate and cover the fibrous tissue
Sometimes fibrous tissue from the surfaces of a serous sac unites together, resulting in the formation of fibrous adhesions covered by mesothelial cells.

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Description

This quiz explores the definition, structure, and complications of abscesses, including the role of pyogenic microorganisms. Learn about the formation and potential outcomes of an abscess, such as ulcers and fistulas. Test your knowledge on this important medical concept.