Abscess, Skin/Soft Tissue, Emergency Medicine

Neal P. O’ Connor Reviewed 06/2017
 


Basics

Description

  • A localized collection of pus surrounded and walled off by inflamed tissue. Abscesses can occur on any part of the body

  • Furuncle:

    • Arises from infected hair follicle

    • Most common on back,...

Diagnosis

Signs and Symptoms

  • Local:

    • Erythema

    • Tenderness

    • Heat

    • Swelling

    • Fluctuance

    • May have surrounding cellulitis

    • Regional lymphadenopathy and lymphangitis may occur

  • Systemic:

    • Often absent

    • Patients with extensive...

Treatment

Pre-Hospital

Caution: Septic patients may require rapid transport with IV access and volume resuscitation. 

Initial Stabilization/Therapy

Septic patient: 
  • Immediate IV access

  • Oxygen

  • Crystalloid vo...

Follow-Up

Disposition

In accordance with abscess type and severity of infection 

Admission Criteria

  • Sepsis/systemic illness

  • Immunocompromised host with moderate/large cellulitis

  • Perirectal involvement

  • Any a...

Pearls and Pitfalls

  • Consider CA-MRSA in recurrent abscesses

  • Pain control is essential during incision and drainage of abscesses

  • Beware of tenosynovitis and deep fascial space infections

Additional Reading

  • Alison  DC, Miller  T, Holtom  P, et al. Microbiology of upper extremity soft tissue abscesses in injecting drug abusers. Clin Orth Related Res.  2007;461:9–13.

  • Buescher  ES. Co...

Codes

ICD9

  • 566 Abscess of anal and rectal regions

  • 682.9 Cellulitis and abscess of unspecified sites

  • 685.0 Pilonidal cyst with abscess

  • 680.9 Carbuncle and furuncle of unspecified site

  • 705.83 Hidradenitis

ICD10

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