EAS Journal of Pharmacy and Pharmacology

Abbreviated Key Title: EAS J Pharm Pharmacol

ISSN: 2663-0990 (Print) & ISSN: 2663-6719 (Online)
Published By East African Scholars Publisher, Kenya
Volume-3 | Issue-5 | Sept-Oct: 2021 | DOI: 10.36349/easjpp.2021.v03i05.005

Review Article

A Brief Study on Abscess: A Review

Jyoti Nayak1*, Jai Narayan Mishra2, Navneet Kumar Verma3
1
Assistant Professor, Kailash Institute of Pharmacy and Management, GIDA, Gorakhpur, UP, India-273209
2
Director, Kailash Institute of Pharmacy and Management, GIDA, Gorakhpur, UP, India-273209
3
Assistant Professor, Buddha Institute of Pharmacy, GIDA, Gorakhpur, UP, India-273209

Abstract: Abscess is a localised collection of pus contained with a cavity and it

Article History is widely affected skin, anal area, tooth pulp etc. It cause swallowing, pain
Received: 16.07.2021
Accepted: 19.08.2021 ,fever, the main cause of abscess is incision ,bacterial infection ,wounds and it
Published: 16.09.2021 can be diagnosed by CT scan, MRI, X-ray and radioisotopes scaning. It can be
treated by using some antibiotic ,surgery but most promising treatment is
Journal homepage: homeopathic treatment because this treatment is fully cure the disease and it
https://www.easpublisher.com
decreased chance of reoccurrence but it has contain a longer time .
Quick Response Code Keywords: Abscess, CT scan, MRI, X-ray and radioisotopes scaning.

Copyright © 2021 The Author(s): This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International
License (CC BY-NC 4.0) which permits unrestricted use, distribution, and reproduction in any medium for non-commercial use provided the original
author and source are credited.

show up any place on your body [28, 29]. The most

INTRODUCTION common sites are in your armpits (axillae), areas around
An abscess is a collection of pus in any part of your anus and vagina (Bartholin gland abscess), the
the body that, in most cases, causes swelling and base of your spine (pilonidal abscess), around a tooth
inflammation around it. Abscesses are often easy to feel (dental abscess) [3].
by touching [2]. The middle of an abscess is full of pus
and debris. Painful and warm to touch, abscesses can

Fig-1: An abscess

An abscess is a tender, easily pressed mass commonly due to pyogenic, amebic or mixed
generally surrounded by a colored area from pink to infections. Less commonly these may be fungal in
deep red. The middle of an abscess is full of pus and origin [12]. Liver abscess has been recognized since
debris. Painful and warm to touch, abscesses can show Hippocrates [circa 400 B.C.] who speculated that the
up any place on your body. Liver abscesses are most prognoses of the patients were related to the type of
*Corresponding Author: Jyoti Nayak 138
Jyoti Nayak et al; EAS J Pharm Pharmacol; Vol-3, Iss-5 (Sept-Oct, 2021): 138-143
fluid within the abscess cavity [13]. Liver abscess is a A brain abscess is a collection of pus, immune
major tropical disease of the gastrointestinal system [14, cells, and other material in the brain, usually from a
15]. The liver abscess is mainly classified into amebic bacterial or fungal infection. The germs that cause a
and pyogenic. Pyogenic liver abscess which used to be brain abscess can reach the brain through the blood. The
mainly tropical in location is now more common due to source of the infection is often not found. However, the
increased biliary interventions, stenting, cholecystitis, most common source is a lung infection. Less often, a
cholangitis etc. Liver abscess is 3 to 10 times more heart infection is the cause. Germs may also travel from
common in men [16]. a nearby infected area [for example, an ear infection or
a tooth abscess] or enter the body during an injury [such
as a gun or knife wound] or neurosurgery [17].

Fig-2: (a) Normal skin; (b) Patient suffering from abscess; (c) Patient suffering from abscess but abscess burst without
treatment

Peritonsillar abscess (PTA), also known as a in the developing world. Specific parasites known to do
quinsy or quinsey, is a recognized complication of this include: dracunculiasis and myiasis [9].
tonsillitis and consists of a collection of pus beside the
tonsil in what is referred to as peritonsilar space [peri— Some other cause of Abscess
meaning surrounding]. It is a commonly encountered Indigestion Abscess is usually caused because
otorhinol aryngological (ENT) emergency [18]. of improper lifestyle and eating habits Inadequate
consumption of fresh food, lack on antioxidants in the
Sign & Symptom body, lack of vitamin C, diet, Uncleanliness [11].
The main symptoms and signs of a skin
abscess are redness, heat, swelling, tenderness , Skin Abscess can be formed in some area such as
lesion that may be an open or closed sore [10], pain and Sites of abscess:
loss of function. There may also be high temperature a) External sites: In external area some sites are
[fever] and chills [5]. mostly affected such as-
 Fingers and hand
If superficial, abscesses may be fluctuant when  Neck
palpated. This is a wave-like motion which is caused by  Axilla
movement of the pus inside the abscess [4].  Breast
 Foot
Cause  Thigh
Abscesses are caused by bacterial infection,  Ischiorectal and perianal region
parasites, or foreign substances. Bacterial infection is
 Abdominal wall
the most common cause [6]. Often many different types
 Dental abscess, tonsillar abscess and other
of bacteria are involved in a single infection [7]. In the
abscesses in the oral cavity
United States and many other areas of the world the
most common bacteria present is methicillin resistant
b) Internal sites: Internal area some sites are mostly
Staphylococcus aureus [1]. Among spinal subdural
affected such as-
abscesses, methicillin sensitive Staphylococcus aureus
is the most common organism involved [8]. Rarely  Abdominal, pelvic, paracolic, amoebic liver
parasites can causes abscesses and this is more common abscess, pyogenic abscess of liver, splenic
abscess, pancreatic abscess.

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 Perinephric abscess. but it is still thought there is an abscess. Plain

 Retroperitonial abscess. abdominal x-rays have little diagnostic value and often
 Lung abscess. highlight the need for further investigation [26].
 Brain abscess
An Abscess can easily be identified with
Pathophysiology swelling bumps on the skin with pain. It is usually
An abscess is a defensive reaction of the tissue accompanied with pain, there is a pus collection on the
to prevent the spread of infectious materials to other skin along with mild fever. Usually no medical tests are
parts of the body. The organisms or foreign materials required as physical appearance confirms the condition.
kill the local cells, resulting in the release of cytokines.
The cytokines trigger an inflammatory response, which Allopathic Treatment of Abscess
draws large numbers of white blood cells to the area The abscess should be inspected to identify if
and increases the regional blood flow. foreign objects are a cause, which may require their
removal. If foreign objects are not the cause, a doctor
The final structure of the abscess is an abscess will incise and drain the abscess and prescribe
wall, or capsule, that is formed by the adjacent healthy painkillers and possibly antibiotics. [22] In those cases
cells in an attempt to keep the pus from infecting of abscess which do require antibiotic treatment,
neighboring structures. However, such encapsulation Staphylococcus aureus bacteria are a common cause
tends to prevent immune cells from attacking bacteria in and an anti-staphylococcus antibiotic such as
the pus, or from reaching the causative organism or flucloxacillin or dicloxacillin is used. The Infectious
foreign object. Diseases Society of America advises that the draining
of an abscess is not enough to address community-
Diagnosis acquired methicillin-resistant Staphylococcus aureus
Abscesses must be differentiated from [MRSA], and in those cases, traditional antibiotics may
empyemas, which are accumulations of pus in a be ineffective. Alternative antibiotics effective against
preexisting rather than a newly formed anatomical community-acquired MRSA often include clindamycin,
cavity. For those with a history of intravenous drug use, doxycycline, minocycline, and trimethoprim-
an X-ray is recommended before treatment to verify sulfamethoxazole [1]. The American College of
that no needle fragments are present [21]. In this Emergency Physicians advises that typical cases of
population if there is also a fever present infectious abscess from MRSA get no benefit from having
endocarditis should be considered Abdominal antibiotic treatment in addition to the standard
ultrasound- Reasonably reliable and safe test. treatment. If the condition is thought to be cellulitis
rather than abscess, consideration should be given to
CT has proven reliable in helping to delineate possibility of strep species as cause that are still
fistulas and abscesses from isolated rectal inflammation sensitive to traditional anti-staphylococcus agents such
[20]. It scan can be useful for patients with complex as dicloxacillin or cephalexin in patients able to tolerate
suppurative anorectal conditions, and is especially penicillin [23].
helpful in identifying supralevator abscesses, or for
those patients who would otherwise be difficult to Antibiotic therapy alone without surgical
examine without anesthesia [19]. drainage of the abscess is seldom effective due to
antibiotics often being unable to get into the abscess
Radioisotope scanning using white blood cells and their ineffectiveness at low pH levels.Surgical
labelled with special radioactive substances that localise drainage of the abscess [e.g., lancing] is usually
in the abscess. These are however very time consuming indicated once the abscess has developed from a harder
so will only be used if other investigations are negative serous inflammation to a softer pus stage.

Some Marketed Product [Antibiotics] Used In Abscess

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Homeopathic Treatment processes, the so called gum boils, Belladonna is often

Homeopathic treatment of abscess can be a the first remedy and Mercurius follows here in most
great boon to person suffering from it. Homeopathic cases. In acute glandular abscess Belladonna is often
medicines are very effective in treating skin abscess and indicated and is a beginning remedy. Chamomilla is not
boils. Once the abscess gets treated with homeopathic a remedy to suggest itself in abscess, yet has proved
medicines, the chances of it recurring again are very valuable in promoting the formation of pus in chronic
less. Moreover, homeopathic medicines are very safe abscesses where Hepar has failed to act promptly, and
and natural medicines thus produce no side effects. in making the pains more bearable [27].
Acute abscess of recent origin can respond to
homeopathic medicines; however, it may take little Hepar sulphur [Hep]
longer than antibiotics. Homeopathy is best indicated in Is the great homoeopathic remedy for
the cases of- suppurations where the pus is not decomposed. It suits
1. Frequent abscesses especially lymphatic, phlegmatic individuals. Excessive
2. Prolonged (chronic) abscess sensitiveness of the parts is a leading indication. It is
3. Resistant abscess. further indicated by these symptoms: chilly sensations,
throbbing in the parts, or sharp, sticking pains which are
In the above three categories, the formation of worse at night and from if given low in threatening
an abscess is surely a sign of altered underlying suppuration it will favour the formation of pus.
immunity, which can be treated effectively using
homeopathy. Homeopathy is strongly indicated for Ayurvedic Treatment of an abscess
recurring and resistant cases of abscesses Medicines According to Ayurveda, in the very beginning
used in abscess is given below- stage of an abscess, always try to subside the swelling.
Give hot fomentation to the patient around the area of
Gun powder an abscess. Do Ayurvedic bloodletting [Siravyadha
Belladonna Treatment] procedure near the affected area. Advice the
Is the remedy most often indicated for the patient to do fast for 24-48 hours or should give him
initiatory symptoms of abscess. The parts swell rapidly, light diet. One should apply the ‘Ayurvedic herbal
become bright red, there is intense throbbing which is paste’ having anti inflammatory properties on the
painful, pus develops speedily the swelling increases affected area, e.g. Dashang lepa, Doshagna lepa ,
and the redness radiates; here Belladonna is in close Triphala Kwath, Varunaadi Kwath, Punarnavaadi
relation with Hepar and Mercurius. It comes in earlier ,Kwath, Shigru Kwath, Tab. Shilajit, Tab. Pathyadi
than either of these remedies and corresponds more ghanvati, etc. By using these above appropriate
closely to the active, asthenic variety of abscess before measure, if the swelling is not getting subsided and
pus is matured. In abscesses about the alveolar become larger and larger, then go for the next step, and

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Jyoti Nayak et al; EAS J Pharm Pharmacol; Vol-3, Iss-5 (Sept-Oct, 2021): 138-143
try to ripe the swelling fast. For achieving it, apply the comes out is collected and sent for culture and
‘Ayurvedic herbal paste’ which can ripe, mild squeeze sensitivity. A sinus forceps or a finger is introduced
and burst the swelling, e.g. Lepa ghuti lepa, Apamarg within the abscess cavity and all the loculi are broken
kshara lepa, Yav kshara lepa etc. Incision and drainage down. Fresh bleeding is an indication of completeness
of the abscess would the last treatment choice. Incision of the procedure. The abscess cavity is irrigated with
and drainage [I & D]: It is done under local, spinal or mild antiseptic agents like iodine solution or hydrogen
general anaesthesia. A stab incision is made over the peroxide solution [24].
most prominent part of an abscess. The pus which

Some Marketed Product Used In Ayurvedic Treatment of Abscess

Precaution 9. Marx, John, A. M. (2014). Skin and Soft Tissue

 Drink lots of water, let the body eliminate the Infections. Rosen's emergency medicine: concepts
toxins out of the body. and clinical practice (8th ed. ed.). Philadelphia, PA:
 Stay away from constipation, eat fresh fruits or Elsevier/Saunders. pp. Chapter 137.
go on a juice fasting couple of days in a week. 10. http://www.nytimes.com/health/guides/disease/skin
 Lose weight -abscess/overview.html.
11. http://www.treatmentguru.com/abscess.
Prognosis 12. Singh, S., Chaudhary, P., Saxena, N., Khandelwal,
Even without treatment they rarely result in S., Poddar, D. D., & Biswal, U. C. (2013).
death as they will naturally burst through the skin [27]. Treatment of liver abscess: prospective randomized
comparison of catheter drainage and needle
aspiration. Annals of Gastroenterology: Quarterly
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Cite This Article: Jyoti Nayak et al (2021). A Brief Study on Abscess: A Review. EAS J Pharm Pharmacol, 3(5), 138-143.

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