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An abscess is an area of infected tissue that is swollen with pus and dead tissue. When pelvic infections occur, but are not treated properly, they lead to abscess formation in the female reproductive tract (tuboovarian abscess). This condition can be very serious if left untreated. In the past, before suitable antibiotics were available, this type of abscess was treated surgically, and was associated with high mortality caused by rupture of the abscess. Today, antibiotics, such as clindamycin and metronidazole, are considered to be the best treatment for tuboovarian abscesses. To evaluate the effectiveness of different antibiotics in treating tuboovarian abscesses the following three groups were studied: 37 patients were treated with a combination of cefoxitin and doxycycline (group 1); 64 patients were treated with either clindamycin and tobramycin or clindamycin and gentamicin (group 2); and an additional 18 patients were treated with cefoxitin and doxycycline for two to three days and then switched to clindamycin and tobramycin or clindamycin and gentamicin. Eighty-four percent of those in group 1; 70 percent of those in group 2; and 78 percent of those in group 3 were treated successfully with antibiotic therapy. The rest of the patients required surgery to remove the abscess. The larger abscesses were less likely to respond to treatment with antibiotics and were more likely to require surgery. The results of this study indicate that tuboovarian abscesses can be successfully treated by each of these three antibiotic regimens, and that surgery is not required in all cases. (Consumer Summary produced by Reliance Medical Information, Inc.)

Infections deep within the spaces of the neck are termed abscesses. The formation of abscesses in the necks of children is a common problem. Such infections may be associated with the area surrounding the tonsils, the muscles of the throat and neck, and the lymph nodes in the walls of the neck (tonsilar, parapharyngeal, and retropharyngeal abscesses, respectively). The anatomic sites of abscesses in the neck and the organisms responsible for causing infection were studied in a group of 112 patients ranging in age from less than 1 year to 5 years. In these patients, 93 percent of the abscesses occurred in the structures deep within the sides of the neck. In many cases the condition was high in the neck and was associated with the salivary glands (submandibular or parotid glands). Four children had infections on both sides of their necks (bilateral abscess formation). Approximately twice as many infections occurred deep in the side of the neck on the left side as on the right side. The bacterium Staphylococcus aureus was found by itself in 44 cases, and with another organism in 3 cases. Beta hemolytic streptococcus was found in 15 additional cases. No bacterial growth could be detected in 29 patients. The remaining cases were found to have many different infecting organisms. Three of the four cases with infections on both sides of the neck were found to have S. aureus. Three patients were treated with antibiotics on an outpatient basis. Four patients had their abscesses drained by a needle, the remaining group of 109 patients underwent a surgical procedure in which the abscess is opened and a drain is placed within it (incision and drainage). Drains were kept in place for periods of one to three days. These patients also received intravenous antibiotic therapy for three days, followed by oral administration of antibiotics for approximately one week. The average length of hospitalization in this group of children was 7 days (with a range of 3 to 28 days). (Consumer Summary produced by Reliance Medical Information, Inc.)

Hereditary hemorrhagic telangiectasia, also referred to as Osler-Weber-Rendu disease, is a genetic disorder characterized by thinning of the walls of the blood vessels in the nose, skin, and digestive tract. This abnormality results in the tendency to bleed. Other signs of the disease include telangiectases, blood vessel lesions resulting from the dilation of a group of small vessels, and malformations of the arteries and veins. Complications of this disease include recurrent bleeding, iron deficiency, low blood oxygen levels, congestive heart failure, brain disease, and various nerve-related disorders. Two cases are described of patients with hereditary hemorrhagic telangiectasia complicated by bacterial infection with Streptococcus. Both patients developed nerve-related symptoms from embolic abscesses, or lesions containing foreign matter. One patient was treated with the antibiotics erythromycin, penicillin, and gentamicin, and was discharged 17 days after hospital admission. The other patient was treated with the antibiotic ceftriaxone, but died 18 days after hospital admission. The incidence and microbiologic characteristics of hereditary hemorrhagic telangiectasia are similar to that of endocarditis (inflammation of the tissue lining the heart) in patients with disease of the heart valves. Routine antibiotic treatment is recommended to prevent bacterial infection in patients with hereditary hemorrhagic telangiectasia. (Consumer Summary produced by Reliance Medical Information, Inc.)

Wound healing has been studied for thousands of years in many parts of the world, and in India as early as 500 to 300 BC. In India, a common problem in surgical clinics is abscess formation, which is treated by incision and drainage, and administration of antibiotics. The resulting abscess cavity heals slowly, resulting in prolonged illness. The antiseizure medication phenytoin (Dilantin) has been reported to improve wound healing. To determine the effect of phenytoin on wound healing, 40 patients with abscesses were assessed. The healing of experimental wounds in 16 guinea pigs was also evaluated. In 20 subjects, phenytoin was applied to the abscess cavity; 20 controls received conventional wound treatment. The phenytoin-treated patients experienced enhanced healing with decreased edema and less need for pain medication. On the 10th day, the average daily rate of wound reduction was significantly lower in the phenytoin group, compared with the control group (2.02 versus 1.58 square centimeters). By the 20th day, 17 patients in the phenytoin-treated group had completely healed abscesses, compared with only one of the control group. In the animal model, the wounds of all 8 phenytoin-treated animals had healed by the 21st day, compared with only one of the controls. Microscopic study of biopsies taken from the phenytoin-treated wounds showed less inflammation and no necrosis (dead tissue). Colonies of bacteria decreased faster in the phenytoin-treated wounds. These findings demonstrate that topical application of phenytoin can promote healing of abscess cavities. (Consumer Summary produced by Reliance Medical Information, Inc.)

Patients with severe postoperative abscesses (infected pockets) at site of incisions in the abdomen sere treated by having them opened and drained, followed by early reclosure and administration of the antibiotics metronidazole and ampicillin anhydricum. One group of patients with subcutaneous abscesses (under the skin) was treated with antibiotics for one day, and another group was treated for four days. All patients underwent reclosure of the wound four days later. In a third group of patients, abscesses had grown down to, but not through, the lining of the abdominal cavity. This group received antibiotic treatment for four days and underwent reclosure of the wound an average of five-and-half days later. No abscesses reappeared in any of the groups of patients. Thus in addition to antibiotic therapy the early reclosure technique is a safe procedure for abscesses which have been drained.

No. Simply incising and draining a superficial skin abscess was sufficient treatment and resulted in a very high cure rate in this study. Adding a beta-lactam antibiotic did not improve [...]