The Consequences of Untreated Abscesses: What You Need to Know

Understanding the complications that arise from an untreated abscess is crucial for maintaining good health. An abscess is a collection of pus that forms as a result of an infection typically walled off by the body. This barrier is intended to isolate the infection and prevent it from spreading further. However, if left untreated, an abscess can lead to serious health complications that range from localized issues to life-threatening conditions.

What Happens When an Abscess Is Not Treated?

When an abscess is not treated, several potential outcomes can occur:

Formation of Chronic Sinus Tracts

If a nidus of infection such as a foreign object or hair remains in the body, it can cause the abscess to reform after the initial opening closes. Alternatively, the abscess may form a chronically draining sinus, where continuous discharge of purulent material occurs through a tunnel in the skin.

Localized Infection and Scar Tissue

In some cases, if the abscess has fully drained and the opening is large enough to prevent reformation, it may heal on its own, albeit slowly. However, this healing process often results in the formation of a hard, indurated mass of scar tissue. This scenario is favorable but may leave a physical reminder of the initial infection.

Sepsis and Disseminated Infection

If the abscess does not “point” upwards and ruptures within the tissues, it can lead to a disseminated infection, where the infected material spreads to other areas of the body. This can be particularly dangerous if the infection breaches into body cavities like the peritoneum or mediastinum, leading to severe conditions such as peritonitis or mediastinitis. These complications can be fatal if left untreated.

Severe Sepsis

The infected material can also travel through the bloodstream or lymphatic system, causing satellite abscesses in other parts of the body or infecting structures like heart valves. In worse cases, this can lead to a systemic response known as sepsis, which is a severe and often fatal immune reaction to infection throughout the body.

Antibiotic Treatment and Limitations

While antibiotics can be used to reduce local tissue inflammation, they are rarely sufficient to completely resolve an abscess because of poor penetration into the infected tissue. For some abscesses, particularly dental abscesses, antibiotics may be used in combination with other treatments to facilitate local anesthesia, which might be ineffective due to changes in tissue pH.

Treatment Options

The most effective treatment for an abscess involves incision and drainage, removal of any foreign bodies, and breaking down of any loculi to aid in healing. Deep abscesses within body cavities may also benefit from the placement of a drain, either passive or suction, to help manage the wound as it heals.

It is important to note that packing superficial soft tissue abscesses after 24 hours has very little evidence to support its efficacy, as the wound edges retract naturally, allowing healing from the bottom up. Similarly, wide deroofing of the abscess is also not well-supported by evidence and may even hinder the healing process.

Conclusion

Untreated abscesses can lead to a range of serious complications, from the formation of chronic sinus tracts to life-threatening conditions like sepsis. Early intervention through prompt and appropriate treatment is essential to prevent these complications and ensure a successful recovery. If you suspect you have an abscess, seek medical attention immediately to avoid potential health risks.