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An internal abscess is more difficult to identify and depend on the location of the abscess and the type of infection. General signs include pain in the affected area, a high temperature, and generally feeling unwell. [17] Internal abscesses rarely heal themselves, so prompt medical attention is indicated if such an abscess is suspected.
In a periapical abscess, usually the origin is a bacterial infection that has accumulated in the soft, often dead, pulp of the tooth. This can be caused by tooth decay, broken teeth or extensive periodontal disease (or combinations of these factors). A failed root canal treatment may also create a similar abscess.
The first line of treatment is the removal of the source of inflammation or infection by local operative measures. [9] Generally, the abscess can be eradicated through surgical drainage alone; however this is sometimes inadequate. Therefore, systemic antibiotic treatment may be required, but only if there is evidence of spreading infection. [9]
Odontogenic infections can be severe if not treated and are associated with mortality rate of 10 to 40%. [4] Furthermore, about 70% of odontogenic infections occur as periapical inflammation, i.e. acute periapical periodontitis or a periapical abscess. [3] The next most common form of odontogenic infection is the periodontal abscess. [3]
For incisional abscesses, it is recommended that incision and drainage is followed by covering the area with a thin layer of gauze followed by sterile dressing.The dressing should be changed and the wound irrigated with normal saline at least twice each day. [4]
A peritonsillar abscess (PTA), also known as a quinsy, is an accumulation of pus due to an infection behind the tonsil. [2] Symptoms include fever, throat pain, trouble opening the mouth, and a change to the voice. [1] Pain is usually worse on one side. [1] Complications may include blockage of the airway or aspiration pneumonitis. [1]
Treatment is with antibiotics and drainage of the abscess; typically guided by ultrasound or CT, through the skin, via the rectum, or transvaginal routes. [3] Occasionally antibiotics may be used without surgery; if the abscess is at a very stage and small. [2] Until sensitivities are received, a broad spectrum antibiotic is generally required. [2]
Anorectal abscess (also known as an anal/rectal abscess or perianal/perirectal abscess) is an abscess adjacent to the anus. [1] Most cases of perianal abscesses are sporadic, though there are certain situations which elevate the risk for developing the disease, such as diabetes mellitus, Crohn's disease, chronic corticosteroid treatment and others.