Cold Abscess


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Cold Abscess

 

an accumulation of pus in a limited region, without such local or general manifestations of an inflammatory reaction as pain, reddening of the skin, or fever, which are typical of an ordinary abscess.

Cold abscesses occur mainly during certain stages of actinomycosis or of tuberculosis of bones and joints. In tuberculosis of bones, and most commonly in spondylitis, a cold abscess tends to become diffused in adjacent tissues owing to the pressure of the pus, and to form a wandering abscess. For example, in tubercular spondylitis of the lumbar region of the spine, a cold abscess may extend to the iliac region or to the upper third of the thigh; it becomes discernible only when a subcutaneous tumor-like formation appears. If the abscess is not treated it may break through the soft tissues and skin, form fistulas that are slow to heal, and discharge a characteristic granular type of pus containing the abscess’s causative agents.

A cold abscess is treated at its original site. Surgical treatment involves puncturing or incising the region of the swelling in order to remove the purulent necrotic mass and to introduce chemotherapeutic agents.

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Distribution According to Clinical Presentation Clinical Presentation Number Percentage Lymphadenitis 6 11.5 Peri-Adenitis 24 46.1 Cold Abscess 11 21.2 Collar Stud Abscess 7 13.4 Sinus 5 9.6 Table 8.
5) Clinically the patient gave the impression of a cold abscess but in the absence of signs of acute inflammation it can be misleading.
A "cold abscess" is cold because it is not accompanied by the classical signs of inflammation.
(31) Cold abscesses of the chest wall which involve the ribs require debridement and wide resection.
This appearance may be typical of a cold abscess of a superficial nerve in leprosy.
In this study, patients presenting with discharging sinus constituted only 4.1% and patients presenting with cold abscess constituted 19.9%.
A diagnosis of pulmonary TB along with metastatic cold abscess and concomitant BT Hansen was made.
Others include Streptococcus and Acinetobacter in few cases and one case of tuberculous lymphadenitis with cold abscess. Polymicrobial origin was documented by I Liau et al.
Nerve abscess may occur in various forms of leprosy due to caseation of nerve fasciculi leading to cold abscess formation.
Extrapulmonary tuberculosis in the breast may present as a mass, discharging sinus, cold abscess or non-healing ulcers mimicking carcinoma.
The case is a documented because of the rarity of reports on retropharyngeal abscess in the literature and because of the large size of a retropharyngeal cold abscess sufficient to cause respiratory distress in an adult patient.