Management of Acute Abscesses in Jos, Nigeria

Abstract

Background: Acute abscesses are common in the tropical environment. Whereas certain types of abscesses are decreasing in prevalence in the Western world, the situation is quite different in the most developing countries.


Method: A prospective study of two hundred (200) acute abscesses managed in 2 years.


Results: Majority of the patients, 196 (98%) were low-income earners. Identifiable associated medical conditions were diabetes mellitus, sickle cell anaemia, liver cirrhosis, and acquired Immunodeficiency Syndrome (AIDS). The age range of the patients was 0-80 years (mean 21.6 +/- 15.4 years). There were two peaks of age incidence at less than 10 years, and between 20-40 years. The M: F ratio was 1:1.4. One hundred and sixty patients (80%) had used one type or another of antibiotic before presentation. Breast abscess was the commonest type of abscess seen occurring in 65 patients (32.5%). Lactational breast abscess accounted for 59 (90%) of the breast abscess. The average size of abscesses was 6.02 +/- 1.74cm. Staphylococcus aureus was the most commonly isolated organism, in 170 aspirates (85%); it was sensitive to erythromycin in 140 isolates (82.86%). The prognosis after simple incision and drainage was generally good, with a mortality of 3 (1.5%); 2 of the patients had AIDS and one resulted from a neglected ischiorectal abscess.


Conclusion: Improvement in living standards, early presentation and treatment should reduce the incidence, morbidity and mortality from acute abscesses in our environment.

(Nig J Surg Res 2001;3:24-28)



KEY WORDS:

Abscess, AIDS, incision and drainage, low socio-economic status