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| Abscess |
| Etiology •Bacteria, i.e. staph., strep., pseudomonas, others. •Fungi, i.e. candida, aspergillus, others |
| Pathogenesis •Infective Endocarditis: Friable vegetations embolize via coronary arteries causing a focal myocarditis, which can progress to abscesses. •Infection of a valve prosthesis along valve ring suture may progress to a valve ring abscess extending into myocardium. •Opportunistic infections in immunocompromised host with septicemia and metastatic abscesses in multiple organs including heart, lung, brain and kidneys., |
| Epidemiology •Complicating infective endocarditis, infection of a prosthetic valve, immunosuppresion, or rarely occurring in an otherwise well individual with a secondary pyemia. |
| General Gross Description •A sharply defined rounded lesion contaning a thick viscid fluid. Often white, but can also be shades of grey and yellow. •Size may vary from microscopic dimensions to visible lesions up to as much as 3 cm in diameter. •Chronic abscesses may have a we1l defined capsule of reactive fibrosis. |
| General Microscopic Description •Neutrophils compose the purulent contents. •Bacteria and/or fungi may be identified with or without the aid of special stains. |
| Clinical Correlation •Most commonly seen at autopsy as microscopic lesions in immunocompromised cases. Clinical setting is sepsis. •Cases of infective endocarditis may also show microabscesses. •Abscesses complicating infected sutures securing a prosthetic valve are usually grossly obvious. The clinical picture is that of sepsis, and, possibly, a mechanically failing prosthesis with insufficiency of the valve. |
| References •Cotran RS et.al.: Robbins Pathologic Basis of Disease. 5th edition. Philadelphia, W.B. Saunders, 1994, pp. 550-4 • Harrison's Principles of Internal Medicine, 13th Edition: Isselbach et. al. (eds). New York, McGraw-Hill, 1994, pp. 494-8 |
| Abscess |
| Synopsis by: J. Hasson, MD (T32000M41740)[328] |
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