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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Article Home Adult and Senior Health Perianal Abcess

Perianal Abcess

A perianal abscess represents an infection of the soft tissues surrounding the anal canal, with formation of a discrete abscess cavity containing pus of bacterial, parasital or foreign materials and is often associated with formation of a fistulous tract



  • Occur due to the obstruction of anal crypts
  • Infection of the static glandular secretions results in suppuration and abscess formation within the anal gland
  • Poor hygienic conditions
  • Frequent diarrhea
  • Decreased immunity
  • Foreign bodies, Injuries, Bacteria such as Escherichia coli, Enterococcus species, and Bacteroides species, Parasites and recurrent abcess formations


  • Pain
  • Redness
  • Increased temperature in and surrounding area
  • Swelling
  • Extensive regional tissue death

Tests and Diagnosis

  • Complete blood count for elevation of white blood cells, a check for diabetes and other infections
  • Ultrasound, CT scan and MRI for confirmation and extension of the tracts
  • Digital examination under anaesthesia
  • Endoscopic visualization of the sinus tract
  • Culture and sensitivity of the pus for antibiotic use and sensitivity


  • Incision and drainage of the abcess and removal of foreign particles if any
  • Primary closure of the drained tract with antiseptic and bandage
  • Antibiotics: flucloxacillin or dicloxacillin or clindamycin, trimethoprim-sulfamethoxazole and Analgesics for pain relief
  • Recurrent infections: Recurrent abscesses are often caused by community-acquired resistant organisms causing the abcess so clindamycin, trimethoprim-sulfamethoxazole , and doxycycline are used as alternative antibiotics
  • Nasal mupirocin twice daily 5 days a month for 1 year
  • Chlorhexidine baths and hot packages
  • Magnesium sulfate paste is best applied at night with a sterile dressing covering it.