ABSCESS AND PHLEGMON An abscess is a localized collection of pus often caused by bacteria such as staphyloccus aureus.

Foreign material, fibrin, and blood clot (bekuan darah) may predispose. There is severe (parah) inflammation with masses of neutrophils, living and dead, necrotic tissue debris, and formation of granulation tissue at the periphery to wall off the abscess. Leukocytes gather in the infected area and produce proteases that degrade dead tissue and convert (mengubah) it into pus. This process is termed liquefactive necrosis. The pus may discharge (dibuang) to the surface or if resolution occurs, there is healing with scar formation. CLINCAL ASPECTS: A common site for abscess in the head and neck area is the peritonsillar space. A peritonsillar abscess is also known as a quinsy. Bacteria spread from an acute infection of the palatine tonsil to the potential space between the tonsil and the adjacent muscle with the resultant development of an abscess. A large abscess may literally dissect the tonsil from its bed but more commonly the abscess is less advanced. In the healing process, a marked fibrotic reaction results in dense scar that may make dissection difficult should the patient later undergo tonsillectomy. Untreated, a peritonsillar abscess usually ruptures into the pharynx spontaneously, or slowly resolves. In rare instances, an untreated patient may develop a life-threatening situation should the peritonsillar abscess obstruct the airway, rupture with aspiration of pus, or extend into the parapharyngeal space and superior mediastinum (carotid rupture), or travel along the carotid sheath and reach the intracranial cavity resulting in cerebritis/meningitis. Thyroglossal cysts and branchial cysts commonly develop intermittent infections with abscess formation and there are a multitude of other conditions about the head and neck predisposing to abscess. CLINCAL ASPEK: Sebuah situs umum untuk abses di kepala dan leher adalah ruang peritonsillar. Abses peritonsillar juga dikenal sebagai "quinsy." Bakteri menyebar dari suatu infeksi akut pada tonsil palatina ke ruang potensial antara amandel dan otot yang berdekatan dengan perkembangan yang dihasilkan dari abses. Abses besar harfiah dapat membedah tonsil dari tempat tidur, tetapi lebih sering abses kurang canggih. Dalam proses penyembuhan, sebuah hasil reaksi ditandai fibrosis di bekas luka padat yang dapat membuat sulit diseksi harus pasien kemudian menjalani operasi amandel. Tidak diobati, abses peritonsillar biasanya pecah ke dalam faring spontan, atau perlahan-lahan sembuh. Dalam kasus yang jarang, pasien yang tidak diobati dapat mengembangkan situasi yang mengancam jiwa harus abses peritonsillar menghalangi jalan napas, pecah dengan aspirasi nanah, atau memperpanjang ke dalam ruang parafaringeal dan mediastinum superior (karotis pecah), atau perjalanan sepanjang selubung karotis dan mencapai rongga intrakranial mengakibatkan cerebritis / meningitis. Kista tiroglosus dan kista branchial umumnya mengalami infeksi intermiten dengan pembentukan abses dan ada banyak kondisi lain mengenai kepala dan leher predisposisi abses.

A phlegmon results when an acute infection is not confined as in the case of abscess. Instead the infection spreads along tissue planes and between muscle fibers. Ludwigs angina is a phlegmon of the neck. In that condition, infection (usually streptococcal) comes from a mandibular tooth and produces brawny induration of the neck that may extend from mandible to clavicle and be life-threatening.
Sebuah hasil phlegmon saat infeksi akut tidak terbatas seperti dalam kasus abses. Sebaliknya infeksi menyebar di sepanjang pesawat jaringan dan antara serat otot. Angina Ludwig adalah phlegmon leher. Dalam kondisi itu, infeksi (biasanya streptokokus) berasal dari gigi rahang bawah dan menghasilkan indurasi berotot leher yang dapat memperpanjang dari mandibula untuk klavikula dan mengancam nyawa.