What is a Cold Abscess?

A cold abscess is a specific type of abscess that forms without the heat or inflammation characteristically associated with standard abscesses. One usually forms gradually over time, which results in less irritation or inflammation. Pain generally only occurs when pressure is applied. These swellings can be chronic, persisting after initial growth with no sign of either healing or worsening. Abscesses are caused by infection at the site of the swelling, and these abscesses are usually associated with tuberculosis bacterial infections.

When a cold abscess forms, the infected area fills with pus which can harden over time. Abscesses can range in size, from the size of a pimple to a baseball or larger. In tuberculosis patients they can form in multiple areas, but are most common in the spinal region, the pelvic area, the groin, or the lymph nodes. One common site for this condition is the psoas muscles, in which case the abscess is known as a psoas abscess.

An abscess can be identified by physical examination. In the case of a cold abscess, a medical professional may use an MRI, CT scan, or other type of scan to verify that the abscess is not some other form of non-inflammatory swelling, like a tumor. In some cases, this condition can form without a tuberculosis infection, such as when skin abscesses form as a result of a staph infection. Persistent cold abscesses from staph infections are known as MRSA abscesses. Cold abscesses can also form in the psoas region in patients with inflammatory bowel disease, or in patients suffering from specific types of gunshot wounds.

In the case of tuberculosis, a cold abscess may be accompanied by damage to bones at the infected site. Depending on the size and location of the abscess, the nearby organs may also suffer compression as the abscess expands and presses against them. If it continues to grow without drainage, the bones and organs may suffer permanent damage from compression or spreading infection.

While some abscesses swell and fade on their own, the majority of these abscesses require drainage via percutaneous catheter or surgical methods, such as drainage incisions. Small abscesses may be treated without surgery or other invasive methods. Hot and cold compress treatments can encourage the abscess to dissolve or drain. Absorption techniques can also work to reduce swelling and drain pus, but may not be as successful. Antibiotic treatments after drainage can reduce the risk of repeated infection.