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A cold abscess is an abscess without heat, redness, fever, significant pain, or inflammation. An abscess is a well-defined collection of pus that has escaped from blood vessels and has been deposited on tissues or in tissue surfaces. A cold abscess usually forms slowly over time (known as a chronic abscess). Because it forms gradually, there is typically less pain and inflammation. The pain usually occurs when touching the surrounding area. Chronic abscesses are known for occurring in the psoas muscles (a muscle that connects the spine to the leg), which is why these are also known as psoas abscesses. This is particularly likely to occur in patients suffering from gunshot wounds to this area or some type of inflammatory bowel disease.
Cold abscesses can be caused by bacterial infections such as MRSA infections and tuberculosis. When caused by MRSA infections, cold abscesses are sometimes called MRSA abscesses. Tuberculosis usually affects the lungs but can affect other body parts as well. Cold abscesses in tuberculosis can form in the lungs, spine, groin, pelvis, and lymph nodes. Lymph nodes are small egg shaped structures in the body that help fight against infection.
The skin can also be affected by cold abscesses. In some cases, such as in tuberculosis and dental abscesses, the underlying bone can become damaged. Nearby organs can become damaged as well from the effects of expanding pressure. The effects on the bones and organs can sometimes be permanent.
Cold abscesses can be identified by a physical examination but a computerized tomography (CT) scan or magnetic resonance imaging (MRI) scan may be used to rule out that it is not something else such as a tumor. CT scanning is an advanced imaging technique that uses x-rays and computer technology to produce more clear and detailed pictures than a traditional x-ray. MRI scans produce extremely detailed pictures of the inside of the body by using very powerful magnets and computer technology. Tumors are abnormal masses of tissue that form when cells in a certain area of the body reproduce at an increased rate. Ultrasound scanning can also be used to evaluate for abscesses but they are not as useful as CT or MRI scans. Ultrasound scanning is a procedure that uses high-frequency sound waves to produce images of internal body structures.
Cold abscesses can be treated by draining them. This can be accomplished by non-surgical means such as applying hot and cold compresses to allow them to drain or dissolve. Sometimes, an incision is required along with insertion of a catheter (flexible, hollow tube) for drainage under the guidance of a CT scan. Antibiotics are often used to decrease the risk of repeat infection. Cold abscess comes from the Gothic word "kalds" meaning "cold" and the Latin word “abscessus” meaning “a going away.” Put the words together and you have “a going away cold.”