Pus

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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List of terms related to Pus

Definition

Pus is the collection of dead tissue such as white blood cells, secretions or exudate, that collects after certain types of bacterial, protozoal and fungal infections and is typically white-yellow, yellow, or yellow-brown

Abscess

An abscess is nothing but collection of pus in an enclosed space. If there is a visible collection of pus, then it is called pustule or pimple.

Composition

Pus consists of a thin, protein-rich fluid, filled with dead tissues, and is also known as liquor puris

Eye with conjunctivitis exuding pus

Pyogenic

Bacteria that cause pus are called pyogenic.

In almost all cases when there is a collection of pus in the body, a clinician will try to create an opening to drain it. This principle has been distilled into the famous Latin aphorism "Ubi pus, ibi evacua" ("Where there is pus, evacuate it").

Examples of pyogenic infections

Some disease processes caused by pyogenic infections are impetigo, osteomyelitis, septic arthritis, and necrotizing fasciitis.

Symptoms

If the pus is superficial, it is usually seen as a swelling that is visible or palpable. If the pus is deep in the body, it may lead to symptoms such as obstruction, based on the location. In most cases, the symptoms such as fever, chills, loss of appetite, pain, redness of the skin etc. will also be seen.

Diagnosis

Diagnosis is through a thorough history, and physical examination, blood tests including culture, and sensitivity, imaging studies such as ultrasound, CT scan or MRI might also be used.

Duodenoscopy image of hepatopancreatic ampulla with pus exuding from it, indicative of cholangitis

Treatment

The pus must drain for the infection to heal. You may use warm compresses to “ripen” the abscess, but DO NOT try to pop or puncture the abscess yourself. If your abscess is not draining on its own, your doctor may help the pus to drain through a small incision. Sometimes cotton gauze is also packed inside the abscess cavity to draw out the pus. Important advice for patients: • Avoid touching the abscess with bare hands. • Keep the abscess covered with a clean, dry dressing. If the dressing becomes wet with pus, it should be carefully changed and thrown away in a plastic bag. Pus is very contagious. • Wash your hands frequently with soap and water or hand sanitizer. • Avoid contact-sports and gym class until the wound is completely healed. • Avoid close skin-to-skin contact with other people to keep the infection from spreading.

Pyogenic bacteria

A great many species of bacteria may be involved in the production of pus.

• Staphylococcus aureus
• Staphylococcus epidermidis
• Streptococcus pyogenes
• Escherichia coli (Bacillus coli communis)
• Streptococcus pneumoniae (Fraenkel's pneumococcus)
• Klebsiella pneumoniae (Friedländer's bacillus)
• Salmonella typhi (Bacillus typhosus)
• Pseudomonas aeruginosa
• Neisseria gonorrhoeae
• Actinomyces
• Burkholderia mallei (Glanders bacillus)
• Mycobacterium tuberculosis (tubercle bacillus)

Staphylococcus aureus bacteria is the most common cause of boils.

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