Abscesses are caused by a high-density infection of (usually) common bacteria which collect in one place or another for any variety of reasons. Anal abscesses, without treatment, are likely to spread and affect other parts of the body, particularly the groin and rectal lumen. All abscesses can progress to serious generalized infections requiring lengthy hospitalizations if not treated.

Historically, many rectal abscesses are caused by bacteria common in the digestive system, such as E. coli. While this still continues often to be the case, there has recently been an uptick in the causative organism being staphylococcus, as well as the difficult to treat community-acquired methicillin-resistant S. aureus. Because of the increasing appearance of more exotic bacteria in anal abscesses, microbiological examination will always be performed on the surgical exudate to determine the proper course of any antibiotic treatment.

If left untreated, an anal fistula will almost certainly form, connecting the rectum to the skin. This requires more intensive surgery. Furthermore, any untreated abscess may (and most likely will) continue to expand, eventually becoming a serious systemic infection.

Closing an abscess immediately after draining it appears to speed healing without increasing the risk of recurrence. This may not apply to anorectal abscesses. While they heal faster, there may be a higher rate of recurrence than those left open.

Even without treatment they rarely result in death as they will naturally break through the skin.

In some cases, abscesses may be prevented by draining an existing pseudocyst which is likely to become inflamed. However, in most cases the developing of abscesses cannot be prevented.

Pancreatic abscesses usually develop in patients with pancreatic pseudocysts that become infected. They may also form as a result of fibrous wall formation around fluid collections or penetrating peptic ulcers. Other causes include gall stones or alcohol consumption and, in rare cases, drugs, blunt trauma and following extension abscess from nearby structures.

An anorectal abscess is an infection that forms a pocket of pus within the tissues around the anus. It is treated surgically by incision and drainage.

Bacterial, viral, and protozoal infections may occur in the area surround the rectum. These may be the result of a sexually transmitted disease.

Paraproctitis is a purulent inflammation of the cellular tissues surrounding the rectum. The most frequent cause is penetration of bacterial flora from the rectum into the surrounding cellular tissues, which may occur through an anal fissure. The inflammation is sometimes limited to the formation of an abscess, and in some cases it spreads for a considerable distance and may be complicated by sepsis.

The symptoms are acute pain in the rectal region, tenderness during defecation, elevated body temperature, and the appearance of an infiltrate in the anal region or on the buttocks. An unlanced abscess may burst and a fistula form. The disease becomes chronic after recurrences. Treatment includes administration of antibiotics and anti-inflammatory agents and, in the suppurative stage, surgical lancing of the abscess.

The epidemiology of TOA is closely related to that of pelvic inflammatory disease which is estimated to one million people yearly.

RPA is usually caused by a bacterial infection originating from the nasopharynx, tonsils, sinuses, adenoids or middle ear. Any upper respiratory infection (URI) can be a cause. RPA can also result from a direct infection due to penetrating injury or a foreign body. RPA can also be linked to young children who do not have adequate dental care or brush their teeth properly.

Both sex are equally affected

Any age group can develop a parapheryngeal abscess but it is most commonly seen in children and adolescents. Adults who are immunocompromised are also at high risk.

Complications of TOA are related to the possible removal of one or both ovaries and fallopian tubes. Without these reproductive structures, fertility can be affected. Surgical complications can develop and include:

- Allergic shock due to anesthetics

- A paradoxical reaction to a drug

- Infection

Treatment for a nasal septal abscess is similar to that of other bacterial infections. Aggressive broad spectrum antibiotics may be used after the infected area has been drained of fluids.

90% of cases are smokers, however only a very small fraction of smokers appear to develop this lesion. It has been speculated that either the direct toxic effect or hormonal changes related to smoking could cause squamous metaplasia of lactiferous ducts. It is not well established whether the lesion regresses after smoking cessation.

Extrapuerperal cases are often associated with hyperprolactinemia or with thyroid problems. Also diabetes mellitus may be a contributing factor in nonpuerperal breast abscess.

Infection can occur from:

- Pharynx: acute and chronic infection of tonsil and adenoids

- Teeth: dental infection occurs from lower last molar tooth

- Ear: bezold abscess and petrositis

- Other space: infection of parotid retropharyngeal space

- External trauma: penetrating injuries of neck, injection of local anaesthetic

PTA usually arises as a complication of an untreated or partially treated episode of acute tonsillitis. The infection, in these cases, spreads to the peritonsillar area (peritonsillitis). This region comprises loose connective tissue and is hence susceptible to formation of an abscess. PTA can also occur "". Both aerobic and anaerobic bacteria can be causative. Commonly involved aerobic pathogens include "Streptococcus, Staphylococcus" and "Haemophilus". The most common anaerobic species include "Fusobacterium necrophorum", " Peptostreptococcus", "Prevotella species", and "Bacteroides".

Anal fistula (plural fistulae), or fistula-in-ano, is a chronic abnormal communication between the epithelialised surface of the anal canal and (usually) the perianal skin. An anal fistula can be described as a narrow tunnel with its internal opening in the anal canal and its external opening in the skin near the anus. Anal fistulae commonly occur in people with a history of anal abscesses. They can form when anal abscesses do not heal properly.

Anal fistulae originate from the anal glands, which are located between the internal and external anal sphincter and drain into the anal canal. If the outlet of these glands becomes blocked, an abscess can form which can eventually extend to the skin surface. The tract formed by this process is a fistula.

Abscesses can recur if the fistula seals over, allowing the accumulation of pus. It can then extend to the surface again - repeating the process.

Anal fistulae "per se" do not generally harm, but can be very painful, and can be irritating because of the drainage of pus (it is also possible for formed stools to be passed through the fistula). Additionally, recurrent abscesses may lead to significant short term morbidity from pain and, importantly, create a starting point for systemic infection.

Treatment, in the form of surgery, is considered essential to allow drainage and prevent infection. Repair of the fistula itself is considered an elective procedure which many patients opt for due to the discomfort and inconvenience associated with an actively draining fistula.

Spinal epidural abscess (SEA) is a collection of pus or inflammatory granulation between the dura mater and the vertebral column. Currently the annual incidence rate of SEAs is estimated to be 2.5-3 per 10,000 hospital admissions. Incidence of SEA is on the rise, due to factors such as an aging population, increase in use of invasive spinal instrumentation, growing number of patients with risk factors such as diabetes and intravenous drug use. SEAs are more common in posterior than anterior areas, and the most common location is the thoracolumbar area, where epidural space is larger and contains more fat tissue.

SEAs are more common in males, and can occur in all ages, although highest prevalence is during the fifth and seventh decades of life.

Retropharyngeal abscess (RPA) is an abscess located in the tissues in the back of the throat behind the posterior pharyngeal wall (the retropharyngeal space). Because RPAs typically occur in deep tissue, they are difficult to diagnose by physical examination alone. RPA is a relatively uncommon illness, and therefore may not receive early diagnosis in children presenting with stiff neck, malaise, difficulty swallowing, or other symptoms listed below. Early diagnosis is key, while a delay in diagnosis and treatment may lead to death. Parapharyngeal space communicates with retropharyngeal space and an infection of retropharyngeal space can pass down behind the esophagus into the mediastinum. RPAs can also occur in adults of any age.

RPA can lead to airway obstruction or sepsis – both life-threatening emergencies. Fatalities normally occur from patients not receiving treatment immediately and suffocating prior to knowing that anything serious was wrong.

In people with renal failure, requiring dialysis, a cimino fistula is often deliberately created in the arm by means of a short day surgery in order to permit easier withdrawal of blood for hemodialysis.

As a radical treatment for portal hypertension, surgical creation of a portacaval fistula produces an anastomosis between the hepatic portal vein and the inferior vena cava across the omental foramen (of Winslow). This spares the portal venous system from high pressure which can cause esophageal varices, caput medusae, and hemorrhoids.

Fungi and parasites may also cause the disease. Fungi and parasites are especially associated with immunocompromised patients. Other causes include: "Nocardia asteroides", "Mycobacterium", Fungi (e.g. "Aspergillus", "Candida", "Cryptococcus", "Mucorales", "Coccidioides", "Histoplasma capsulatum", "Blastomyces dermatitidis", "Bipolaris", "Exophiala dermatitidis", "Curvularia pallescens", "Ochroconis gallopava", "Ramichloridium mackenziei", "Pseudallescheria boydii"), Protozoa (e.g. "Toxoplasma gondii", "Entamoeba histolytica", "Trypanosoma cruzi", "Schistosoma", "Paragonimus"), and Helminths (e.g. "Taenia solium"). Organisms that are most frequently associated with brain abscess in patients with AIDS are poliovirus, "Toxoplasma gondii", and "Cryptococcus neoformans", though in infection with the latter organism, symptoms of meningitis generally predominate.

These organisms are associated with certain predisposing conditions:

- Sinus and dental infections—Aerobic and anaerobic streptococci, anaerobic gram-negative bacilli (e.g. "Prevotella", "Porphyromonas", "Bacteroides"), "Fusobacterium", "S. aureus", and Enterobacteriaceae

- Penetrating trauma—"S. aureus", aerobic streptococci, Enterobacteriaceae, and "Clostridium" spp.

- Pulmonary infections—Aerobic and anaerobic streptococci, anaerobic gram-negative bacilli (e.g. "Prevotella", "Porphyromonas", "Bacteroides"), "Fusobacterium", "Actinomyces", and "Nocardia"

- Congenital heart disease—Aerobic and microaerophilic streptococci, and "S. aureus"

- HIV infection—"T. gondii", "Mycobacterium", "Nocardia", "Cryptococcus", and "Listeria monocytogenes"

- Transplantation—"Aspergillus", "Candida", "Cryptococcus", "Mucorales", "Nocardia", and "T. gondii"

- Neutropenia—Aerobic gram-negative bacilli, "Aspergillus", "Candida", and "Mucorales"

Anaerobic and microaerophilic cocci and gram-negative and gram-positive anaerobic bacilli are the predominate bacterial isolates. Many brain abscesses are polymicrobical. The predominant organisms include: "Staphylococcus aureus", aerobic and anaerobic streptococci (especially "Streptococcus intermedius"), "Bacteroides", "Prevotella", and "Fusobacterium" species, Enterobacteriaceae, "Pseudomonas" species, and other anaerobes. Less common organisms include: "Haemophillus influenzae", "Streptococcus pneumoniae" and "Neisseria meningitides".

Bacterial abscesses rarely (if ever) arise "de novo" within the brain, although establishing a cause can be difficult in many cases. There is almost always a primary lesion elsewhere in the body that must be sought assiduously, because failure to treat the primary lesion will result in relapse. In cases of trauma, for example in compound skull fractures where fragments of bone are pushed into the substance of the brain, the cause of the abscess is obvious. Similarly, bullets and other foreign bodies may become sources of infection if left in place. The location of the primary lesion may be suggested by the location of the abscess: infections of the middle ear result in lesions in the middle and posterior cranial fossae; congenital heart disease with right-to-left shunts often result in abscesses in the distribution of the middle cerebral artery; and infection of the frontal and ethmoid sinuses usually results in collection in the subdural sinuses.

Peritonsillar abscess (PTA), also known as a quinsy, is pus due to an infection behind the tonsil. Symptoms include fever, throat pain, trouble opening the mouth, and a change to the voice. Pain is usually worse on one side. Complications may include blockage of the airway or aspiration pneumonitis.

They are typically due to infection by a number of types of bacteria. Often it follows streptococcal pharyngitis. They do not typically occur in those who have had a tonsillectomy. Diagnosis is usually based on the symptoms. Medical imaging may be done to rule out complications.

Treatment is by removing the pus, antibiotics, sufficient fluids, and pain medication. Steroids may also be useful. Admission to hospital is generally not needed. In the United States about 3 per 10,000 people per year are affected. Young adults are most commonly affected.

In the United States and other developed countries, the incidence of mastoiditis is quite low, around 0.004%, although it is higher in developing countries. The condition most commonly affects children aged from two to thirteen months, when ear infections most commonly occur. Males and females are equally affected.