Q: My son has perianal abscess since he was 15 days old. Now he is 2.5 months old, but the new abscess appear around time to time and pus comes out. We have been giving him antibiotics since the last 2 months, but have stopped them now. Some friends advise that it needs surgical treatment under anaesthesia for opening and cleaning the fistula. Is it safe to operate my child at this age? Should we wait for some more time?

A:An abscess is a localised collection of pus in a cavity, formed when tissue disintegrates. The site of the abscess, along with the age and immunologic status of the patient, determines how the abscess is managed. Abscesses most often develop when a primary infection extends locally into the skin or when a secondary infection develops at a site of skin disease or injury. Trauma that allows pathogens to invade subcutaneous tissue can lead to an abscess, as can the spread of pathogens through the blood. Often, no factor can be identified in the child with an abscess. Although many immunodeficiency diseases are associated with abscesses, most children with recurrent abscesses are not immunodeficient. Please consult a paediatric surgeon as abscesses, which are recurrent or not responding to antibiotics, should be incised and drained as soon as they are evident.