RT Book, Section A1 Dooley-Hash, Suzanne A1 Herrman, Nicholas W.C. A2 Knoop, Kevin J. A2 Stack, Lawrence B. A2 Storrow, Alan B. A2 Thurman, R. Jason SR Print(0) ID 1181041502 T1 Pilonidal Abscess T2 The Atlas of Emergency Medicine, 5e YR 2021 FD 2021 PB McGraw-Hill PP New York, NY SN 9781260134940 LK accessemergencymedicine.mhmedical.com/content.aspx?aid=1181041502 RD 2024/03/28 AB Pilonidal abscesses typically occur at the superior aspect of the gluteal fold and are more common in teenage and young adult males. Patients present with pain, swelling, and drainage, but usually do not have systemic symptoms. They are thought to occur when bacteria enter the hair follicle and cause edema that obstructs the opening to the skin surface. Eventually the follicle may rupture, which allows spread into the subcutaneous fatty tissue and abscess formation. Acute abscesses typically contain mixed organisms, including Staphylococcus aureus and Streptococcus species. Anaerobes and gram-negative organisms may also be present. Cellulitis in the sacrococcygeal area may result from a simple abscess or furuncle. Consider alternative causes such as anal fistulae, hidradenitis, inflammatory bowel disease, or tuberculosis.