Anal abscesses are very common, and most are secondary to infected glands at the dentate line. Abscesses present near the anus (perianal) or more laterally (ischiorectal) after several days of steadily increasing pain. Sometimes, only the induration is seen, and there is no fever or redness because organisms are anaerobes, and there is no fluctuance till late. Usually, however, patients present with local pain and induration.
Antibiotics are not appropriate in the management of anal abscesses unless there is also rapidly spreading cellulitis, immunosuppression, a heart valve or joint prosthetic. Instead, the abscesses should be drained surgically on the same day, mostly under general anesthetic.