Snap Shot A 45-year-old man has severe rectal pain when he defecates. He has a fever of 39 C. On exam a palpable mass is felt at the anal verge. Introduction Infectious abscess typically occurs in perianal and intersphincteric spaces Infection begins in anal gland and spreads Presentation Symptoms fever perirectal/perianal pain Physical exam perirectal tender swollen mass Evaluation CT scan of pelvis only if recurrent Treatment Prompt treatment critical to prevent necrotizing infections Treat with incision and drainage Antibiotics not needed