FURUNCLE and CARBUNCLE – Causes and Risk Factors, Clinical Manifestations, Treatment
FURUNCLE and CARBUNCLE – Causes and Risk Factors, Clinical Manifestations, Treatment
Furuncle is another word for “boil.” A boil is a bacterium or fungal infection of a hair follicle. The infected hair follicle can be on any part of body. Furuncles mostly occur on body areas prone to excessive perspiration, friction and irritation such as back of neck, thigh, axillae and perineum or on buttocks.
CAUSES AND RISK FACTORS
- Any type of bacteria or fungi can cause a furuncle
- The most common cause is a bacterium called Staphylococcus aureus
- Diabetes and eczema
- Close, personal contact with someone who already has a staph infection
CLINICAL MANIFESTATIONS
When the hair follicle becomes infected, the skin around it also becomes inflamed.
The main symptoms of a boil include:
- Pain gets worse as it fills with pus and dead tissue
- A bump about the size of a pea but may be as large as a golf ball
- White or yellow centers (pustules)
- Spreading to other skin areas or joining with other boils
- Quick growth
- Weeping, oozing or crusting
- Fatigue
- Fever and general ill-feeling
- Itching before the boil develops
- Skin redness around the boil
TREATMENT
- Boils may heal on their own after a period of itching and mild pain. More often, they become more painful as pus builds up.
- Put warm, moist compresses on the boil several times a day to speed draining and healing
- Cleanse surrounding skin with antibacterial soap, followed by application of antibacterial ointment
- Surgical incision and drainage may be performed
- Follow standard precautions. Double bag all soiled dressings and dispose of properly
- Systemic antibiotic therapy is instituted for carbuncles or spreading furuncles
- Analgesia and antipyretics are ordered as necessary
- Bed rest is advised with carbuncles or furuncles on perineal or anal regions
- Cover mattress and pillows with plastic and wipe daily with a disinfectant
- Wash all linens, towels and clothing after each use
- Properly discard razor blades after each use
- Strict hand washing is maintained by prevent cross-contamination
CARBUNCLES
A carbuncle is a red, swollen, and painful cluster of boils that are connected to each other under the skin. A carbuncle occurs when a group of hair follicles next to each other become infected. It is like a multiple boil. Furuncles may progress to carbuncles. Carbuncles found on back of neck, upper arm, buttocks and lateral thighs.
CAUSES AND RISK FACTORS
Most carbuncles are caused by staphylococcus aureus bacteria, which inhabit the skin surface, throat and nasal passages.
Older age, obesity, poor hygiene and poor overall health are associated with carbuncles. Other risk factors for carbuncles include:
- Chronic skin conditions, which damage the skin’s protective barrier
- Diabetes
- Kidney disease
- Liver disease
- Any condition or treatment that weakens the immune system
CLINICAL MANIFESTATIONS
Carbuncle lesion begins as firm mass in subcutaneous tissue and lower dermis. Then it becomes swollen, painful and has multiple openings to skin surface. Carbuncles may progress to infection of bloodstream.
- The boils that collect to form carbuncles usually start as red, painful bumps.
- The carbuncle fills with pus and develops white or yellow tips that weep, ooze or crust
- Untreated carbuncles rupture, discharging a creamy white or pink fluid
- Superficial carbuncles – which have multiple openings on the skin’s surface – are less likely to leave a deep scar. Deep carbuncles are more likely to cause significant scarring
- Other carbuncle symptoms include chills, fever, fatigue and a feeling of general sickness
- Swelling may occur in nearby tissue and lymph nodes, especially lymph nodes in the neck, armpit or groin
TREATMENT
- Cleanse surrounding skin with antibacterial soap, followed by application of antibacterial ointment
- Warm compresses may promote drainage and healing of carbuncles. Gently soak carbuncle in warm water, or apply a clean, warm, moist washcloth for 20 minutes several times per day
- Surgical incision and drainage may be performed
- Similar strategies include covering the carbuncle with a clean, dry cloth and gently applying a heating pad or hot water bottle for 20 minutes several times per day. After each use, washcloths or cloths should be washed in hot water and dried at a high temperature
- Avoid squeezing or irritating a carbuncle, which increases the risk of complications and severe scarring
- Washing the carbuncle and covering the area with a sterile bandage also may promote drainage and healing and help prevent the infection from spreading
- Over-the-counter medications such as acetaminophen or ibuprofen can help relieve the pain of an inflamed carbuncle