Carbuncles are skin infections, which are larger than furuncles with more than one opening draining pus. It is mainly caused due to bacteria such as Staphylococcus aureus or Streptococcus pyogenes.
Presentation
Typical appearance of carbuncle can be described as development of red lump right beneath the skin. The affected area gets irritated and is extremely painful to touch. The lump is filled with pus and is of the size of a lentil. The area undergoes swelling and the neighboring areas can also swell and become red. The lump has several pus-filled openings, which may ooze and the skin develops crustiness. Carbuncles usually grow very fast and enlarge. In many cases, individuals also experience fever and malaise, along with fatigue [9].
Entire Body System
- Pain
Definitions car·bun·cle Archaic any of certain deep-red gems a smooth, convex, deep-red garnet a painful bacterial infection (esp. [yourdictionary.com]
Overview Boils and carbuncles are painful, pus-filled bumps that form under your skin when bacteria infect and inflame one or more of your hair follicles. Boils (furuncles) usually start as red, tender lumps. [mayoclinic.org]
The name belongs for the most part to ruby sapphire, though it has been also given to red spinel and garnet. 2. ( n. ) A very painful acute local inflammation of the subcutaneous tissue, esp. of the trunk or back of the neck, characterized by brawny hardness [biblehub.com]
‘It relieves menstrual pains, promotes menstruation, treats rheumatic aches and pains, and ripens carbuncles, sores and abscesses.’ [lexico.com]
Skip to content Read Time: 1 minutesCarbuncle While a single boil is a painful pus-filled lump that grows until it ruptures, a carbuncle is a cluster of such painful pus-filled boils that are connected. [northstardermatology.com]
- Fever
These may include: Fatigue Fever General discomfort or sick feeling Skin itching before the carbuncle develops The health care provider will look at your skin. The diagnosis is based on what the skin looks like. [nlm.nih.gov]
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There is no fever. – Carbuncle: a cluster of interconnected furuncles, sometimes with fever and peripheral lymphadenopathy. [medicalguidelines.msf.org]
Patients with fever, multiple abscesses, or carbuncles are given 10 days of TMP/SMX 160/800 mg to 320/1600 mg 2 times a day plus rifampin 300 mg 2 times a day. [merckmanuals.com]
These may include: Fatigue Fever General discomfort or sick feeling Skin itching before the carbuncle develops Treatment Carbuncles usually must drain before they will heal. This most often occurs on its own in less than 2 weeks. [account.allinahealth.org]
- Inflammation
The name belongs for the most part to ruby sapphire, though it has been also given to red spinel and garnet. 2. ( n. ) A very painful acute local inflammation of the subcutaneous tissue, esp. of the trunk or back of the neck, characterized by brawny hardness [biblehub.com]
[…] lump papula papule pustule spot whitehead zit abscess blister boil bruise bulge bump bunion carbuncle contusion corn dilation distention enlargement hump increase inflammation injury knob knurl node nodule pimple pock protuberance puff puffiness pustule [thesaurus.com]
Overview Folliculitis is the inflammation of hair follicles due to an infection, injury or irritation. Boils are tender, swollen areas that form around hair follicles, and carbuncles are clusters of boils. [childrenshospital.org]
These areas are a result of local inflammation of the hair follicles. [onhealth.com]
- Fatigue
Carbuncles may also be accompanied by fever and fatigue. Treatment may include topical antibiotics (for folliculitis), oral or intravenous (IV) antibiotics (to treat the infection) or possible removal of the boils and carbuncles. [childrenshospital.org]
In many cases, individuals also experience fever and malaise, along with fatigue. A preliminary physical examination is often enough to diagnose carbuncles. [symptoma.com]
Symptoms: This infection is manifested by the following symptoms Bump appearance in the infected area Fever General sickness Fatigue Swelling of nearby tissue Treatment: The treatment of this infectious ailment involved following methods Warm compress [marham.pk]
• Unhygienic living conditions • Being in contact with an infected person • Weak immune system • Conditions like diabetes • Skin conditions like psoriasis Symptoms: • A heavy yellow or white lump on the skin • Itching & pain in the affected area • Fatigue [youtube.com]
Symptoms for boils may include: Pus in the center of the boil Whitish, bloody discharge from the boil Symptoms for carbuncles (clusters of boils) may include: Pus in the center of the boils Whitish, bloody discharge from the boils Fever Fatigue The symptoms [stlouischildrens.org]
- Severe Pain
Ask to be seen immediately if a boil of any size: Develops in an infant Is located on the face, rectum, groin or spine Produces fever or severe pain Interferes with movement Causes swelling, red streaks or other discoloration in nearby skin If you have [2minutemedicine.com]
This is especially true if you have a boil or carbuncle and have a fever, severe pain, or worsening redness or warmth of the area. [reddymedicalgroup.com]
Boils and carbuncles are red, painful lumps on the skin that are usually caused by a bacterial infection. Boils Credit: DR P. [nhs.uk]
pain and discomfort It's very important to finish the course of antibiotics even if the boil goes away. [nidirect.gov.uk]
Develop on your face or affects your eyesight Worsens quickly or is severely painful Raise the temperature Gets larger despite self-care Hasn't been cured in two weeks Recurs Doctors to treat Carbuncle Dr. [healthwire.pk]
Respiratoric
- Cough
WET COUGH : http://goo.gl/u0vtD0 C. [youtube.com]
Skin
- Furunculosis
Furunculosis of skin AND/OR subcutaneous tissue Multiple boils Applies To Boil NOS Carbuncle NOS Furuncle NOS ICD-9-CM Volume 2 Index entries containing back-references to 680.9 : [icd9data.com]
Patients with recurrent furunculosis should be treated for predisposing factors such as obesity, diabetes, occupational or industrial exposure to inciting factors, and nasal carriage of S. aureus or MRSA colonization. [merckmanuals.com]
[…] tracts between infected hair follicles • Staphylococci and anaerobic diphtheroids are most common organisms • Hidradenitis suppurativa is a serious skin infection of the axillae or groin consisting of multiple abscesses of the apocrine sweat glands • Furunculosis [accesssurgery.mhmedical.com]
If furunculosis persists after screening and treating the person, consider outside sources of infection such as family and close contacts. [patient.info]
- Erythema
Urticaria (Dermatographic urticaria, Cholinergic urticaria) - Erythema (Erythema multiforme, Stevens-Johnson syndrome, Toxic epidermal necrolysis, Erythema nodosum, Erythema annulare centrifugum, Erythema marginatum) Radiation-related disorders Sunburn [bionity.com]
[…] the back of the neck are seen almost exclusively in diabetic patients or other relatively immunocompromised patients • Furuncles itch and cause pain • Skin first becomes red and then turns white and necrotic over the top of the abscess • Surrounding erythema [accesssurgery.mhmedical.com]
[…] purchases to WHO’s COVID-19 Solidarity Response Fund Get 10 images free trial Royalty-Free Illustration Download preview Infection of the skin infected by a hair follicle hair follicle, follicle, folliculitis, hair, infection, pustula, skin, bacteria, erythema [dreamstime.com]
There may be localized erythema or skin irritation, and the area may be painful when touched. [en.wikipedia.org]
- Acne Vulgaris
vulgaris - Rosacea (Perioral dermatitis, Rhinophyma) - follicular cysts (Epidermoid cyst, Sebaceous cyst, Steatocystoma multiplex) - Pseudofolliculitis barbae - Hidradenitis suppurativa sweat disorders: eccrine (Miliaria, Anhidrosis) - apocrine (Body [bionity.com]
They are rather more common in adolescents and in early adulthood - especially in boys - and the peak incidence is the same as for acne vulgaris. [patient.info]
and prednisolone are also risk factors The rash, which is often itchy, presents with follicular papules and pustules, most commonly on the upper trunk and shoulders Acne vulgaris may be distinguished by the presence of comedone, cysts and scars, and [pcds.org.uk]
Face, Head & Neck
- Neck Swelling
Case presentation A 55-year-old Bangladeshi male with a history of type 2 diabetes mellitus and hypertension presented to the Emergency Department of Farwaniya Hospital, Kuwait in December 2015 with a left-sided neck swelling (8 cm × 6 cm) discharging [gutpathogens.biomedcentral.com]
Neurologic
- Lethargy
Meanings of غنودگی - Ghunuudgi in English are drowsiness, lethargy, nap. [meaningin.com]
Workup
A preliminary physical examination is often enough to diagnose carbuncles. However, the pus samples may also be tested for presence of bacteria to confirm the diagnosis. The bacterial culture test helps in determining the appropriate course of treatment.
In conditions when individuals develop carbuncles recurrently, various other tests are done to determine underlying health conditions such as diabetes. Urine and blood tests are conducted to evaluate the overall health of the affected individuals [10].
Microbiology
- Staphylococcus Aureus
Carbuncle carbuncle A focal folliculitis, which is most common in the neck and back and often caused by infection of Staphylococcus aureus, which spreads by direct contact. [medical-dictionary.thefreedictionary.com]
Methicillin-resistant Staphylococcus aureus colonization and risk of subsequent infection in critically ill children: importance of preventing nosocomial methicillin-resistant Staphylococcus aureus transmission. [medscape.com]
aureus carriers on surface of skin Common in obese patients Carbuncles may occur in patients with immune deficiency, anemia, diabetes or iron deficiency Sites Staphylococcus aureus is most commonly found in intertriginous regions (where two skin areas [pathologyoutlines.com]
A boil is a skin infection that is usually caused by the bacteria Staphylococcus aureus (staph). A carbuncle is a group of boils located in one area of the body. [my.clevelandclinic.org]
Staphylococcus aureus and Streptococcus pyogenes are the bacteria that favor the development of boils and carbuncles. [symptoma.com]
Treatment
In many conditions carbuncles heal by themselves in less than 2 weeks. In the initial stages, individuals can help drain pus by providing warm treatment by means of warm cloth that needs to be placed over the affected area. This needs to be done several times during the day. Individuals are advised against pricking or piercing the boils to prevent spread of infection [11].
In situations, when the carbuncles have persisted over 2 weeks, medical treatment is required. Antibiotics are the preferred treatment regime which are given orally and also through topical application of antibacterial ointments. Antibacterial soaps are also given to locally disinfect the affected area.
Surgery is the method of choice in cases when the lesions are deep and large. The carbuncle is then drained with the help of needle or a scalpel [12].
Prognosis
In majority of the cases, carbuncles can heal by themselves, seldom requiring any treatment. In cases, when they do not, treatment may be required. However, carbuncles have a high recurrence rate if appropriate precautionary and preventive measures are not adopted.
Etiology
Carbuncles are a result of bacterial infection, mostly caused due to bacteria residing on the skin surfaces. The bacteria responsible for causing such skin infections are Staphylococcus aureus and Streptococcus pyogenes. Small injury or insect bite gives the bacteria the access to enter the skin and cause an infection. Various body parts which are moist, are more prone to develop carbuncles. These areas include the groin region, armpit, nose, thighs and mouth [2]. Individuals with weakened immune system, poor nutrition and poor hygienic practices are at an increased risk of developing carbuncles.
Epidemiology
The exact incidence of carbuncles is unknown. It is a common occurrence amongst the adolescent group and in early adulthood years. Boys are more prone to develop carbuncles than girls. Children are less likely to develop such a type of skin abscess [3]. There has been a rise in the incidence of methicillin-resistant staphylococcus aureus infections in the past 20 years [4] [5].
Pathophysiology
For a bacterium to cause an infection, it must first gain entry into the skin. Individuals with skin rashes such as folliculitis, or cuts during practices such as shaving and friction due to clothing can also cause the skin to break. In such situations, bacteria such as Staphylococcus aureus can gain entry into the skin causing an infection [6].
A carbuncle has several openings and is pus filled. Individuals with diabetes or compromised immune systems are more prone to contract carbuncles [7]. Carbuncles more commonly develop on moist areas of the body which is apt for the growth and development of the bacteria. Body areas such as groin, mouth, thighs, nose and armpits are the common regions for development of carbuncles [8].
Prevention
Practicing good personal hygiene is the basis for prevention of carbuncle and its recurrence. Individuals are advised to wash hands after using the bathroom and before eating. Regular bathing also keeps the skin free from bacteria. Individuals should also avoid squeezing boils in order to prevent spread of infection. It is also advised that clothes and towels should be regularly washed in hot water. In cases, when chances of developing carbuncles repeatedly are high, then antibiotics may be prescribed as a preventive regime.
Summary
Carbuncles are infectious and may spread by contact. Family members can develop carbuncles at almost the same time. Some individuals develop more than one carbuncle, such a condition is termed as carbuinculosis. Carbuncles appear to be larger than furuncles and are filled with pus. The infection is deep rooted in the skin and includes hair follicles as well. Such a type of condition can turn painful and can be accompanied by fever [1].
Patient Information
- Definition: Carbuncle is a skin abscess which is larger than a boil, having multiple pus filled openings. It is a contagious condition which can spread to other individuals. Carbuncle consists of multiple boils which are filled with dead tissues and pus.
- Cause: Bacterial infections are the major cause for development of carbuncles. Staphylococcus aureus and Streptococcus pyogenes are the bacteria that favor the development of boils and carbuncles. Individuals with poor immunity, poor personal hygiene and underlying disease conditions such as diabetes are at an increased risk of developing carbuncle.
- Symptoms: A carbuncle develops as a large lump which is filled with pus and the affected area becomes swollen and turns red. In many cases, the neighboring area also becomes red and swollen. The lump is very painful to touch and can also itch. In many cases, affected individuals also suffer from fever, fatigue and general weakness.
- Diagnosis: A physical examination is enough for diagnosing carbuncle. In order to determine the causative organism, bacteria culture by testing the pus is also required. Urine and blood tests would also be needed in order to diagnose other underlying heath conditions that would be causing carbuncle.
- Treatment: Antibiotics are the treatment of choice for carbuncles. In cases, when the skin abscess turns large and deep, surgical intervention is required to drain the pus.
References
- Zimakoff J, Rosdahl VT, Petersen W, Scheibel J. Recurrent staphylococcal furunculosis in families. Scand J Infect Dis 1988; 20:403.
- Gordon RJ, Lowy FD. Bacterial infections in drug users. N Engl J Med 2005; 353:1945.
- Sosin DM, Gunn RA, Ford WL, Skaggs JW. An outbreak of furunculosis among high school athletes. Am J Sports Med 1989; 17:828.
- van Belkum A, Verkaik NJ, de Vogel CP, Boelens HA, Verveer J, Nouwen JL. Reclassification of Staphylococcus aureus Nasal Carriage Types. J Infect Dis. Jun 15 2009;199(12):1820-6.
- BARBER M. Methicillin-resistant staphylococci. J Clin Pathol 1961; 14:385.
- Otto M. How Staphylococcus aureus Breaches Our Skin to Cause Infection. J Infect Dis. May 2012;205(10):1483-5.
- Brook I, Frazier EH. Aerobic and anaerobic bacteriology of wounds and cutaneous abscesses. Arch Surg 1990; 125:1445.
- Stollery N. Skin infections. Practitioner. Apr 2014;258(1770):32-3.
- Weedon D, Strutton G. Skin Pathology. 2nd ed. New York, NY: Churchill Livingstone; 2002:459-66.
- Long CB, Madan RP, Herold BC. Diagnosis and management of community-associated MRSA infections in children. Expert Rev Anti Infect Ther. Feb 2010;8(2):183-95.
- Thwaites GE, Edgeworth JD, Gkrania-Klotsas E, Kirby A, Tilley R, Török ME. Clinical management of Staphylococcus aureus bacteraemia. Lancet Infect Dis. Mar 2011;11(3):208-222.
- Derkson, DJ. Incision and drainage of an abscess. In: Procedures for primary care physicians, 1st ed, Pfenninger, J, Fowler, GC (Eds), Mosby, St. Louis 1994. p.50.