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].

• 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]

  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]

  In many cases, individuals also experience fever and malaise, along with fatigue. A preliminary physical examination is often enough to diagnose carbuncles. [symptoma.com]

  If the infection spreads or worsens, individuals may experience fatigue, fever or other generalized symptoms of illness. [abilenederm.com]

  Sometimes other symptoms may occur, such as fatigue, fever and a general discomfort or sick feeling. Itching may occur before the carbuncle develops. [cancerhomoeoclinic.co.in]

• Gangrene

  Clinical examination showed red, swollen, painful carbuncle with gangrenous patch at the centre and multiple pus points (figure 1). [casereports.bmj.com]

  2013 43 Evaluation of anti-bacterial and wound healing activity of the fruits of Amorpha fruticosa L. 61 Qu X...Jia Y 24146475 2013 44 Granulicatella adiacens--an unusual causative agent for carbuncle. 61 Swain B...Otta S 23455831 2012 45 Fournier's gangrene [malacards.org]

  Introduction Skin carbuncle is a necrotizing infection of the skin and subcutaneous tissues.1 It is composed of a cluster of furuncles, which coalesce into an inflammatory mass with multiple pus-draining sinuses.2 It is also described as an infective gangrene [woundsresearch.com]

  Purulent infection of skeletal muscle, often with abscess Impetigo Superficial infection of skin characterized by pustules or vesicles that progress to crusting or bullae Ecthyma Deeper variant of impetigo evolving into ulcer Clostridium myonecrosis (gas gangrene [dynamed.com]

• 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]

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].

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].

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.

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.

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].

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].

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.

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].

• 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.

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