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FurunculosisAka: Furuncle, Carbuncle, Skin Abscess, Skin Boil

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  1. See Also
    1. Deep Folliculitis
    2. Incision and Drainage
    3. Perianal Abscess
    4. Paronychia
    5. Hidradenitis Suppurativa
  2. Pathophysiology
    1. Hair Follicle infection that spreads to deeper tissue
      1. Often begins as Folliculitis
    2. Walled-off Nodule of purulent infection
      1. Firm wall with inner fluctuant core
    3. Carbuncles involve a coalition of furuncles
      1. Deeper, more extensive involvement
      2. Require greater degree of debridement
  3. Risk Factors
    1. Obesity
    2. Impaired Neutrophil function
    3. Corticosteroid use
    4. Diabetes Mellitus
  4. Causes
    1. Staphylococcus aureus (most common)
    2. Streptococcus species
    3. Mixed bacterial infection
  5. Signs
    1. Tender, erythematous skin mass
    2. Often spontaneously opens and drains to skin surface
    3. Distribution
      1. Occur most commonly in areas of increased friction
      2. Buttock
      3. Extremities
      4. Breast
        1. Lactating women: Associated with Mastitis
        2. Non-Lactating women: Usually subareolar
          1. Biopsy non-subareolar lesions
  6. Management: Acute Episode
    1. Trial of warm compresses for small abscesses
    2. Incision and Drainage
    3. Antibiotic
      1. Antibiotics usually not required once lesion opened
        1. Antibiotics do not shorten course of abscess
      2. Antibiotics indications (post-drainage)
        1. Cellulitis (see Cellulitis for antibiotic choices)
        2. Carbuncle
        3. Immunocompromised patients
  7. Management: Recurrent Episodes
    1. Optimize personal hygiene
    2. Mupirocin (Bactroban)
      1. Apply intranasally bid for 5 days
      2. Reduces nasal Staphylococcus aureus carriage
    3. Systemic antibiotic protocols (10 day course)
      1. Rifampin 600 mg PO qd and
      2. Dicloxacillin 500 qid or Septra DS bid
    4. Vitamin C 1 gram per day
      1. Effective in those with impaired Neutrophil function
  8. Complications
    1. Cellulitis
    2. Gangrene
    3. Necrotizing Fasciitis
    4. Hidradenitis Suppurativa
    5. Recurrent furunculosis
  9. References
    1. Derksen in Pfenninger (1994) Procedures, p. 50-3
    2. Gilbert (2002) Sanford Guide, p. 36-37
    3. Carroll (1996) Postgrad Med 100(3):311
    4. Stulberg (2002) Am Fam Physician 66(1):119

carbuncle (C0007078)

Definition (MSH)An infection of cutaneous and subcutaneous tissue that consists of a cluster of boils. Commonly, the causative agent is STAPHYLOCOCCUS AUREUS. Carbuncles produce fever, leukocytosis, extreme pain, and prostration.
ConceptsDisease or Syndrome (T047)
ICD9680.9
Englishcarbuncle, Carbuncle of skin AND/OR subcutaneous tissue, Carbuncles
Spanishántrax, ántrax cutáneo y/o subcutáneo, ántrax de la piel Y/O del tejido celular subcutáneo, antrax, antrax cutaneo y/o subcutaneo, antrax de la piel Y/O del tejido celular subcutaneo, carbunco cutáneo y/o subcutáneo, carbunco cutaneo y/o subcutaneo, carbunco de la piel Y/O del tejido celular subcutáneo, carbunco de la piel Y/O del tejido celular subcutaneo
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Furunculosis (C0016867)

Definition (MSH)A persistent skin infection marked by the presence of furuncles, often chronic and recurrent. In humans, the causative agent is various species of STAPHYLOCOCCUS. In salmonid fish (SALMONIDS), the pathogen is AEROMONAS SALMONICIDA.
ConceptsDisease or Syndrome (T047)
EnglishFORUNCULOSIS, Furunculoses, Furunculosis, Furunculosis of skin AND/OR subcutaneous tissue, Recurrent boils, Recurring furuncles of skin, Recurring skin boils
Spanishdiviesos cutáneos recidivantes, diviesos cutaneos recidivantes, forúnculos cutáneos recidivantes, forunculos cutaneos recidivantes, forunculosis, forunculosis de la piel Y/O del tejido celular subcutáneo, forunculosis de la piel Y/O del tejido celular subcutaneo, furúnculos cutáneos recurrentes, furunculos cutaneos recurrentes, furunculosis, furunculosis de la piel Y/O del tejido celular subcutáneo, furunculosis de la piel Y/O del tejido celular subcutaneo
CreditsDerived from the NIH UMLS (Unified Medical Language System)


furuncle (C0242301)

ConceptsDisease or Syndrome (T047)
ICD9680.9
EnglishBoil, Boil of skin AND/OR subcutaneous tissue, Boils, furuncle, Furuncle of skin AND/OR subcutaneous tissue, Furuncles, Furunculus
Spanishdivieso de la piel Y/O del tejido celular subcutáneo, divieso de la piel Y/O del tejido celular subcutaneo, forúnculo, forúnculo de la piel Y/O del tejido celular subcutáneo, forunculo, forunculo de la piel Y/O del tejido celular subcutaneo, furúnculo, furúnculo de la piel Y/O del tejido celular subcutáneo, furunculo, furunculo de la piel Y/O del tejido celular subcutaneo
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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