carbuncle (carbunculosis)

Introduction

More than one carbuncle is called carbunculosis.

Etiology

• generally caused by bacterial infection
  • Staphylococcus aureus, including MRSA
  • Streptococcus pyogenes
• risk factors
  • poor hygiene
  • immunosuppression

Epidemiology

• more common in men than women

Pathology

• a deep pyogenic infection of the skin & subcutaneous tissues arising from several contiguous hair follicles with formation of connecting sinuses
• a carbuncle is made up of several furuncles

Clinical manifestations

• most common on the back & the nape of the neck
• the infected material forms a lump, which occurs deep in the skin and may contain pus
• fever
• malaise

Complications

• contagious
• sepsis
• involvement of organs other than the skin
  • brain abscess, spinal cord abscess
  • renal abscess
  • endocarditis
  • osteomyelitis
• permanent scarring

Management

• incision & drainage
• oral antibiotics generally not necessary
  • indications
    • MRSA is involved & drainage is incomplete
    • cellulitis
    • immunosuppression
    • infection has spread to other parts of the body
  • include coverage for Staphylococcus aureus, including MRSA if appropriate

More general terms

• hair disease
• skin infection
• bacterial infection
• subcutaneous abscess; boil

Components

• furuncle