Boils (Furuncle)/Carbuncle

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ICD10 CODE: L02

A boil or furuncle is a deep-seated infection of the hair follicles with a walled-off collection of pus. A carbuncle is a cluster of interconnected furuncles.

Cause

  • Bacterial infection with Staphylococcus aureus, leading to the collection of pus

Clinical features

  • Common in people with poor general health, diabetes, or the debilitated
  • Painful mass, warm, and tender
  • Swelling becomes fluctuant, may point after 3 days

Differential diagnosis

  • Acne
  • Epidermal cyst
  • Lipoma
  • Lymphadenitis

Investigations

  • Pus swab for Gram staining and C&S
  • If recurrent, check for diabetes mellitus and HIV infection

Management

Treatment LOC

General measures

  • Intermittent warm compresses to allow lesion to point
  • Incise and drain when ready, then cover with dressing (pack cavity)

Antibiotics

  • May be useful if instituted early and in carbuncles, lesions on face and in immunocompromised patients
  • Cloxacillin 250-500 mg every 6 hours before food for 5 days
    • Child: 12.5-25 mg/kg per dose
  • OR in penicillin allergy patients, erythromycin 500 mg every 6 hours
    • Child: 7.5 mg/kg per dose
 HC2

Prevention

  • Personal hygiene with use of antiseptic soap