Boils (Furuncle)/Carbuncle
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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
Investigations
- Pus swab for Gram staining and C&S
- If recurrent, check for diabetes mellitus and HIV infection
ManagementTreatment
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
Prevention
-
Personal hygiene with use of antiseptic soap