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CarbuncleL02.94
Synonym(s)
Carbuncle; Carbunculus
DefinitionThis section has been translated automatically.
Severe form of hair follicle inflammation in which several furuncles confluence to form a carbuncle.
EtiopathogenesisThis section has been translated automatically.
Infection with coagulase-positive Staphylococcus aureus, also staphylococcal and streptococcal mixed infections.
ManifestationThis section has been translated automatically.
Occurs mainly in older men.
LocalizationThis section has been translated automatically.
Mainly neck and back.
Clinical featuresThis section has been translated automatically.
Infestation of several neighbouring follicles, multicentric foci of fusion. Fever, pain, infiltration of the surroundings, necroses reaching the fascia, lymphangitis, lymphadenitis.
HistologyThis section has been translated automatically.
Abscessing inflammation.
Complication(s)This section has been translated automatically.
Sepsis.
TherapyThis section has been translated automatically.
- After skin disinfection wide incision of the abscess and insertion of a flap (e.g. rubber flap) under local or general anaesthesia. In the case of extensive abscesses, multiple incisions and the provision of a drainage.
- Daily irrigation with polyvidon iodine solution(e.g. Betaisodona solution or R203 ) or 0.1% polihexanide (Serasept, Prontoderm).
Internal therapyThis section has been translated automatically.
Antibiotic first step treatment with an antibiotic effective against staphylococci such as Flucloxacillin 1.5-3.0 g/day p.o. (e.g. Staphylex Kps.). For the most severe infections, reduce up to 12 g in 3-4 ED/day i.v. dose for renal failure! Later, if necessary, change the antibiotic after an antibiogram.
Further common therapy options are cephalosporins of the 1st generation or with clindamycin.
Progression/forecastThis section has been translated automatically.
Accumulates over weeks.