Carbuncle L02.94

Author: Prof. Dr. med. Peter Altmeyer

Co-Autor: Dr. med. Jeton Luzha

All authors of this article

Last updated on: 29.10.2020

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Synonym(s)

Carbuncle; Carbunculus

Definition
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Severe form of an inflammation of the hair follicles in which several boils confluent to form a carbuncle.

Etiopathogenesis
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Infection with coagulase-positive Staphylococcus aureus, also staphylococcal and streptococcal mixed infections.

Manifestation
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Occurs mainly in older men.

Localization
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Mainly neck and back.

Clinical features
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Infestation of several neighbouring follicles, multicentric foci of fusion. Fever, pain, infiltration of the surroundings, necroses reaching the fascia, lymphangitis, lymphadenitis.

Histology
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Abscessing inflammation.

Complication(s)
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Sepsis.

Therapy
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  • 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 therapy
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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/forecast
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Accumulates over weeks.

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

Authors

Last updated on: 29.10.2020