Furuncles/Carbuncles Non-scaly Nodules. What is it? (Boil) an acute, round, tender, circumscribed,...
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Transcript of Furuncles/Carbuncles Non-scaly Nodules. What is it? (Boil) an acute, round, tender, circumscribed,...
Furuncles/Carbuncles
Non-scaly Nodules
What is it?
• (Boil) an acute, round , tender, circumscribed, perifollicular staphylococcal abscess, that ends in central suppuration
Furuncle
Carbuncle
Causative agent
Staphylococcus aureus
- Gram (+) cocci
- Skin flora (20-40% adults are nasal carriers)
- Causes a wide range of illness
- Spreads by physical contact
• Some disappear before rupture
• Most undergo central necrosis and rupture, discharging purulent material and necrotic debris
• Common sites; nape, axillae, and buttocks
Risk factors/Predisposing factors
Disruption of skin integrityAlcoholismMalnutritionBlood dyscrasiaImmunosuppressionDrug-resistant Staph.Improper Handwashing
Treatment
• Apply warm compress and oral antibiotics (1-2g/day)– Penicillinase resistant penicillin– 1st gen. Cephalosporin
• Bactroban, to prevent recurrence
• Surgical incision and drainage
• 4% Chlorhexidine for skin and umbilical cord care
Chronic Furunculosis
• Usually common
• Autoinoculation and familial spread
• Region of furuncles may be a source of colonization to areas with cuts, excoriation, or eczematous change.
Control of Chronic Furunculosis
• Recurrence prevented by daily Chlorhexidine wash
• Frequent handwashing
• Laundering of bedding and clothing
• Bactroban ointment 2x /day
• Rifammpin(600mg) + dicloxacillin (for MSSA)/ Co-trimoxazole (for MRSA) for 10 days
• Clindamycin(150mg) for 3 months