carbuncle

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Carbuncle
Classification and external resources
Carbuncle on buttock of a diabetic patient
ICD-10	L02
ICD-9	680.9
DiseasesDB	29434
MeSH	D002270

A carbuncle ( /ˈkɑːbʌŋkəl/) is an abscess larger than a boil, usually with one or more openings draining pus onto the skin. It is usually caused by bacterial infection, most commonly Staphylococcus aureus. The infection is contagious and may spread to other areas of the body or other people. ^[1] Because the condition is contagious, family members may develop carbuncles at the same time.

Causes

Often, the direct cause of a carbuncle cannot be determined. Things that make carbuncle infections more likely include friction from clothing or shaving, generally poor hygiene and weakening of immunity. For example, persons with diabetes and immune system diseases are more likely to develop staphylococcal infections.

Presentation

A carbuncle is made up of several skin boils. The infected mass is filled with fluid, pus, and dead tissue. Fluid may drain out of the carbuncle, but sometimes the mass is so deep that it cannot drain on its own. Carbuncles may develop anywhere, but they are most common on the back and the nape of the neck.

The carbuncle may be the size of a pea or as large as a golf ball. It may be red and irritated, and might hurt when touched. It may also grow very fast and have a white or yellow center. It may crust or spread to other skin areas. Sometimes, other symptoms may occur, such as fatigue, fever and a general discomfort or sick feeling. Itching may occur before the carbuncle develops.

Etymology

The word is believed to have originated from the Latin: carbunculus, originally a small coal; diminutive of carbon-, carbo: charcoal or ember, but also a carbuncle stone, "precious stones of a red or fiery colour", usually garnets.^[2]

Treatment

Carbuncles usually must drain before they will heal. This most often occurs on its own in less than two weeks. Placing a warm moist cloth on the carbuncle and soaking the affected area several times each day helps it to drain, which speeds healing. Squeezing the carbuncle, or cutting it open without medical supervision can spread and worsen the infection.

Treatment is needed if the carbuncle lasts longer than two weeks, returns frequently, is located on the spine or the middle of the face, or occurs along with a fever or other symptoms. Treatment helps reduce complications related to an infection. A doctor may prescribe antibacterial soaps and antibiotics applied to the skin or taken by mouth. Deep or large lesions may need to be drained by a health professional. Proper excision by cruciate incision under strict aseptic conditions will treat the condition effectively.

Proper hygiene is very important to prevent the spread of infection. Hands should always be washed thoroughly, preferably with antibacterial soap, after touching a carbuncle. Washcloths and towels should not be shared or reused. Clothing, washcloths, towels, and sheets or other items that contact infected areas should be washed in very hot (preferably boiling) water. Bandages should be changed frequently and thrown away in a tightly-closed bag. If boils/carbuncles recur frequently, daily use of an antibacterial soap or cleanser containing triclosan, triclocarban or chlorhexidine, can suppress staph bacteria on the skin.

Monstrous carbuncle

In 1984 Charles, Prince of Wales famously described the proposed Sainsbury Wing extension to the National Gallery in London as a "monstrous carbuncle on the face of a much-loved and elegant friend",^[3] a term now widely used to describe architecture, particularly modernist architecture, unsympathetic to its surroundings.^[4][5]

References