What is a Carbuncle?
Carbuncle is a common purulent-necrotic inflammation of the deep layers of the skin and subcutaneous layer with simultaneous damage to several hair follicles located next to each other at once. Compared with a boil, purulent-necrotic infiltrate with carbuncle is located on a larger area of the skin and captures its deeper layers. The name of the disease is of Greek origin, translated into Russian means “carbohydrate” due to the formation of large areas of necrotic molten skin of a dark color. Carbuncle most often located on the back, lower back. The causative agent of this disease is mainly Staphylococcus aureus.
Pathogenesis during Carbuncle
As a rule, general severe conditions of the body, hypotrophy caused by chronic malnutrition, and diabetes mellitus predispose to the disease with carbuncle.
Symptoms of Carbuncle
The carbuncle begins to develop with the appearance of several nodules of dense consistency, located separately from each other. Further, these nodules form one extensive infiltrate, which is prone to increase. It takes on a hemispherical shape, skin tension builds up, its color becomes cyanotic, marked soreness is noted. All these symptoms constitute the first stage of the development of infiltrate, which lasts 8-12 days.
At the end of this stage, several pustules form in the infiltrate, which open up with the formation of several holes at once, from which pus with necrotic masses of green color and an admixture of blood is secreted. As a result of rejection of a large number of molten tissues, a deep ulcer forms, which sometimes reaches the muscle. This is the second stage, which is called the stage of suppuration and necrosis. Its duration is 14-20 days. Subsequently, the ulcer is filled with granulations with the formation of a deep coarse scar that is fused to the lower tissues.
The same large scars form after surgical operations performed on the carbuncle. Carbuncles are more often solitary. Common symptoms that accompany the carbuncle are characteristic. This is a high fever, chills, malaise. In the area of the pathological focus, patients feel tearing and tugging painful pains. Particularly dangerous carbuncles are in old age, in patients with diabetes mellitus, with exhaustion. In these cases, the course of the disease becomes malignant. This is expressed in deep prostration and septic fever.
When a large vessel is melted, profuse bleeding opens, which leads to death. The same outcome can be with the development of sepsis and severe meningeal complications (in cases of the location of the carbuncle in the nose and nasolabial triangle).
A typical diagnosis is easy to make. Differential diagnosis is carried out with a boil, anthrax carbuncle, in which a specific pathogen is released – anthrax bacillus.
The treatment is almost the same as with a boil. Antibacterial drugs are prescribed, mainly antibiotics and sulfonamides. It is advisable to select antibiotics according to the sensitivity of the selected pathogen to them. Surgical methods of treatment are often used, which include excision of necrotic tissue with mandatory disinfection of the skin around the pathological focus with 2% camphor or salicylic alcohol twice a day, an alcoholic solution of iodine, Castellani liquid.
The prognosis is mostly favorable, but much depends on the body’s resistance, age, location of the outbreak, and the presence of concomitant diseases.