Carbuncle
Carbuncle is a purulent necrotic inflammation of the deep layers of the dermis (skin itself), hypodermis (subcutaneous fat) with the involvement of several hair follicles and sebaceous glands in the process.
reasons
In most cases, carbuncle occurs as a result of infection with streptococcus, Staphylococcus. In rare cases, the cause may be E. coli, enterococci.
PROVOKING FACTORS
Exogenous:
Superficial injuries, scratches, cuts, burns, scratches, ulcers, maceration, wetness
Hypothermia
Overheating of the body
In childhood, the imperfection of thermoregulation
Endogenous:
Diseases of the endocrine system (diabetes mellitus)
Disorders of the nervous system: neurosis, chronic stress, lack of sleep, depression
Poor nutrition
Diseases of the gastrointestinal tract
Diarrhea, dehydration, repeated vomiting
In childhood – imperfection and immaturity of the stratum corneum of the epidermis
Increased sweating
Allergic diseases (dermatitis, eczema, scabies, pruritus)
FAVORITE LOCALIZATION
Back of the neck
Face
Buttocks
Lower back
Between the shoulder blades
symptoms
At the beginning of development, several dense cone-shaped tubercles form on the skin, which merge into one extensive infiltrate after a couple of days. The skin above the infiltrate is hyperemic, edematous, painful on palpation.
After 8-12 days, the infiltrate increases, takes a spherical shape of a bluish color. Symptoms of general intoxication appear: headache, fever up to 39 degrees, discomfort, weakness, general malaise. After a few days, several pustular elements with tires appear on the infiltrate, then the purulent rods are opened, suppuration with an admixture of blood occurs. The infiltrate looks like a sieve.
Then the necrotic plugs are separated. A deep gaping ulcer forms in place of the carbuncle. In particularly severe cases, the lesion can be up to the muscles. This condition lasts for 2 weeks.
The healing stage lasts a long time, there is a slow granulation of the bottom of the ulcer. Healing can take several weeks. At the site of the ulcer, rough scars are formed, soldered to the surrounding areas. (keloid scar).
With the development of a carbuncle in the nasal area. Meningeal symptoms appear on the upper lip: vomiting, which does not bring relief, rigidity of the occipital muscles, non-canceling headaches.
COMPLICATIONS
Abscess
Myositis
Osteomyelitis
Phlebitis
Thrombophlebitis
Lymphangitis
Erysipelas
Purulent meningitis
diagnostics
Examination by a dermatologist, differential diagnosis of anthrax. Laboratory diagnostics includes bacterial inoculation to determine the pathogen, sensitivity to antibiotics. Computed tomography to exclude a brain abscess, lumbar puncture if purulent meningitis is suspected.
treatment
Symptomatic treatment of intoxication syndrome: antipyretic, heavy drinking, anti-inflammatory, analgesics. Antibacterial therapy with drugs of a wide range of actions: ampicillin, carbenicillin. Local treatment of carbuncle with syntomycin, streptomycin ointment.
In the second stage (necrosis), the carbuncle is subject to surgical treatment. Dissection of tissues, removal of anesthetized tissues, drainage, placement of a hypertensive tampon, or with proteolytics is carried out.
In rehabilitation, a good effect is given by UFOs and UHF in the first stages of carbuncle. In some cases, intravenous laser irradiation of blood is indicated.
In severe cases, patients are hospitalized, infusion therapy, surgical intervention with strong antibiotics is provided.
