1. Furuncles/Carbuncles
Non-scaly Nodules
Furuncles/Carbuncles

2. What is it?
(Boil) an acute, round , tender, circumscribed, perifollicular staphylococcal abscess, that ends in central suppuration

3. Furuncle

4. Carbuncle

5. Causative agent Staphylococcus aureus Gram (+) cocci
Skin flora (20-40% adults are nasal carriers)
Causes a wide range of illness
Spreads by physical contact

6. Some disappear before rupture
Most undergo central necrosis and rupture, discharging purulent material and necrotic debris
Common sites; nape, axillae, and buttocks

7. Risk factors/Predisposing factors
Disruption of skin integrity
Alcoholism
Malnutrition
Blood dyscrasia
Immunosuppression
Drug-resistant Staph.
Improper Handwashing

8. 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
Penicillinase resistant penicillin; Cloxacillin, Dicloxacillin, Methicillin, Nafcillin, Oxacillin
1st gen. Cephalosporin;
Surgery for localized fluctuating furuncle or if antibiotic therapy fails. Afterwards Bactroban should be applied or another antibiotic taken internally

9. 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.
Autoinoculation especially is nasal carriers

10. 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