Carbuncle : A skin infection in diabetics

A carbuncle is a confluent mass of furuncles and is characterized by painful, red, indurated swelling which becomes pustular and necrotic and the pus discharges from multiple opening. It is almost similar to boil of furuncle but the only difference is there is mutiple pus point here.

Causes and features of carbuncles

Carbuncles is also caused by a bacterial infection Staphylococcus aureus as in boils. In fact is may be considered as a more severe or chronic form of a boil. The constitutional symptoms like feverand pain may be moderate to severe. There is local tenderness at the site and fever may sometimes be swinging associated with chill.

Carbuncles sometimes if left untreated may get worse and the infection may spread via bloodstream and may cause septicemia or the infection of the blood. Now a days the resistant variety of Staphylococcus called meticillin resistant Staph aureus (MRSA) is more responsible for causing carbuncle.

Common sites involved in carbuncle

As in boils the hairy part is the most common site for carbuncle too, but more than axillae it is present on the back, nape of skin and buttocks. Face is rare part where carbuncle can occur as the acne is less present in a person with diabetes causing carbuncle in comparison to a boil. The lesion of carbuncle heals slowly by granulation and scar formation.

Factors responsible for formation of carbuncle

One factor which is almost always a culprit is diabetics. Carbuncle is the common skin infection in diabetics as the diabetics are more prone to infections. A diabetic having mild abrasion or cut can end up forming a painful carbuncle if not treated early. Immunosuppressive drugs or corticosteroids are also responsible as they suppress the immune system of the body and make the skin more prone to infection. Other skin lesions like dermatitis or fungal infection can lead to a secondary bacterial infection causing carbuncles in an immunocompromised or diabetic patients. Other factors responsible are poor hygiene, malnutrition and obesity.

Diagnosis of Carbuncle

A pustular skin lesion with multiple pus points and necrotic lesion. There may be a history of immunosuppressive drug intake or corticosteroid intake. Diabetes is present in most of the cases and the level of blood sugar should be checked as the controlled sugar level may help in quick healing. Pus culture and sensitivity test is done which reveals the bacteria causing infection and the drug on which it is sensitive.

Treatment is antibiotics with some vitamins supplements, control of sugar level and symptomatic drugs for constitutional symptoms. Details is given at Treatment and Prevention of boil and carbuncles.



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