Carbuncle - Causes, Stages And Treatment

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Carbuncle: how to treat?

A carbuncle is an inflammation that is concentrated under the skin and is accompanied by suppuration. Several hair follicles suffer from this pathological process at once.

Carbuncles are dangerous complications that they can provoke. Such suppuration on the face is difficult. This not only affects the person's appearance, but also increases the likelihood of the infection spreading through the skull. Therefore, treatment should be started as early as possible. If therapy is carried out with the wrong methods, then the carbuncle can be transformed into a cancerous tumor.

Content:

• What is a carbuncle?
• Types of carbuncles and their symptoms
• Causes of the carbuncle
• Common symptoms of carbuncle
• Stages and localization of the carbuncle
• Diagnostics
• Which doctor treats carbuncle?
• Carbuncle treatment
• First aid
• Disease prevention
• Disease prevention

What is a carbuncle?

A carbuncle is an abscess that is located in the area of the hair follicles. At the same time, a necrosis focus is formed on the skin. When the dead area of the dermis comes off, an ulcer forms under it. It can be quite deep. Muscles are often affected.

Uglevik - this is the old Russian name for carbuncle. The abscess got it because of the rich dark color. In translation, the word "karbo" means coal.

Carbuncles are characterized by a high growth rate. Sometimes they reach 10 cm in size and are accumulations of several abscesses at once. The skin and tissues in the area of carbuncle formation dies off, the purulent-necrotic process cannot be started, since it progresses very quickly. This is the reason for contacting a specialist.

The boil and carbuncle characterize two different inflammatory processes. With a carbuncle, the affected area is much wider. The deep layers of the dermis are exposed to necrosis and suppuration.

If a person suffers from diabetes mellitus or from another chronic disease, then the risks of malignancy of the carbuncle increase. The likelihood of bleeding and sepsis also increases.

Types of carbuncles and their symptoms

Depending on what kind of flora caused the formation of the carbuncle, the following types of suppuration are distinguished:

• Emphysematous. The disease has an acute course. Only cattle suffer from such carbuncles. People are not infected with this type of carbunculosis.
• Purulent. This type of carbuncles is diagnosed more often than others.
• Anthrax. The symptoms of this disorder are very specific. Such carbuncles can occur in both humans and animals (domestic and wild).
• Plague. Pathology is rarely detected. The causative agent is the plague stick.

Emphysematous carbuncle

This disease is triggered by a bacterial flora from the Clostridium class, namely Clostridium chauvoei. Most often, artiodactyl animals suffer from emphysematous carbuncles, the disease is practically not diagnosed in humans. When cattle are damaged, tumors are palpated in their muscles, emitting a specific crunch.

Most often, the disease is found in young animals. In most cases, carbuncles lead to the death of individuals. The peak incidence occurs in summer and autumn.

Purulent carbuncle

Most often, people have a purulent carbuncle, provoked by Staphylococcus aureus. Other pathogenic flora causes inflammation less often. A person develops suppuration of the epidermis and tissue that surrounds the sebaceous glands and hair follicles. Single carbuncles tend to merge into large foci, forming an infiltration.

This type of disease often requires the help of a surgeon, as it threatens the development of serious complications.

Anthrax carbuncle

The anthrax carbuncle looks like a small red pimple that itches all the time. After 2 days, a pustule forms at the site of the lesion. It looks like a bubble, inside of which there is a reddish liquid. The collection of contents from the pustule for bacterial inoculation allows the identification of anthrax bacilli.

After a while, the bubble opens, a crust forms on its surface. The scab darkens quickly. After a few hours, the crust becomes hard and completely black, new small bubbles appear around it. There is also liquid inside these bubbles. The tissues surrounding the carbuncle swell and then die off.

Inflammation develops under the influence of toxins that bacteria release. They provoke tissue malnutrition. Edema grows in the affected area, and then necrosis occurs.

Symptoms of an anthrax infection:

• Pain in the affected area is barely perceptible, or absent altogether.
• After opening the papule, a scab begins to form instead.
• New bubbles appear around the scab.
• There is no pus in the affected area.

• The site of inflammation loses its former sensitivity, the skin in this area becomes numb.

Plague Carbuncle

A plague carbuncle forms on the part of the body that has been affected by the plague pathogen.

Disease symptoms:

• Intense pain.
• Significant swelling.
• Suppuration. There will be a lot of pus in the affected area.
• Tissue necrosis.

Causes of the carbuncle

Carbuncles appear due to the fault of pathogenic flora that affects a living organism. These can be staphylococci, streptococci, Escherichia coli, etc.

In order for an infectious agent to enter the hair follicle and suppuration occurs, one or more pathological factors must immediately affect the body, including:

• Excessive activity of the sebaceous glands or sweat glands
• Contamination of the skin with certain substances (coal, sand, cement).
• Skin trauma.

Staphylococcal carbuncle is formed through the fault of staphylococci. The source of the spread of infection is a person. Staphylococci are conditionally pathogenic flora. This means that until a certain point in time they will peacefully exist on human skin without causing any harm to the body. Bacteria are activated after the immune system fails. The pathogenic flora penetrates into the tissues through small lesions on the dermis.

Anthrax carbuncle is a contagious disease. The infection spreads by contact. A person can get infected from pets, such as a pig, goat, or cow. Spores of the ulcer penetrate through the injured skin, less often the mucous membranes become the gateway for infection. Pathogenic flora quickly spreads throughout the body, affecting the lymph nodes. This leads to their inflammation.

Risk factors that can provoke carbunculosis:

• A decrease in the body's defenses, which often occurs after an illness.
• The presence in the body of a chronic focus of infection.
• Lack of vitamins.
• Anemia.
• Diabetes mellitus and other metabolic disorders.
• Exhaustion of the body.
• Psychological overload.

Common symptoms of carbuncle

A person with carbunculosis will develop both local and general symptoms.

Local symptoms include:

• Formation of a red knot on the skin. It grows in size very quickly. When you click on it, a person experiences painful sensations.
• The tissues that surround this knot swell a lot, become hot to the touch, and acquire a red or bluish tint.
• On days 5-8, the symptoms worsen. The abscess swells strongly and responds with intense pain on palpation.
• Starting from 8-12 days, whitish abscesses form in the middle of the carbuncle. The pain is pulsating, so you cannot touch these neoplasms.
• The plugs open on their own, purulent masses flow out of them. They can have different colors: yellow, green, milky. Sometimes blood is present in the pus.
• After the pus is completely gone, the skin and tissues in the area of inflammation begin to die off. The dermis becomes black, covered with ulcerative defects.
• When the necrosis is complete, an ulcer forms in the inflamed area. Its edges are not clear, the bottom is grayish. As it recovers, it tightens, becoming covered with granulation tissue.
• In the place where the carbuncle used to be, a scar is formed.

Common symptoms of the disease include:

• Increased body temperature.
• Increased heart rate.
• Nausea.
• Lack of appetite.
• Weakness.

If a carbuncle forms on the face, then its symptoms will be much more intense.

Stages and localization of the carbuncle

There are 3 stages of the carbuncle:

1. Infiltrate. During this period, nodes are formed under the skin, which will be represented by inflamed hair follicles. The infiltrate contains adipose tissue, pus, lymph and lymphocytes. The nodules rise above the surface of the skin. Since the nutrition of the dermis is disturbed, it acquires a bluish color. After a few days (from 9 to 12), the infiltration reaches impressive sizes. In diameter, it can be about 10 cm. The skin is swollen, taut, hot to the touch. The more swelling, the more intense the pain.
2. Purulent education. At the stage of suppuration, the carbuncle reaches maturity. Bubbles are formed on it, which are filled with pus. They open, so the surface of the carbuncle resembles a sieve. Pus, mixed with blood and dead epithelium, seeps through these small holes. The suppuration stage lasts about 14-21 days. During this period, the patient's general well-being worsens.
3. Necrosis and tissue rejection. During this period, the pus from the carbuncle ceases to ooze. At the site of inflammation, ulcers are formed, which will have rods. They merge with each other, forming one large defect. The tissue damage is very intense and often involves muscles. This area is black. The wound heals slowly, gradually filling with granulations. A scar remains in its place. The necrosis stage lasts about 21 days.

A carbuncle can form in various parts of the body:

• Head. Sometimes carbuncles appear on the face, in the place where the acne was previously. Another favorite place for localization of the abscess is the back of the neck.
• Housing. Often carbuncles grow in the armpit, which is the result of an underamed axillary boil.
• Lower half of the body. A carbuncle can form in the groin area, in the perineum. The cause of its formation is an abscess, which was squeezed out without observing the rules of asepsis.

Carbuncles, which are located on the lips, chin and nose, are especially dangerous.

Most often, carbuncles are formed on the face, provoked by staphylococcal flora. An anthrax carbuncle can form on the body and mucous membranes (in the nose and mouth).

Diagnostics

It is enough for the doctor to examine the patient to make a diagnosis.

To clarify the nature of inflammation, the doctor recommends the patient such diagnostic tests as:

• Bacterial analysis of material taken from the abscess.
• Blood test. This allows you to assess the degree of intensity of the inflammatory process.
• Blood test to determine the level of sugar. Often carbuncles are formed in people with diabetes. To prevent relapses of suppuration, efforts should be made to treat the underlying disease.
• Microbiological blood test, which will eliminate sepsis.

Which doctor treats carbuncle?

When the first signs of a carbuncle appear, you need to visit a dermatologist. If it is not possible to cope with the inflammation, then the help of a surgeon is required.

When a patient has carbuncles regularly, an immunologist's consultation is required. To cope with a disease, you need to find out the causes of its occurrence. In addition to the listed specialists, the patient may need to consult an endocrinologist, oncologist, hematologist, etc.

Depending on where exactly the carbuncle is formed, you need to choose a narrow specialist. If it is located near the ear, then the help of an otolaryngologist is required. When the carbuncle is concentrated in the groin, the woman should visit the gynecologist.

Carbuncle treatment

Goals to be achieved during carbuncle therapy:

• Approximate the ripening time of the abscess.
• Prevent purulent masses from spreading to nearby tissues and organs.
• Remove the central part of the suppuration and thoroughly clean the ulcer from dead tissue.
• Do not allow the bacterial flora to cause severe intoxication of the body.
• Direct efforts to prevent complications of the disease.

If the carbuncle is small and is located on the arms, legs or on the body, then the treatment is carried out at home. Specific recommendations depend on the stage of the abscess. Provided that a person has consulted a doctor before a purulent-necrotic focus has formed, there is a possibility of drug correction. Antibiotics form the basis of treatment.

Inpatient therapy is indicated for patients at a late stage of the disease, when there is already a focus of necrosis. These patients require surgery. It is carried out on an emergency basis, if the disease has a severe course, the abscess is large, located on the face. When the main symptoms of the disease are eliminated and the person's well-being returns to normal, he will be prescribed physiotherapy treatment.

During the entire stay in the hospital, the patient will need to receive antibiotics.

Therapeutic treatment

You can limit yourself to therapeutic methods in the following situations:

• The carbuncle is small in size, it forms far from the brain, that is, on the trunk, on the limbs, on the buttocks, etc.
• The person does not develop complications of the carbuncle.
• Consideration of the cosmetic aspect. The fact is that after surgery, a scar will remain on the skin.

Physiotherapy procedures. Physical therapy can speed up your recovery. These treatments are applicable at any stage of the inflammatory process. Thanks to this approach, it is possible to improve tissue nutrition and increase the speed of regenerative processes. The swelling, inflammatory reaction and pain will go away faster.

Physiotherapy methods that are applicable for carbunculosis:

• Laser therapy. Laser treatment of the skin can increase immunity at the local level, as well as reduce the number of pathogenic microorganisms.
• Magnetotherapy. This method helps to accelerate metabolic processes in tissues.
• UHF. Under the influence of electromagnetic impulses, lymph and blood begin to flow faster, so the waste products of the pathogenic flora are excreted from the body without having time to cause significant harm to it.

Local treatment. Rehabilitation of the inflammation focus is carried out according to the following algorithm:

• Necrotic masses are removed from the focus of inflammation every day. This procedure is performed during dressing.
• Physiotherapeutic method of treatment involves treating the wound with low-frequency ultrasonic cavitation using ozone. This allows you to qualitatively and painlessly clean the inflammation focus.

Other topical treatments include the following:

• The imposition of medical bandages. They may contain Liniment synthomycin, Dioxidin solution (concentration up to 30%), Ichthyol ointment, Vishnevsky ointment. Such dressings allow to accelerate the maturation of the abscess and draw out the purulent masses closer to the surface. Such methods of treatment were actively used in wartime, but in view of their high efficiency, they have not lost their relevance today.
• Injecting the inflamed area with antibacterial and anesthetic drugs. In the latter case, Novocaine is used.
• Applying a bandage with proteolytic enzymes. They disinfect the affected areas and accelerate tissue rejection. For this purpose, drugs such as Chymotrypsin, Trypsin, Bromeamine, Streptokinase, Collagenase, and pancreatic ribonuclease are used.

Medication correction

If treatment with medications is started at an early stage of the development of the disease, then this will allow you to cope with the carbuncle without the help of a surgeon. The formed infiltrate will simply dissolve under the influence of antibiotics. Drugs that can be used for treatment:

• Antibacterial agents. Intramuscular administration of Ampicillin, Gentamicin or other antibacterial drug is indicated. First, the doctor recommends a broad-spectrum antibiotic for use. If it is not possible to cope with the carbuncle with its help, then a bacteriological study is required. After determining the sensitivity of the pathogenic flora to a specific drug, they are treated with it.
• Preparations for relieving inflammation: Ibuprofen, Analgin, Paracetamol.
• Pain relievers: Ketonal, Ketanov, Nise.
• Vitamins.
• Blood thinners: Trental, Pentoxifylline, Thrombo Ass.
• Drugs that accelerate the rejection of areas of necrosis: Retasol, Skinoren, Akriderm SK.
• Preparations that allow you to remove toxins from the body: Legalon, Zorex, Duphalac, Agri.
• Preparations for tissue healing: Contractubex, Dermatiks. They are used for severe cicatricial changes.

Surgery

The operation is indicated for patients in the case when the carbuncle is large, areas of necrosis are formed, suppuration is extensive, and its separation is difficult. It is impossible to hesitate with surgical help if the patient's state of health is rapidly deteriorating and the disease progresses.

If a carbuncle forms on the head, on the neck or in the armpit, then the help of the surgeon to the patient is required without fail.

Depending on the area of the surgical site and the complexity of the operation, it can be performed under general and local anesthesia.

Implementation progress:

• Dissection of the infiltrate and removal of purulent masses.
• Treatment of the wound with antiseptic agents, setting up drainage to remove accumulated exudate.
• Cleansing wounds, treatment with anti-inflammatory drugs and healing agents.

The operation rarely takes more than an hour. After it, the patient remains in the hospital, receives the necessary drugs, undergoes physiotherapy. His bandages are changed every day. During the rehabilitation period, you will need to follow a diet. As a rule, the patient begins to feel better immediately after opening and removing the carbuncle.

First aid

The earlier treatment is started, the more favorable the prognosis. In this case, it will be possible to get rid of the carbuncle without the help of a surgeon. Therapy will be limited to antibiotic therapy and anti-inflammatory drugs.

Provided that a person's health deteriorates sharply, and the carbuncle quickly necrotizes, the patient is referred for surgery. Without fail, the carbuncle, which is caused by anthrax, is surgically removed.

If, immediately after the appearance of the abscess, a person receives high-quality help, then complications of the carbuncle will not develop.

Basic treatment recommendations:

• Wipe the affected area with alcohol.
• Apply a bandage with Vishnevsky ointment to the carbuncle.
• Consult a surgeon.

If the symptoms of the disease progress rapidly and the state of health deteriorates sharply, you need to call an ambulance.

Complications and consequences

Pus is constantly forming in the carbuncle cavity. The larger the abscess, the more intense the inflammatory process will be. The infection affects deep tissues and can enter the bloodstream and lymphatic tract.

If a person's immunity is weakened by chronic diseases, then a carbuncle can lead to complications such as:

• Thrombophlebitis.
• Erysipelas.
• Damage to the integrity of blood vessels and the development of bleeding.
• Osteomyelitis
• Abscess.
• Inflammation of the brain.
• Phlebitis.

If a person develops sepsis, then the likelihood of his death increases.

Disease prevention

To prevent the formation of a carbuncle, you need to adhere to the following recommendations:

• Do not neglect the rules of personal hygiene, wear clean linen, regularly change the bed. Take a shower every day. It is necessary to wash in the morning and in the evening. Areas of increased friction must be cared for with great care. This applies to the back of the body, armpits, etc. If a person sweats a lot, rinse more often. It is not always necessary to use soap. Sometimes just taking a shower is enough.
• If a person is forced to be in unsanitary conditions, it is necessary to avoid touching the face, neck and other vulnerable parts of the body with the hands. When the opportunity arises, you need to take a shower.
• Do not squeeze out acne and other abscesses. If there was a wound on the body that was combed, you need to treat it with an antiseptic and cover it with a plaster. This will prevent bacteria from entering the wound.
• It is necessary to increase the body's defenses, rest more, and avoid nervous overstrain. It is important to follow the daily routine.
• Vitamins must be taken in winter and spring. During this period, you should eat citrus fruits, fresh fruits and vegetables.
• If there is a risk of developing carbuncles due to health conditions, then it is recommended to use antibacterial soap.

People prone to carbunculosis 4 times a year need to visit a doctor and take a blood test. This applies to patients with diabetes mellitus, persons suffering from obesity and excessive sweating.

Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist

Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".