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Folliculitis, Furuncles and Carbunculosis

A bacterial infection of the hair follicle, folliculitis causes the formation of a pustule. The infection can be superficial (follicular impetigo or Bockhart's impetigo) or deep (sycosis barbae).

Furuncles, commonly known as boils, are another form of deep folliculitis. Carbuncles are a group of interconnected furuncles. The prognosis depends on the severity of the infection and the patient's physical condition and ability to resist infection.

Causes

The most common cause of folliculitis, furuncles, or carbuncles is coagulase-positive Staphylococcus aureus. Predisposing factors include an infected wound, poor hygiene, debilitation, diabetes, alcoholism, occlusive cosmetics, tight clothes, friction, chafing, incorrect shaving technique, exposure to chemicals, treatment of skin lesions with tar or with occlusive therapy, and immunosuppressive therapy.

Signs and Symptoms

Folliculitis, furuncles, and carbuncles have different signs and symptoms. Folliculitis pustules usually appear on the scalp, arms, and legs in children and on the trunk, buttocks, bearded face and legs in adults. Furuncles are hard, painful nodules that commonly develop on the neck, face, axillae, and buttocks. For several days, these nodules enlarge and then rupture, discharging pus and necrotic material. After the nodules rupture, pain subsides, but erythema and edema may persist for days or weeks. Carbuncles are extremely painful, deep abscesses that drain through multiple openings onto the skin surface, usually around several hair follicles. Fever and malaise may accompany these lesions, which are now rather rare.

Diagnosis

The obvious skin lesion confirms folliculitis, furuncles, or carbuncles. Wound culture usually shows S. aureus. In carbuncles, patient history reveals preexistent furuncles. A complete blood count may show an elevated white blood cell count (leukocytosis).

The differential diagnosis for folliculitis includes pustular miliaria, varicella, and eczema with folliculitis. The differential diagnosis for furuncles includes necrotic herpes simplex and hidradenitis suppurativa.

Treatment

Folliculitis is treated by cleaning the infected area thoroughly with antibacterial soap and water; applying warm, wet compresses to promote vasodilation and drainage from the lesions; applying topical antibiotics, such as mupirocin ointment or clindamycin or erythromycin solution; and, in extensive infection, administering systemic antibiotics (a cephalosporin or dicloxacillin).

Furuncles may require incision and drainage of ripe lesions after application of warm, wet compresses and systemic antibiotics after drainage.

Carbuncles require systemic antibiotic therapy as well as incision and drainage.

Special Considerations and Prevention Tips

Below are some Tips which will help to control the disease and prevent it from getting serious.

Care for folliculitis, furuncles, and carbunculosis is basically supportive and emphasizes teaching the patient scrupulous personal and family hygiene measures. Taking the necessary precautions to prevent spreading infection is also an important part of care.

  • Caution the patient never to squeeze a boil because this may cause it to rupture into surrounding area.
  • To avoid spreading bacteria to family members, urge the patient not to share towels or washcloths.
  • The patient should change clothes and bed sheets daily, and they also should be washed in hot water.
  • Encourage the patient to change dressings frequently and to discard them promptly in paper bags.
  • Advise the patient with recurrent furuncles to have a physical examination because an underlying disease, such as diabetes, may be present.
  • Instruct men to use disposable razors to help decrease the spread of infection.

Mrsa Iinfection

Mucormycosis

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Mycobacterium Avium Complex

Myocarditis

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Nocardiosis

NonspecificGenitourinary Infections

Orbital Cellulitis

Otitis Media

Pelvic-Iflammatory Disease

Perirectal Abscess And Fistula

Pharyngitis

Pneumocystis Carinii Pneumonia

Pneumonia.

Pseudomembranous Enterocolitis

Pseudomonas Infections

Pyelonephritis

Rheumatic Fever And Rheumatic Heart Disease

Saeptic Arthritis

Sore Throat

Sporotrichosis

Stomatitis And- Oher Oral Infection

Tetanus

Toxoplasmosis

Virsa Infection

Yick Paralysis


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