Carbuncle: causes, symptoms, diagnosis, treatment

Carbuncle is an acute, purulent-necrotic inflammation of several hair follicles, the dermis itself and the underlying tissue with the formation of an extensive infiltrate, necrosis. The process has a phlegmonous character and tends to spread.

[ 1 ], [ 2 ], [ 3 ], [ 4 ], [ 5 ], [ 6 ], [ 7 ]

What causes a carbuncle?

The formation of such an abscess and its spread can be caused by many factors: constant exposure to reactive environments that deplete the local resistance of the skin; the nature and intensity of the influencing microflora, the state of the macroorganism that determines the general resistance of the body (immunodeficiency, diabetes, vitamin deficiency, old age of the patient), and most often - inadequate treatment of the primary furuncle.

The localization of carbuncles may vary, except for the palms and soles, but most often carbuncles are observed on the neck, face, in the interscapular, lumbar and gluteal regions. Carbuncles most often develop on the back of the neck and lower back.

How does a carbuncle manifest itself?

The process begins with the development of a primary - "parent" furuncle, which has a malignant course, with the expansion of edema and hyperemia, the involvement of neighboring hair follicles and subcutaneous tissue in the process; manifestations of purulent-resorptive fever. In 3-4 days, "daughter" furuncles are formed around the parent. The purulent-necrotic process progressively expands with the involvement of large areas of skin and subcutaneous tissue. The skin above it becomes thinner and opens with non-slippery holes (like a "honeycomb") with scanty purulent discharge. Necrotic masses are intimately fused with the surrounding tissues and are not rejected. With a spontaneous course, the skin above the abscess necrotizes and the purulent-necrotic area is slowly rejected with the formation of granulations and a rough keloid scar. But such a course is rare. When carbuncles occur, the general condition is usually disrupted, complications such as the development of lymphangitis, lymphadenitis, pyemia and sepsis are possible.

Carbuncles caused by modern microflora are characterized by a "malignant" course: accompanied by tearing pains; development of intoxication syndrome; prone to extensive and rapid spread of the purulent-necrotic process, development of complications - lymphangitis, lymphadenitis, adenophlegmon, sepsis, osteomyelitis, thrombophlebitis, etc. In terms of complications, facial carbuncles are especially dangerous.

Differential diagnostics are carried out with anthrax carbuncle. It develops upon contact with cattle. It is absolutely painless, after spontaneous opening it quickly becomes covered with a black scab.