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Carbuncle: causes, symptoms, diagnosis, treatment
Last reviewed: 23.04.2024
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[What causes carbuncle?
The reasons for the formation of such an abscess and its spread can be a number of factors: the constant impact of reactive media that deplete local skin resistance; the nature and strain of the influencing microflora, the state of the macroorganism that determines the general resistance of the organism (immunodeficiency, diabetes, beriberi, elderly patient), and more often - inadequate treatment of the primary boil.
The localization of carbuncles can be different, except for the palms and soles, but most often carbuncles are observed on the neck, face, in the interblade, lumbar and gluteal regions. Carbuncles often develop on the back of the neck and lower back.
How does carbuncle manifest?
The process begins with the development of the primary "mother" 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. After 3-4 days around the parent formed "daughter" furuncles. The purulent-necrotic process progressively expands with the involvement of large areas of the skin and subcutaneous tissue. The skin above it is thinned and opened by non-slip holes (like "honeycomb") with a scant purulent discharge. Necrotic masses are intimately intertwined with surrounding tissues and are not rejected. With spontaneous flow, the skin over the abscess is necrotic and the purulent-necrotic area is slowly torn off with the formation of granulations and a coarse keloid scar. But such a flow is rare. When a carbuncle occurs, the general condition is usually disturbed, complications in the form of development of lymphangitis, lymphadenitis, peeemia and sepsis are possible.
Carbuncles caused by a modern microflora are distinguished by a "malignant" course: they are accompanied by tearing pains; development of intoxication syndrome; are prone to extensive and rapid spread of purulent-necrotic process, the development of complications - lymphangitis, lymphadenitis, adenophlegmons, sepsis, osteomyelitis, thrombophlebitis, etc. On complications, carbuncles of the face are especially dangerous.
Differential diagnosis is carried out with an anthrax carbuncle. It develops on contact with cattle. It is absolutely painless, after self-opening is quickly covered with a black scab.