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Carbuncle – this is inflammation, which is concentrated under the skin and is accompanied by suppuration. Several hair follicles suffer in this pathological process at once.
Carbuncles are dangerous complications that they can provoke. Such suppuration on the face is hard. This not only affects the appearance of a person, but also increases the likelihood of 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 transform into a cancerous tumor.
What is a carbuncle?
A carbuncle is an abscess that is located in the area of uXNUMXbuXNUMXbthe hair follicles. At the same time, a focus of necrosis 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.
Carbuncles are characterized by a high growth rate. Sometimes they reach a size of 10 cm and are clusters of several abscesses at once. The skin and tissues in the area of carbuncle formation die off, the purulent-necrotic process cannot be started, since it progresses very quickly. This is the reason for contacting a specialist.
If a person suffers from diabetes mellitus or from another chronic disease, then the risks of carbuncle malignancy increase. It also increases the likelihood of bleeding and sepsis.
Types of carbuncles and their symptoms
Depending on which 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 do not get infected with this type of carbunculosis.
Purulent. This type of carbuncle is diagnosed more often than others.
anthrax. The symptoms of this disorder are very specific. Such carbuncles can occur both in humans and in animals (domestic and wild).
Plague. Pathology is rarely detected. The causative agent is the plague bacillus.
Emphysematous carbuncle
This disease is provoked by a bacterial flora from the Clostridium class, namely Clostridium chauvoei. Most often, artiodactyl animals suffer from emphysematous carbuncles; in humans, the disease is practically not diagnosed. When cattle are affected, 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 frequently. A person has suppuration of the epidermis and fiber that surrounds the sebaceous glands and hair follicles. Single carbuncles tend to merge into large foci, forming an infiltrate.
This kind of disease often requires the help of a surgeon, as it threatens the development of serious complications.
anthrax carbuncle
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 which contains a reddish liquid. Sampling of the contents from the pustule for bacterial culture reveals anthrax.
After some time, 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. These vesicles also contain liquid. The tissue surrounding the carbuncle swells and then dies.
Inflammation develops under the influence of toxins that bacteria secrete. They provoke malnutrition of tissues. Edema increases in the affected area, and then necrosis occurs.
Symptoms of anthrax infection:
Pain in the affected area is barely perceptible, or absent altogether.
After opening the papule, a scab begins to form instead.
New blisters 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.
Symptoms of the disease:
Intense pain.
Significant swelling.
Suppuration. There will be a lot of pus in the affected area.
Tissue necrosis.
Causes of carbuncle
Carbuncles appear due to the fault of pathogenic flora that affects a living organism. It can be staphylococci, streptococci, E. coli, etc.
In order for an infectious agent to enter the hair follicle and suppuration occurs, the body must be affected immediately by one or more pathological factors, including:
Excessive activity of the sebaceous glands or sweat glands
Contamination of the skin with certain substances (coal, sand, cement).
Skin injury.
Staphylococcal carbuncle is formed due to the fault of staphylococci. Human beings are the source of infection. Staphylococci are opportunistic pathogens. This means that up to 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. Inside the tissues, the pathogenic flora penetrates through small lesions on the dermis.
Anthrax carbuncle is a contagious disease. The infection is spread by contact. A person can become infected from domestic animals, for example, from a pig, goat or cow. Ulcer spores penetrate through injured skin, less often mucous membranes become gates for infection. Pathogenic flora quickly spreads throughout the body, affecting the lymph nodes. This causes them to become inflamed.
Risk factors that can provoke carbunculosis:
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.
Depletion of the body.
Psychological overload.
Common symptoms of carbuncle
A person with carbunculosis will experience both local and general symptoms.
Local symptoms include:
Formation of a red knot on the skin. It grows in size very quickly. When you press it, a person experiences pain.
The tissues that surround this node swell strongly, become hot to the touch, acquire a red or bluish tint.
On the 5th-8th day, the symptoms intensify. The abscess strongly swells and responds with intense pain on palpation.
Starting from 8-12 days, whitish abscesses form in the middle of the carbuncle. The pain is throbbing, so you can not touch these neoplasms.
The plugs open on their own, purulent masses flow out of them. They can have a different color: yellow, green, milky. Sometimes there is blood in the pus.
After the pus is completely released, the skin and tissues in the area of uXNUMXbuXNUMXbinflammation begin to die off. The dermis becomes black, covered with ulcerative defects.
When necrosis is completed, 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:
Increase in body temperature.
Increased heart rate.
Nausea.
Lack of appetite.
Weakness.
Stages and localizations of the carbuncle
There are 3 stages of carbuncle:
Infiltrate. During this period, nodes form under the skin, which will be represented by inflamed hair follicles. The infiltrate contains adipose tissue, pus, lymph and lymphocytes. Nodules rise above the surface of the skin. Since the nutrition of the dermis is disturbed, it acquires a cyanotic color. After a few days (from 9 to 12), the infiltrate reaches an impressive size. In diameter, it can be about 10 cm. The skin is edematous, stretched, hot to the touch. The pain will be more intense, the more swelling.
Purulent education. At the stage of suppuration, the carbuncle reaches maturity. Bubbles form on it, which are filled with pus. They open, so the surface of the carbuncle resembles a sieve. Pus seeps through these small holes, mixed with blood and dead epithelium. The stage of suppuration lasts about 14-21 days. During this period, the general well-being of the patient worsens.
Necrosis and tissue rejection. During this period, 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. Tissue damage is very intense and often captures the 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 on various parts of the body:
Head. Sometimes carbuncles appear on the face, in the place where the acne was previously. Another favorite place for the localization of the abscess is the back of the neck.
Корпус. Often, carbuncles grow in the armpit, which is the result of an undertreated axillary boil.
lower half of the body. A carbuncle can form in the inguinal zone, in the perineum. The reason for its formation is an abscess, which was squeezed out without observing the rules of asepsis.
Most often, carbuncles are formed on the face, provoked by staphylococcal flora. Anthrax carbuncle can form on the body and on the 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 to the patient such diagnostic studies as:
Bacterial analysis of material taken from an abscess.
Blood analysis. This allows you to assess the degree of intensity of the inflammatory process.
Blood test to determine the level of sugar. Carbuncles often form in people with diabetes. To prevent relapses of suppuration, it is necessary to direct efforts to treat the underlying disease.
Microbiological blood test to rule out sepsis.
Which doctor treats carbuncle?
When the first signs of 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 carbuncles occur regularly in a patient, consultation with an immunologist is required. To cope with the disease, you need to find out the causes of its occurrence. In addition to these 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, a woman should visit a gynecologist.
Carbuncle treatment
Goals to be achieved during carbuncle therapy:
Approach the time of ripening of the abscess.
Do not allow purulent masses to spread to nearby tissues and organs.
Remove the central part of 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 body, then the treatment is carried out at home. Specific recommendations depend on the stage of the abscess. Provided that the person turned to the doctor before the point in time until a purulent-necrotic focus has formed, there is the possibility of drug correction. The mainstay of treatment is antibiotics.
Inpatient therapy is indicated for patients at a late stage of the disease, when there is already a focus of necrosis. Such patients require surgery. It is carried out on an emergency basis, if the disease is severe, the abscess is large, located on the face. When the main symptoms of the disease are eliminated and the person’s health returns to normal, he will be prescribed physiotherapy treatment.
Patients will receive antibiotics throughout their stay in the hospital.
Therapeutic treatment
You can limit yourself to therapeutic methods in the following situations:
The carbuncle is small, it is formed away from the brain, that is, on the trunk, on the limbs, on the buttocks, etc.
A person does not develop complications of carbuncle.
Cosmetic aspect. The fact is that after surgery, a scar will remain on the skin.
Physiotherapeutic procedures
Physiotherapy can speed up 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. Swelling, inflammation and pain will go away faster.
Physiotherapy methods that are applicable for carbunculosis:
Laser therapy Laser treatment of the skin allows you to 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
Sanitation of the focus of inflammation is carried out according to the following algorithm:
Necrotic masses are removed from the focus of inflammation every day. Perform this procedure during dressing.
The physiotherapeutic method of treatment involves the treatment of the wound with low-frequency ultrasonic cavitation using ozone. This allows you to qualitatively and painlessly clean the focus of inflammation.
Other methods of local treatment are reduced to the following procedures:
The imposition of medical bandages. They may contain various ointments that accelerate the maturation of the abscess. Such methods of treatment were actively used in wartime, but due to their high efficiency, they have not lost their relevance today.
Injection of the inflamed area with antibacterial and analgesic drugs.
Dressing with proteolytic enzymes. They disinfect the affected areas and accelerate tissue rejection.
Medical correction
If drug treatment 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 under the influence of antibiotics will simply resolve. In a hospital setting, the doctor may prescribe a number of drugs: antibacterial agents, anti-inflammatory drugs, NSAIDs, antiplatelet drugs, and others.
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 delay with surgical help if the patient’s health deteriorates rapidly and the disease progresses.
Depending on the area of the surgical field and the complexity of the operation, it can be performed under general or local anesthesia.
The progress of its implementation:
Dissection of the infiltrate and removal of purulent masses.
Treatment of the wound with antiseptic agents, setting up a drain to remove accumulated exudate.
Wound cleansing, treatment with anti-inflammatory drugs and healing agents.
The operation rarely lasts more than an hour. After it is carried out, the patient remains in the hospital, receives the necessary drugs, and undergoes physiotherapy. The 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 sooner treatment is started, the better 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 the person’s health deteriorates sharply, and the carbuncle quickly necrotizes, the patient is sent for surgery. It is mandatory to surgically remove the carbuncle, which is caused by anthrax.
If immediately after the appearance of an abscess, a person receives quality care, then the complications of the carbuncle will not develop.
Basic treatment recommendations:
Wipe the affected area with alcohol.
Apply a bandage with Vishnevsky’s ointment to the carbuncle.
Contact a surgeon.