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Carbuncle

Definition

A carbuncle is a skin infection that often involves a group of hair follicles. The infected material forms a lump, which occurs deep in the skin and may contain pus.

When a person has many carbuncles, the condition is called carbunculosis.

Alternative Names

Skin infection - staphylococcal; Infection - skin - staph; Staph skin infection; Carbunculosis; Boil

Causes

Most carbuncles are caused by the bacteria Staphylococcus aureus. The infection is contagious. This means it can spread to other areas of the body or other people.

A carbuncle is made up of several skin boils (furuncles). The infected mass is filled with fluid, pus, and dead tissue. Fluid may drain out of the carbuncle, but sometimes the mass is so deep that it cannot drain on its own.

Carbuncles can develop anywhere. But they are most common on the back and the nape of the neck. Men get carbuncles more often than women.

Because the bacteria that causes the condition is contagious, family members may develop carbuncles at the same time. Often, the cause of a carbuncle cannot be determined.

You are more likely to get a carbuncle if you have:

  • Friction from clothing or shaving
  • Poor hygiene
  • Poor overall health

Persons with diabetes, dermatitis, and a weakened immune system are more likely to develop staph infections that can cause carbuncles.

Symptoms

A carbuncle is a swollen lump or mass under the skin. It may be the size of a pea or as large as a golf ball. The carbuncle may be red and irritated and might hurt when you touch it.

It may also:

  • Grow very fast
  • Have a white or yellow center (contain pus)
  • Weep, ooze, or crust
  • Spread to other skin areas

Sometimes, other symptoms may occur. These may include:

  • Fatigue
  • Fever
  • General discomfort or sick feeling
  • Skin itching before the carbuncle develops

Exams and Tests

The health care provider will look at your skin. The diagnosis is based on what the skin looks like. A sample of the pus may be sent to a lab to determine the bacteria causing the infection (bacterial culture). The test result helps your provider determine the appropriate treatment.

Treatment

Carbuncles usually must drain before they will heal. This most often occurs on its own in less than 2 weeks.

Placing a warm moist cloth on the carbuncle helps it to drain, which speeds healing. Apply a clean, warm moist cloth several times each day. Never squeeze a boil or try to cut it open at home, because this can spread the infection and make it worse.

You need to seek treatment if the carbuncle:

  • Lasts longer than 2 weeks
  • Returns frequently
  • Is located on the spine or the middle of the face
  • Occurs with a fever or other systemic symptoms

Treatment helps reduce complications related to an infection.Your provider may prescribe:

  • Antibacterial soaps
  • Antibiotics applied to the skin or taken by mouth

Deep or large lesions may need to be drained by your provider.

Proper hygiene is very important to prevent the spread of infection.

  • Wash your hands thoroughly with soap and warm water after touching a carbuncle.
  • Do not re-use or share washcloths or towels. This can cause the infection to spread.
  • Clothing, washcloths, towels, and sheets or other items that contact infected areas should be washed in very hot (preferably boiling) water.
  • Bandages should be changed often and thrown away in a bag that can be tightly closed.

Outlook (Prognosis)

Carbuncles may heal on their own. Others usually respond well to treatment. A carbuncle can return again and again for months or years following the first infection.

Possible Complications

Untreated, carbuncles may lead to any of the following:

When to Contact a Medical Professional

Call your provider if:

  • A carbuncle does not heal with home treatment within 2 weeks
  • Carbuncles come back often
  • A carbuncle is located on the face or spine
  • You have a fever, red streaks running from the sore, a lot of swelling around the carbuncle, or pain that gets worse

Prevention

Good general health and hygiene may help prevent some staph skin infections. These infections are contagious, so care must be taken to avoid spreading the bacteria to other people.

If you get carbuncles often, your provider may give you antibiotics to prevent them.

If you are a carrier of staph aureus, your provider may give you antibiotics to prevent future infection.

References

Millett CR, Halpern AV, Reboli AC, Heymann WR. Bacterial diseases. In: Bolognia JL, Jorizzo JL, Schaffer JV, eds. Dermatology. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 74.

Pallin DJ, Nassisi D. Skin and soft tissue infections. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Mosby; 2014:chap 137.

Review Date:4/14/2015
Reviewed By:Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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