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What is a Carbuncle?

A carbuncle (Baaltod in Hindi) is a cluster of boils (furuncles) that have coalesced and have developed into one large boil (abscess) under the skin. It is a painful infection of multiple hair follicles at a single location and the intervening adjoining skin.

What are the causes and risk factors for Carbuncle (cluster of boils)?

The background for carbuncles and furuncles is the same.

The condition is most commonly caused by a bacterium called Staphylococcus aureus. Streptococcus pyogenes is another common organism.  Risk factors are as follows (same as that for furuncles):

  • Diabetes
  • Obesity
  • Malnutrition
  • Use of immuno-suppressive drugs like anticancer therapy
  • Anaemia
  • Alcoholism
  • HIV/AIDS
  • Bad personal hygiene.

Understanding Carbuncle 

A carbuncle starts as a less alarming infection of a single or multiple distinct infections of hair follicles. In the setting of diabetes, anaemia, bad wound hygiene, or poor immunity, the infection fails to get contained and spreads to the adjoining skin. The result is confluence of the nearby pockets of pus and development of a large abscess under the skin.

Carbuncles are larger and deeper seated than furuncles and cause much larger tissue scarring after healing.

What are the symptoms of Carbuncle or clustered boils?

  • Large boggy swelling under the skin
  • Painful and tender to touch
  • Redness, swelling
  • Fever is common with or without chills
  • Palpable adjacent lymph nodes (red and tender to touch)
  • Generalised weakness

Common sites are back, shoulder, buttocks, under the breast fold, axilla, groin and other moist areas that tend to get neglected in terms of hygiene.

How to diagnose a Carbuncle?

The diagnosis is clinical. Your doctor may advise a test of collecting swab of the pus from the boil to guide the choice of effective antibiotics.

What is the treatment for a Carbuncle?

Warm compresses before the boil bursts can speed the recovery. Most carbuncles will not resolve on their own and will require surgical drainage and wound cleaning.

Under local anaesthesia, the carbuncle is opened with a blade at the point of highest fluidity. The pus is allowed to drain and the opened wound is scrubbed generously with an antiseptic solution till all the pus is drained and the wound bleeds. The wound is then dressed daily and allowed to heal. A skin graft may later be applied if the area involved is large and extensive scarring is expected.

Also Read: How to treat boils at home

What are the complications with clustered boils?

  • Most commonly spread of infection locally with fever and chills
  • Septicaemia (Systemic spread of infection)
  • Renal failure (especially in the setting of diabetes)
  • Delayed or non-healing of a wound, especially in diabetes and immunocompromised

What lifestyle changes are recommended to prevent Carbuncle/ boils?

  • Maintenance of good personal hygiene
  • Daily change of bed linen
  • Thorough hand washing
  • Monitoring of blood sugar and strict control of diabetes
  • Adequate and prompt treatment of seemingly trivial skin infections: complications in the elderly are common and do not show specific symptoms till major damage is done

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