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What is Furunculosis?

Also called a ‘boil’, a furuncle is an infection of a hair follicle. It is a deep infection causing a painful swelling over the infected skin due to the accumulation of pus and dead tissue.

Understanding Furunculosis

Staphylococcus aureus is a normally occurring bacterium over the skin. The colonization of hair follicles by these bacteria is also reasonably common. In the presence of the above-mentioned risk factors, the setting in of infection and inflammation is quick and can cause accumulation of pus, causing local cellulitis.

Common Boil locations

  • Common locations are back, shoulders, axilla (underarms), buttocks, ear canal and groin
  • A boil on the eyelid is called a stye.

What are the causes and risk factors for boil or Furunculosis?

The condition is most commonly caused by a bacterium called Staphylococcus aureus.  Risk factors are as follows:

  • Diabetes
  • Obesity
  • Malnutrition
  • Use of immunosuppressive drugs like anticancer therapy
  • Anemia
  • Alcoholism
  • HIV/AIDS
  • Bad personal hygiene

What are the symptoms of Boil?

  • Local pain and tenderness (pain on touch)
  • Swelling
  • Redness
  • Increased temperature of the skin
  • Fever is rare
  • Centre of the swelling shows a yellow or a white spot. The boil may burst, discharging the thick yellow-white pus. Rupture reduces pain significantly.
  • Enlarged lymph nodes which are also painful to touch

How is a Boil diagnosed?

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

What is the treatment for a Boil?

  • Some boils may resolve on their own by bursting, but most require opening and drainage. The procedure can be carried out as an out-patient procedure under local anesthesia.
  • Warm compresses before the boil open can speed the recovery.
  • Once the boil opens or is drained, a course of antibiotics is given to prevent re-accumulation of pus or secondary infection by another organism.
  • If a patient has recurrent boils, removal of the infective focus by plastic surgery is recommended. Also, the patient should be evaluated for any preexisting diseases like diabetes, HIV, etc.
  • Topical antiseptic or antibiotic cream/ lotion is also given.

What are the complications with boil or Furunculosis?

  • Convergence of nearby boils to form a large abscess (Carbuncle).
  • Scarring
  • Deep-seated cellulitis that may spread to the nearby tissues
  • Systemic infection
  • Bloodstream infection: In immunocompromised patients, it may lead to dissemination of infection to bones, brain, heart valves leading to potentially fatal conditions.
  • Family history of recurrent furuncles is a risk factor to chronic infections and disseminated infections.

What are the lifestyle changes recommended to prevent Furunculosis?

  • Maintenance of good personal hygiene
  • Regular change of bed linen
  • Monitoring of blood sugar
  • Adequate treatment of seemingly trivial skin infections as complications in the elderly are common and do not show specific symptoms until major damage is done.

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