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Understanding Furuncles: Causes and Diagnosis

A furuncle, or boil, is a deep inflammatory nodule that develops around hair follicles, often starting as superficial folliculitis and progressing to an abscess. They commonly occur in hair-bearing areas like the neck, face, armpits, and buttocks. Furuncles are usually caused by Staphylococcus aureus or MRSA bacteria and risk factors include male sex, adolescence/elderly age, poor hygiene, obesity, diabetes, and compromised immunity. Diagnosis involves examining characteristic lesions that enlarge and become painful, tender, red, and fluctuant nodules draining pus. Differential diagnoses include cystic acne, hidradenitis suppurativa

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94 views18 pages

Understanding Furuncles: Causes and Diagnosis

A furuncle, or boil, is a deep inflammatory nodule that develops around hair follicles, often starting as superficial folliculitis and progressing to an abscess. They commonly occur in hair-bearing areas like the neck, face, armpits, and buttocks. Furuncles are usually caused by Staphylococcus aureus or MRSA bacteria and risk factors include male sex, adolescence/elderly age, poor hygiene, obesity, diabetes, and compromised immunity. Diagnosis involves examining characteristic lesions that enlarge and become painful, tender, red, and fluctuant nodules draining pus. Differential diagnoses include cystic acne, hidradenitis suppurativa

Uploaded by

Novi Adri
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd

Furuncle

Furuncle (boil)

 Deep-seated inflammatory nodule yang berkembang disekitar folikel


rambut,
 Biasanya berawal dari superficial folliculitis dan sering berkembang menjadi
abses.
 Banyak ditemukan pada hair-bearing sites, khususnya daerah yang
mengalami gesekan, oklusi, dan perspirasi :
 Leher
 Wajah
 Ketiak
 Bokong
Etiology

 Staphylococcus aureus  Methicillin resistant S. aureus


(MRSA)
Risk factors

 Male  Poor hygiene

 Adolescence, elderly  Overcrowded living conditions

 Preexisting lesions  Excessive


 Obesity friction/perspiration
 Exposure to oils/chemicals
 Compromised immunity
 Exposure to heated contaminated
 Diabetes Melitus water
 Malnutrition
Cutaneous Lesions

Rupture
Enlarges
Hard, with
and
tender, red
become painful
discharge of
folliculocentric
nodule
and fluctuant
pus

The
pai
n
sur
rou
ndi
ng
the
lesi
on
the
n
sub
side
s,
red
nes
s
and
ede
ma
dim
inis
h
Carbuncle

 Cluster of interconnected furuncle


 Larger, deeper and more severe infection
 Extremely painful lesion
 Leaves a depressed scar

 FEVER
DIAGNOSIS
History Taking

 Risk factor
 Pain? Swelling? Redness? Itching?
 Suspect MRSA if:
 Community 10-15% isolated S.aureus is MRSA
 High risk groups
 Does not respond to β-lactam antibiotic
 Invasive procedure / devices
Physical Exam

 Localized redness, swelling  Tenderness


 Pustule and papulapustule  Fluctuance
 Lesion maybe draining, crusted  Regional lymph node enlargement
 Localized induration and tender
 HR may be ↑
Laboratory Exam

 Histologic : dense polymorphonuclear inflamamatory process in dermis and


subcutaneous fat.
 Multiple abscesses separated by CT-trabeculae, infiltrated the dermis and pass along
the edge of hair follicles, reaching the surface through openings in the undermined
epidermis (CARBUNCLE)

 Gram stain of pus for confirm the diagnosis


 Isolation of S.aureus on culture for confirm the diagnosis.
Differential Diagnosis

Cystic acne
Hidrodenitis suppurativa
 Kerion
Kerion
Differential Diagnosis

Furuncular myasis
Ruptured epidermal
inclusion cyst Osteomyelitis
Complication

 Bacteremic spread of infection


 Metastaic infection
 Recurrence

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