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Vaginal Boil: Causes, Treatment & Prevention
What is a vaginal boil?
A vaginal boil (also called a furuncle or skin abscess) is a painful, pus-filled bump that develops under the skin in your pubic area. It usually happens when the bacteria Staphylococcus aureus (commonly called staph) infects the sacs that contain the roots of your hair and oil glands (hair follicles). When a hair follicle becomes infected it is called folliculitis. A vaginal boil can also develop from a cut in the skin from shaving with a razor or other injury to the area. The bacteria will enter the body through the skin and cause infection.
These boils become more painful as they grow. Eventually they will rupture and drain. A boil can develop on the labia (lips of the vagina), in the pubic region (where pubic hair grows) or in the vulvar area around your vagina. Some women will get them in the skin fold of the groin. Boils will start out small but can grow as big as a golf ball.
A group of boils is called a carbuncle. This is when the boils are clustered together to form an area of infection.
Boils are usually not serious. Most will clear up on their own within a few weeks. In some cases, vaginal boils may need medical treatment to get rid of the infection and ease the pain.
How common are vaginal boils?
It’s quite common to have a boil near your vagina. This is because it is easy for a hair follicle to become infected with bacteria. Most vaginal boils can be treated at home.
What does a vaginal boil look like?
The boil may start as a small, red bump. It can develop into a swollen, painful spot with a white or yellow pus-filled tip. This happens quickly — sometimes over a few days. It can feel tender and warm to the touch. Boils tend to get large — some might get as big as two inches or more.
Symptoms and Causes
What are the symptoms of a vaginal boil?
Vaginal boils can start out small and could resemble a pimple or irritation from shaving or chafing. Once it grows and becomes painful, you’re probably developing an infection.
Signs and symptoms of a vaginal boil are:
- Swollen, red lump deep in the skin.
- Painful to touch.
- Develops a white or yellow pus-filled center that may break open.
- May ooze clear fluid or develop a crust.
- Fever or swollen lymph nodes.
What causes vaginal boils?
Boils are caused by a staphylococcus (staph) infection, a type of bacteria that is found on the skin and inside the nose. It only causes problems when it gets inside the body. When bacteria get into areas of the skin that have been cut or broken open, a lump filled with fluid or pus will form. This is your body’s way of trying to eliminate the infection.
Some causes of boils include:
- Being overweight or obese can cause boils to develop between the folds of your skin.
- Poor hygiene. Wash your genital area with soap and water daily and after exercise.
- Diabetes or other conditions that weaken the immune system reduces your ability to fight infection.
- Tight-fitting clothes, especially dirty or sweaty undergarments.
- Ingrown hairs caused by shaving, grooming or waxing your vaginal area.
- Insect bites, injuries to the skin or acne.
- You had close contact with someone who had a boil.
Are vaginal boils contagious?
Yes, vaginal boils can be contagious because it is an infection that can spread from skin-to-skin contact. If you have a boil in your pubic region, you should:
- Wash your hands with soap before and after touching the infected area.
- Practice good hygiene and keep the area clean and dry, especially if the boil begins to drain.
- Avoid sharing personal items like towels, clothing and washcloths until the boil has healed.
Diagnosis and Tests
How are vaginal boils diagnosed?
Your healthcare provider will diagnose a boil on the skin in your pubic area after a physical exam. This should not cause any pain and will be relatively quick. Most of the time, a boil will resolve without any medical intervention. If the infection is severe or causes a lot of pain, you may need to have the boil drained or your provider may prescribe an antibiotic.
What tests will be done to diagnose a vaginal boil?
Tests aren’t usually used to diagnose a vaginal boil. If you have recurring boils, your healthcare provider may collect a sample of the drainage to see what kind of bacteria is causing the infection. Recurring vaginal boils may require a certain antibiotic or be a symptom of an underlying condition. You may also be given a test to check for sexually transmitted infections (STIs).
Management and Treatment
How are vaginal boils treated?
Most vaginal boils can be treated at home with no medical assistance. For at-home treatment you should:
- Apply a warm, moist compress (like a damp washcloth) to the area three to four times per day. This helps draw the pus to the surface and encourages the boil to drain. Use a new washcloth each time.
- Never squeeze, pop or cut open the boil yourself. This can lead to more pain and spread the infection.
- Wear loose fitting clothing to prevent rubbing and irritation to the area.
- Take an over-the-counter pain medication for discomfort.
- Keep the vaginal area clean with soap and water. Wash your hands before and after touching the infected area.
- Clean the boil and cover it with a loose bandage after it begins to drain.
- You may be prescribed antibiotics to help the infection heal or if you have a recurrent infection.
- If the boil is large or doesn’t go away with at-home care, it may need to be drained or lanced. Your healthcare provider will make a small incision to drain the pus from the boil.
What medications are used to treat a boil near the vagina?
Antibiotics are used to treat certain boils that develop near the vagina. Your healthcare provider will determine if an antibiotic is necessary or if at-home treatment will resolve the issue.
How do I treat a boil on my vagina at home?
Most boils will resolve with at-home treatment. Never try to pop or squeeze a boil.
- Apply a warm, moist compress to the area several times a day. This can speed healing and relieve some of the pain and pressure caused by the boil.
- Wash your hands before and after you touch the area to reduce the spread of infection.
- Once the boil opens, keep the area as clean and dry as possible. Wear a loose gauze bandage to protect the area.
What are some complications of a vaginal boil?
Severe complications of a vaginal boil are rare. Bacteria from the boil can spread to other parts of your body or enter your bloodstream. If this occurs, your heart, bones, brain or other organs could be at risk for infection.
Can I squeeze a boil near my vagina?
You should never squeeze or pop a boil that develops near your vagina. This can cause the infection to spread to other areas. It will also make the pain and inflammation worse. Try home remedies that encourage the boil to rupture and drain on its own.
How can I prevent getting another vaginal boil?
Boils on the skin around the vagina can’t always be prevented, especially if you have a weakened immune system. There are some things you can do to reduce the chances of getting another boil near your vagina:
- Wash your genital area with antibacterial soap to prevent bacteria from building up and causing infection.
- If you shave your pubic area, shave in the direction of hair growth and change your razor frequently. Do not share razors.
- Do not share soap, towels, washcloths or other items that touch your vagina.
- Wash your hands regularly, especially before and after touching the genitals.
- Change your underwear daily and after exercise.
- If you are overweight, reducing your weight could help as bacteria can survive on folds of the skin.
What makes people at higher risk for vaginal boils?
Boils result from a bacterial infection. The following factors could make you more likely to get a boil near your vagina:
- Acne or other skin conditions where there are skin lesions present. These can become infected more easily.
- Being in close contact or sharing personal items with someone who has a boil.
- Having a weakened immune system can increase your risk for developing a boil.
- Having diabetes can make it more difficult for your body to fight an infection.
Outlook / Prognosis
How long does it take for a vaginal boil to go away on its own?
Most boils will heal on their own within three weeks. But there is no set time for how long it takes for a boil to develop or heal. Applying warm compresses can help the boil drain on its own. Taking antibiotics can help speed up the healing time, but antibiotics are not always prescribed.
When should I see my healthcare provider?
Contact your healthcare provider if you have these symptoms:
- Your boil gets large and very painful.
- Your boil doesn’t get better within two weeks.
- You get more than one boil.
- Your boil doesn’t seem any better after several days of at-home treatment.
- You get recurrent boils near your vagina.
- You have a fever or swollen lymph nodes.
If you have diabetes or a weakened immune system for any reason and develop a boil, contact your healthcare provider.
Frequently Asked Questions
Why do I keep getting boils on my private area?
Some women are more prone to getting vaginal boils. Boils near the vagina are caused by bacteria that enter through the skin and infect a hair follicle. Keeping your genital area clean and practicing good hygiene is the best way to prevent recurring boils. If you shave your pubic area with a razor, change your razor often. An old or dull razor can harbor bacteria and cause ingrown hairs.
How do you get rid of a vaginal boil fast?
There is not a quick way to get rid of a boil near your vagina. A boil often takes weeks to resolve completely. Antibiotics from your healthcare provider may help speed up the healing process. Do not try to squeeze or pop a boil to get rid of it. This can spread infection and cause scarring. Applying a warm compress several times a day to the area is the best way to get rid of a vaginal boil.
What do I do if I have a vaginal boil and I am pregnant?
You should tell your healthcare provider if you develop a boil when you are pregnant. Pregnancy does not cause boils, but certain hormonal and immune system changes could contribute to boils during pregnancy. In most cases, you will still follow at-home treatment. Apply a warm compress to the area several times a day to encourage the boil to drain. Depending on your symptoms and the size of the boil, your healthcare provider may prescribe antibiotics.
Can I have sex if I have a boil near my vagina?
If you have a boil near your vagina, it is best to avoid having sex. Since a boil is an infection, it could spread to your partner during sexual contact. Friction from sex can also irritate your boil.
Are boils and cysts the same thing?
A boil and a cyst are not the same. They will both look like bumps under the skin. Some of the biggest differences between a boil and a cyst are:
|Bacterial infection.||Not an infection.|
|Red, swollen and painful.||Usually painless.|
|Large and grow quickly.||May be smaller and slower growing.|
|Filled with white-yellow pus.||Filled with fluid or other material.|
A note from Cleveland Clinic
Vaginal boils are a common skin infection that usually resolves with at-home care. Speak with your healthcare provider if you are concerned about a boil near your vagina. They will be able to recommend the best treatment for you and ensure you have the support you need.
Boils and skin infections fact sheet
What are boils?
A boil (sometimes known as a furuncle) is an infection of the skin, often around a hair follicle. It is usually caused by Staphylococcus aureus bacteria (commonly known as golden staph). Many healthy people carry these bacteria on their skin or in their nose, but do not have any symptoms. Boils occur when bacteria get through broken skin and cause tender, swollen, pimple-like sores, which are full of pus. Boils usually get better on their own, but severe or recurring cases may require medical treatment and support.
Staph bacteria may also cause other skin infections, including impetigo. Impetigo, commonly known as school sores (as they affect school-age children), are small blisters or flat crusty sores on the skin. See the Impetigo factsheet for specific information on Impetigo.
How are they diagnosed?
Most skin infections are diagnosed on the basis of their appearance and the presence of any related symptoms (such as fever). Your doctor may take swabs or samples from boils, wounds, or other sites of infection to identify the bacteria responsible. Some infections may be caused by bacteria that are resistant to some antibiotics. See the MRSA in the community factsheet for detailed information on infections caused by antibiotic resistant strains.
How are they treated?
Keep boils or other skin infections clean and covered.
- Bathe the boil or sore with soap and water or a salt water mixture
- Apply a hot compress to encourage the boil to come to a head
- Keep boils and other skin infections covered and change dressing regularly
Do not squeeze boils as this may cause the infection to spread.
- Drainage of skin boils or abscesses should only be performed by a doctor or trained nurse or health worker
- In some circumstances infections may require treatment with antibiotics
If the sores spread or get worse, or you become unwell with fever, see your doctor. Your doctor may prescribe antibiotics (by mouth or as an ointment). It is very important to follow the recommended treatment and finish the full course of antibiotics.
How are they spread?
Boils and other skin infections are spread between people by:
- direct contact with an infected area or spread of the bacteria on hands or items that have been in contact with an infected area
- not washing your hands properly and sharing items such as used towels, bedding, and grooming items such as razors can increase the risk of spread.
How can you stop the spread?
While you have the infection
- Good hand washing is really important to prevent the spread of boils and skin infections. You should thoroughly wash all parts of your hands with soap and running water for 10-15 seconds
- before and after touching/dressing an infected area and before handling or eating food
- after going to the toilet
- after blowing your nose
- after touching or handling used clothing or linen
- keep cuts, scrapes, and boils clean and covered to avoid infection
- don’t share personal items such as clothes, towels, bed sheets (if you share a bed with someone, keep sores or wounds covered overnight), razors and toothbrushes and disinfect/wash grooming items thoroughly after each use, such as nail scissors, tweezers
- wash bed linen and clothing regularly, and dry in the dryer or outside in the sun.
To prevent boils and skin infections children should be encouraged to:
In addition to general hygiene measures, specific measures to prevent spread in schools and childcare include:
- teachers, children and families should understand the importance of good hand washing, covering sores and staying home if sick
- hand washing products (soap dispensers, running water and paper towels) should be available and accessible
- activities should allow time for hand washing as part of routine practice (before eating and after going to the toilet)
- surfaces such as counters, desks and toys that come in contact with uncovered or poorly covered infections, should be cleaned daily with water & detergent, and whenever visibly contaminated
- school exclusion is not recommended except for some children with Impetigo. See the Impetigo fact sheet for further information.
What is the public health response?
Boils and skin infections are not notifiable in NSW. Public health units can advise on the control of outbreaks.
For further information please call your local Public Health Unit on 1300 066 055
Boils and Carbuncles. Facial boils and Carbuncles Info. Patient
A boil (furuncle) is an acute infection of a hair follicle, usually caused by Staphylococcus aureus.
A carbuncle is a swollen, painful area discharging pus from several points. It occurs when a group of adjacent hair follicles becomes deeply infected; S. aureus is usually the pathogen.
An inflammatory reaction occurs in the surrounding and underlying connective tissue, including the subcutaneous fat. The source of staphylococcal infection is usually in the nose or the perineum and it is thought that the infection is disseminated by the fingers and by clothing.
The incidence of boils is uncertain. They are rare in children except in those with atopic eczema. They are rather more common in adolescents and in early adulthood – especially in boys – and the peak incidence is the same as for acne vulgaris.
In England, hospital admissions for severe staphylococcal boils and abscesses trebled between 1989 and 2004.
There is usually no predisposing cause, although boils may complicate atopic dermatitis, excoriations, abrasions, scabies or pediculosis. Staphylococcal colonisation is more common on atopic eczema and may contribute to the pathogenesis.
- The evidence to link diabetes with furunculosis (multiple crops of boils) is conflicting but when boils affect people with diabetes, they tend to be more extensive.
- Other conditions associated with furunculosis include obesityand immune compromise, as with HIV, blood dyscrasias and treatment with immunosuppressive drugs.
- Carbuncles are associated with malnutrition, heart failure, drug addiction, severe generalised skin disease and prolonged steroid therapy.
- The evidence is conflicting with regard to association with diabetes.
- In adults the use of topical steroids is associated with the development of folliculitis.
- A boil starts as a hard, tender, red nodule surrounding a hair follicle. It enlarges and becomes fluctuant (see definition under ‘Management’, below) over several days as an abscess forms.
- Later it may discharge pus from its centre, before healing and it may leave a scar.
- Boils arise in hair-bearing areas, especially where there is friction, occlusion and perspiration. This includes the neck, face, axillae, arms, wrists, fingers, buttocks and anogenital region.
- Boils may be isolated or multiple lesions; the latter are particularly likely on the buttocks.
- There are sometimes mild constitutional symptoms, such as fever and malaise.
- A carbuncle starts as a smooth, dome-shaped, acutely tender, painful lesion. It often occurs at the nape of the neck, the back, or the thighs and it develops into a swollen, painful area discharging pus from several sites.
- Constitutional symptoms, such as fever and malaise, may accompany or even precede the development of the carbuncle.
It is usually safe to assume that this is a staphylococcal infection. However, in persistent or recurrent infection, swabs should be taken from the nose, throat, umbilicus, axillae and perineum. Culture and sensitivities are required.
If there are multiple, severe or recurrent infections, FBC and fasting blood glucose are indicated.
- If lesions are not fluctuant (fluctuance is a wave-like feeling on palpating skin overlying a fluid-filled cavity with non-rigid walls – eg, a cavity containing pus), the application of moist heat 3-4 times daily relieves discomfort, helps to localise the infection and promotes drainage.
- Treatment with a seven-day course of oral antibiotics is recommended for:
- When the lesion is on the face.
- When the lesion is a carbuncle.
- Pain or severe discomfort.
- Other comorbidities, eg diabetes or immunosuppression.
- Oral flucloxacillin is usually the drug of choice against S. aureus, with erythromycin or clarithromycin if penicillin is contra-indicated.
- Meticillin-resistant S. aureus (MRSA) is a growing threat in hospitals but is also being reported in the community.
- Drainage may be spontaneous or surgical but cover the lesion with a sterile dressing to prevent autoinoculation.
- Incision and drainage are indicated for lesions that are large, localised, painful and fluctuant.
Observe the patient for signs of systemic upset. Most cases can be treated in primary care; however, the decision of whether to admit the person will depend on clinical judgement, taking into account the rapidity and degree of spread and comorbidities – eg, diabetes.
Persistent and recurrent infection
S. aureus is a persistent part of normal microbial flora in 10-20% of the population and around 30-50% of healthy adults are colonised with S. aureus at some site, at any given time.
10% of patients with a boil or abscess develop a repeat boil or abscess within 12 months. Obesity, diabetes, young age, smoking and prescription of an antibiotic in the six months before initial presentation have been shown to be associated with recurrent infection.
- In persistent or recurrent infection, swabs should be taken for culture and sensitivities.
- Seek specialist advice if there is a possibility or confirmation of Panton-Valentine leukocidin S. aureus (PVL-SA) or MRSA.
- Exclude underlying causes (eg, systemic disease) that may have compromised the immune system. Also consider skin disease – eg, scabies, pediculosis or eczema.
- There may be industrial exposure to chemicals or oils, or simply poor hygiene.
- Consider sources of infection such as autoinoculation, pyogenic infections in family members, and contact sports.
- If furunculosis persists after screening and treating the person, consider outside sources of infection such as family and close contacts. Overt infection is more likely as a source than asymptomatic carriage but consider screening household members, if they will co-operate.
Extraneous sources of infection
- Eradication of nasal carriage of staphylococci can be achieved with a cream of chlorhexidine with neomycin (Naseptin®) applied to the nostrils four times a day for 10 days. Re-colonisation is common. Mupirocin nasal ointment is excellent at eliminating nasal staphylococci but should be reserved for resistant cases.
- If other sites are involved then oral antibiotics may be necessary. The choice is guided by sensitivities.
- Antiseptics can reduce staphylococci on the skin. Washing the body and hair daily, and bathing in an antiseptic solution of chlorhexidine or triclosan (eg, Hibiscrub®) in a detergent vehicle, help eliminate infection. If there is dry or inflamed skin then an antiseptic emollient should be used. Examples include Dermol® 500, Oilatum®, Emulsiderm® or Dermol® 600.
- The patient should also:
- Wash sheets and underwear regularly in a hot wash (above 55°C). The clothes should be turned inside out and the machine not overloaded so that the water can penetrate.
- Thoroughly clean the bedroom when treatment is started.
- Maintain a personal towel and flannel and rinse the flannel in hot water before use.
- Oral flucloxacillin or erythromycin are usually effective against S. aureus infections. There is no evidence base for the best duration of treatment but treatment for seven days is generally recommended.
- In chronic furunculosis, the choice of antibiotic ideally should be guided by sensitivities. Flucloxacillin is recommended for blind treatment or erythromycin if there is a penicillin allergy. Treat for two weeks initially; however, some people will need a longer course of perhaps six or eight weeks.
- Boils and carbuncles can leave scars.
- Surrounding cellulitis or bacteraemia may develop if furunculosis or carbuncles extend.
- Cavernous sinus thrombosis can complicate boils or carbuncles on the face but this is rare.
- Metastatic infection is rare but can include osteomyelitis, acute endocarditis or brain abscess. Septicaemia is a very rare complication of both furuncles and carbuncles.
- Over a course of two days to three weeks the boil becomes necrotic and develops into an abscess. It ruptures and discharges pus and often a core of necrotic material. Pain subsides as pressure is reduced; the redness and oedema diminish over days to weeks.
- In people who have HIV, boils may coalesce into violaceous plaques.
- A carbuncle grows in size for a few days to reach a diameter of 3-10 cm, occasionally more. After 5-7 days, suppuration occurs and multiple pustules soon appear on the surface, draining externally around multiple hair follicles:
- A yellow-grey irregular crater develops at the centre. In some cases the necrosis develops more acutely without a follicular discharge and the entire central core is shed to leave a deep ulcer with a purulent floor.
- Healing takes place slowly by granulation and the area may remain deeply violaceous for a prolonged period of time.
- Death from toxaemia or from metastatic infection may occur in the frail and the ill.
Boils – Sussex Community Dermatology Service
What are the aims of this leaflet?
This leaflet has been written to help you understand more about boils (furuncles). It tells you what they are, what causes them, what can be done about them, and where you can find out more about them.
What are boils?
Hairs form under the surface of the skin in structures known as hair follicles. A boil is an infection (abscess) of the deep part of a hair follicle with a bacterium called Staphylococcus aureus (S. aureus). Multiple boils are known as a carbuncle. Occasionally, the infection may spread into the surrounding tissues (cellulitis), causing fever and illness.
S. aureuscan spread from one part of the body to another and from one person to another, via fingers, skin-to-skin contact, and contaminated clothing. Boils are most common in adolescents, and affect boys more often than girls. Sufferers of boils seldom have a problem with their immune system, although boils can be more severe when the immune system is suppressed.
What do boils look like?
A boil starts as a small itchy or tender spot that grows over a few days into a large red lump under the skin surface, becoming increasingly painful and tender. Boils inside the nose or ear can be particularly uncomfortable.
At this stage a boil may come to a head and eventually burst through the surface of the skin, releasing pus, or it may settle gradually without bursting. A healed boil tends to leave a red mark, which slowly fades but can leave a small scar. Boils may be single or multiple.
How are boils diagnosed?
Boils are usually straightforward to diagnose by their appearance. If a boil releases pus, this can be swabbed and sent to the laboratory to check which antibiotics are suitable to treat the boils, especially in cases where boils keep recurring.
Can boils be cured?
Yes. Infections caused by S. aureus settle with treatment. Sometimes severe or recurrent boils are caused by a type of bacteria called PVL staphylococcus which may need different antibiotics – please ask your doctor about this type of infection (see Patient Information Leaflet on PVL Staphylococcus Aureus (PVL-SA) skin infection).
The bacteria survive best in moist areas such as the nostrils, the armpits and the groin. Some people carry the S. aureusbacteria at these sites on a long-term basis. If repeated infection occurs, it is wise to treat these areas (see below).
How can boils be treated?
A single boil usually settles naturally, especially if the pus it contains discharges spontaneously. Sometimes your doctor may release the pus by cutting carefully into the boil (lancing it). This should only be done with sterile instruments once the boil has come to a head. An antibiotic cream or ointment can be used around the boil to stop others appearing nearby. Often an antibiotic is given by mouth as well, to make sure that the infection clears.
How do I stop the bacteria from spreading?
- Your doctor will prescribe a topical treatment to wash yourself with and an antibacterial nasal ointment to be applied into each nostril; both of these are to be used for 5-7 days.
- Family members may also have to use this treatment as well, if they are asymptomatic carriers.
- You should also change towels every day and do not share them with anybody else. Use a hot wash and hot tumble dry if possible to wash towels and bed linen.
- Change bed sheets daily.
- Keep the house clean, especially the sink, shower or bath.
It is sensible to seek medical advice if you are not sure of the diagnosis, or if the treatment you have tried seems not to be helping. Recurrent boils may be caused by a toxin producing bacteria (PVL staphyloccus) or be a sign of underlying diabetes so see your doctor if the problem persists.
What can I do?
- Follow the measures outlined above to reduce the spread of boils.
- Bath or shower daily, and keep your hands and nails clean. Avoid picking any sores.
- Being overweight encourages boils, as the bacteria survive in folds of the skin, therefore weight loss if necessary may help prevent recurrence.
- Avoid close contact with others and contact sports, such as rugby and judo, until the boils have cleared to reduce the risk of passing the infection onto others. Do not visit a swimming pool or a gym until they have cleared up.
Where can I get more information?
Web links to detailed leaflets:
Furunculosis – an overview | ScienceDirect Topics
Furuncles and Carbuncles
A furuncle (i.e., boil) is an infection of the hair follicle, but unlike folliculitis in which the infection remains in the epidermis, the inflammation in furuncles extends deep into the dermis.12,43 Furuncles can originate from a preceding folliculitis and manifest as tender, deep-seated, erythematous, perifollicular nodules with an overlying pustule (Fig. 68.6). With time, the inflammatory mass becomes fluctuant and often opens to the skin surface, draining purulent material.17 Lesions are found on hair-bearing areas, with the face, neck, axillae, buttocks, and groin commonly affected.
A carbuncle is a painful infection involving an aggregate of contiguous follicles, with multiple drainage points and inflammatory changes in the surrounding connective tissue. Carbuncles commonly are found on the posterior neck and in persons with diabetes mellitus.12 Although individuals with furuncles usually have no constitutional symptoms, carbuncles can be associated with fever, leukocytosis, and bacteremia. Both furuncles and carbuncles tend to heal with scarring.
The causative agent of furuncles and carbuncles is almost always S. aureus. The staphylococcal isolates (i.e., MSSA and MRSA) associated with furunculosis often possess the virulence factor Panton-Valentine leukocidin, a pore-forming toxin that targets neutrophils.13,43,54 Conditions that predispose to furuncle formation include obesity, immunosuppression, diabetes mellitus, hyperhidrosis, maceration, friction, and pre-existing dermatitis.43 Outbreaks of furunculosis have been reported in sports teams, families, and other settings with close contact.12,55
Recurrent furunculosis frequently is associated with carriage of S. aureus at multiple sites (e.g., nares, axillae, perineum) or with sustained close contact with someone who is a carrier. Rarely, children with recurrent furunculosis have an underlying immunodeficiency.12 Other bacteria or fungi occasionally cause furuncles or carbuncles, and Gram stain and culture of the purulent exudate is indicated. The differential diagnosis of furuncles includes epidermal cysts, cystic acne, and hidradenitis suppurativa.
Treatment consists of frequent application of a hot, moist compress to promote drainage. Large furuncles and most carbuncles require surgical drainage, with disruption of any existing loculations and wound packing as appropriate.12,13,43 When lesions are large, multiple, or associated with extensive cellulitis or fever, treatment with an oral antistaphylococcal agent is indicated. For recurrent furunculosis, eradication of staphylococcal carriage can be attempted. Attention to personal hygiene, bleach baths, or use of chlorhexidine soap may be beneficial.
BOILS- A Guide for Patients
- Boils can range in severity from a pimple to an abscess. They occur when the skin becomes infected by bacteria(usually Staphylococcus aureus).
- Some people are more susceptible than others to boils.
- Single boils may be lanced and heal eventually. Recurrent boils can prove difficult to treat, although there are several possible treatments that may break the cycle including washing with chlorhexidine soap and specialised antibiotic regimens.
- Several methods can be used to treat boils at home, speed up healing and prevent spread to others.
- Anyone with a boil entering a hospital must let medical staff know, to prevent spread of the boil bacteria.
is a boil?
Boils are a very common skin infection. They are a skin disease and in most cases are not due to anything wrong with the blood.
Another name for a boil is a furuncle, and when multiple boils occur on the body, the condition is called furunculosis.
Several boils joined together with tunnels under the skin are called a carbuncle.
As a boil gets larger it gets a cavity inside it filled with pus. This is called an abscess.
A pimple is a mini-boil.
How are boils formed?
Boils are caused by a hair follicle (a tiny tunnel in the skin where hair grows from) or a tiny cut or scratch becoming infected by a bacteria (usually Staphylococcus aureus).
As a boil starts to develop, the body’s immune system carries white cells in the blood to the site of the boil to do battle with the invading bacteria. The body also creates a fibrous wall around the ‘battleground” to contain the infection.
Once the boil reaches a certain size, this fibrous wall prevents antibiotics in the bloodstream penetrating into the boil. Dead white cells and dead bacteria make up the liquid pus in the center of the boil and, because this liquid forms under pressure, it becomes painful.
A boil will always start to “point” towards the skin surface and will eventually burst, draining the pus, relieving pain and will then heal. This whole process can take 2 weeks, and often doctors will “lance” the boil early – make a deliberate hole in it to allow the pus to drain – to speed up the healing process.
It is very common for boils to “crop”, that is, to occur as several boils that go through their life-cycle and heal and then occur weeks or months later. This condition is known as recurrent staphylococcal furunculosis. This condition can be very distressing and although a blood test will usually be arranged by a doctor(to exclude diabetes and other conditions), it is not often due to anything wrong with the sufferer’s internal immunity. It is due to the continuing presence of the bacteria Staphylococcus aureus on the skin and the susceptibility of the person to it.
Who is at risk of getting boils?
Staphylococcus aureus bacteria occurs on the skin of 25% of the average population, with or without the occurrence of boil, but is more prevalent in certain groups.
Usually all sufferers of chronic dermatitis carry Staphylococcus aureus, as do three quarters of those on haemodialysis; half the diabetics taking insulin; and just under half injecting drug users.
What are the treatment options?
If a boil is lanced, a “wick” will usually be inserted. A wick is a piece of ribbon gauze put into the empty cavity of the boil to prevent the hole made in the skin surface closing over too quickly. This allows any further pus that forms to drain through the open hole. The lancing procedure has to be done at the right time. If a boil is lanced too early, there will be no pus to drain and the pain of lancing will have been in vain.
Antibiotics can sometimes prevent a boil forming when used early but will do little to a well developed boil. However antibiotics are sometimes still used to prevent deeper infection occurring.
Staphylococcus aureus bacteria is often resistant to ordinary penicillin so this is not usually prescribed. A special form of Staphylococcus aureus has emerged over recent years called MRSA (Methicillin Resistant Staphylococcus aureus) which can be very difficult to treat with antibiotics and is particularly dangerous when it occurs in hospitals.
How are recurrent cropping boils treated?
Patients suffering recurrent boils need to eradicate Staphylococcus aureus from their skin.
Many types of treatment have been tried to prevent boils cropping without much success. In general, longer continuous courses of antibiotics by mouth do not seem very successful, presumably because they do not act on the Staphylococcus aureus living on the surface of the skin.
Use of a special liquid soap containing chlorhexidine on a long term basis, combined with good hygiene and washing of clothes may help.
The antibiotic mupirocin has been shown to reduce the nasal and hand carriage of Staphylococcus aureus and may prove useful to some sufferers of recurrent boils. A combination of washing using chlorhexidine, and application of mupirocin nasally, twice daily for a week, then three times a week for a further three week period may break the cycle. If this fails, the combination system described below may prove effective.
Various hospitals have developed their own regimens to eradicate carriage of Staphylococcus aureus in nasal passages. To prevent antibiotic resistance, these regimens concentrate on intermittent treatment .(e.g.using two antibiotics, fluctoxacillin and rifampicin.)
This combination is cycled one week in every four (one week on, three weeks off), for a six month period. Flucloxacillin at a dose of 250 mg is taken three times a day on an empty stomach, whilst rifampicin is taken in a single 600 mg morning dose. The patients who have completed this procedure have been successfully stopped recurrent boils, although up to 20% experienced breakthrough occurrences early in treatment. These breakthroughs should be treated conventionally while continuing the regimen.
Those patients allergic to penicillin or with MRSA, substitute fluctoxacillin with clindamycin at a 300 mg dose, three times daily.
Rifampicin causes red discoloration to urine and tears and stains contact lenses; interferes with oral contraceptives; and if used alone, Staphylococcus aureus is almost certain to develop resistance. Rifampicin and clindamycin require specialist approval for use(In New-Zealand).
How can minor boils be treated at home or prevented?
These self-help suggestions may help when a boil occurs.
- Make sure the boil sufferer uses their own towel and facecloth, and wash these frequently in hot water along with their clothing worn close to the skin.
- Avoid close body contact with other people if a boil is active.
- Eat a good selection of fruit and vegetables and keep good sleep habits.
- Avoid squeezing a boil as it can force infection into the deeper tissues.
- Apply a warm wet compress (towel or other cloth) to the boil for 10 minutes, several times a day to try and speed up its life cycle.
The most simple and practical prevention of boils cropping seems to be once daily use of a special liquid soap containing chlorhexidine on a long term basis, combined with good hygiene and washing of clothes. However some people are sensitive to chlorhexidine and react to it. Boil sufferers visiting or going into hospital for any treatments must let medical staff know they have a boil, to reduce any chance of the Staphylococcus transferring to others in hospital.
Boil | Advocare Summit Pediatrics
Is this your child’s symptom?
- Painful red lump in the skin
- Hair follicle infection caused by the Staph bacteria
- Most boils need to be seen by a doctor
If NOT, try one of these:
Symptoms of a Boil
- Bright red lump (swelling) in the skin.
- Painful, even when not being touched.
- Most often ½ to 1 inch across (1 to 2 cm).
- After about a week, the center of the boil becomes filled with pus. The center becomes soft and mushy.
- The skin over the boil then develops a large pimple. This is known as “coming to a head.”
Causes of Boils
- A boil is an infection of a hair follicle (skin pore).
- Boils are caused by the Staph bacteria.
- Friction from tight clothing is a risk factor. Common sites are the groin, armpit, buttock, thigh or waist.
- Shaving is also a risk factor. Common sites are the face, legs, armpits or pubic area.
Prevention of Boils
- Washing hands is key to preventing Staph skin infections. Have everyone in the home wash their hands often. Use a liquid antibacterial soap or alcohol hand sanitizer. Have everyone shower daily. Showers are best, because baths still leave many Staph bacteria on the skin.
- Avoid nose picking. 30% of people have Staph bacteria in their nose.
- When shaving anywhere on the body, never try to shave too close. Reason: It causes small cuts that allow Staph bacteria to enter the skin.
Prevention – Bleach Baths for Boils that Come Back
- Some doctors suggest bleach baths to prevent boils from coming back. Talk with your doctor about this treatment.
- Use ½ cup (120 mL) of regular bleach per 1 full bathtub of water.
- Soak for 10 minutes twice weekly.
- This mix of bleach and water is like a swimming pool.
When to Call for Boil
Call Doctor or Seek Care Now
Contact Doctor Within 24 Hours
Contact Doctor During Office Hours
Self Care at Home
Call Doctor or Seek Care Now
- Widespread red rash
- Boil on the face
- Age less than 1 month old (newborn) with a boil
- Weak immune system. Examples are sickle cell disease, HIV, cancer, organ transplant, taking oral steroids.
- Your child looks or acts very sick
- You think your child needs to be seen, and the problem is urgent
Contact Doctor Within 24 Hours
- Age less than 1 year old with a boil
- Spreading redness around the boil
- There are 2 or more boils
- Size is larger than 2 inches (5 cm) across
- Center of the boil is soft or pus-colored. Exception: a common pimple.
- Boil is draining pus
- You think your child needs to be seen, but the problem is not urgent
Contact Doctor During Office Hours
- Boil suspected (red lump larger than ½ inch or 12 mm across). Reason: confirm your child does have a boil. Note: see home care advice for boil treatment.
- Using antibiotic ointment more than 3 days for small red lump, but not improved
- Boils keep coming back in your family
- You have other questions or concerns
Self Care at Home
- Boil diagnosed by a doctor
- Possible boil not yet seen by a doctor: painful red lump larger than ½ inch (12 mm) across
- Possible early boil or minor skin infection: tender red lump smaller than ½ inch (12 mm) across. Note: see home care advice for small red lump.
Treatment for a Boil (painful red lump larger than ½ inch or 12 mm across)
- What You Should Know About Boils:
- A boil is a Staph infection of a hair follicle.
- It is not a serious infection.
- Boils should be seen by a doctor for treatment.
- The doctor can tell if it needs to be drained and when to do it.
- Here is some care advice that should help.
- Moist Heat:
- Heat can help bring the boil “to a head,” so it can be drained.
- Apply a warm, wet washcloth to the boil. Do this for 15 minutes 3 times a day.
- Pain Medicine:
- Until it drains, all boils are painful.
- To help with the pain, give an acetaminophen product (such as Tylenol).
- Another choice is an ibuprofen product (such as Advil).
- Use as needed.
- Opening the Boil – Done Only by a Doctor:
- The main treatment of boils is to open them and drain the pus.
- Then, boils will usually heal on their own.
- Draining the boil must always be done in a medical setting.
- Caution – Do Not Squeeze:
- Do not squeeze a boil or try to open a boil yourself.
- Reason: this can force bacteria into the bloodstream or cause more boils.
- Squeezing a boil on the face can be very harmful.
- Antibiotics By Mouth:
- Antibiotics may or may not be helpful. Your doctor will decide.
- If prescribed, take the antibiotic as directed.
- Pus Precautions:
- Pus or other drainage from an open boil contains lots of Staph bacteria.
- Once a boil is opened it will drain pus for 3 to 4 days. Then it will slowly heal up.
- Cover all draining boils with a clean, dry bandage. A gauze pad and tape work well.
- Change the bandage twice daily.
- Clean the skin around the boil with an antibacterial soap each time.
- Carefully throw the bandage away in the regular trash.
- Wash your hands well after any contact with the boil, drainage or the bandage.
- What to Expect:
- Without treatment, the body will slowly wall off the Staph infection.
- After about a week, the center of the boil will fill with pus. It will become soft.
- The skin over the boil then develops a large pimple. This is known as “coming to a head.”
- The boil is now ready for draining by your doctor.
- Without draining, it will open and drain by itself in 3 or 4 days.
- Return to School or Child Care:
- Closed boils cannot spread to others.
- Children with a closed boil can go to school or child care.
- The pus or drainage in open boils can spread infection to others.
- For open boils, the drainage needs to be fully covered with a dry bandage. If not, stay home until it heals up (most often 1 week).
- Return to Sports:
- Children with a closed boil may be able to play sports.
- Children with an open boil cannot return to contact sports until drainage has stopped.
- Check with the team’s trainer, if there is one.
- Call Your Doctor If:
- Fever occurs
- Redness spreads beyond the boil
- Boil becomes larger than 2 inches (5 cm) across
- Boil comes to a head (soft pus-colored center)
- You think your child needs to be seen
- Your child becomes worse
Treatment for a Small Tender Red Lump (less than ½ inch or 12 mm across)
- What You Should Know About a Small Tender Red Lump:
- A small red lump most often is a minor infection of a hair follicle.
- It may or may not become a boil.
- Use an antibiotic ointment to keep it from getting worse. No prescription is needed.
- Apply it to the red lump 3 times per day.
- Pain Medicine:
- If painful, give an acetaminophen product (such as Tylenol).
- Another choice is an ibuprofen product (such as Advil).
- Use as needed.
- Caution – Do Not Squeeze:
- Do not squeeze skin lump. Reason: squeezing it can force bacteria into the skin.
- Call Your Doctor If:
- Red lump becomes larger or bigger than ½ inch (12 mm)
- Not improved after using antibiotic ointment for 3 days
- You think your child needs to be seen
- Your child becomes worse
And remember, contact your doctor if your child develops any of the ‘Call Your Doctor’ symptoms.
Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.
Copyright 2000-2021. Schmitt Pediatric Guidelines LLC.
Furuncle: medicines used in the treatment
Boils are painful, inflamed, pus-filled cavities in the skin, most often in areas of scalp and friction.
The size of the boil can be from a pea to a walnut. While boils can occur anywhere on the body, they are most commonly found in areas with hair and friction, such as the neck, armpits, groin, face, chest, buttocks, etc.d.
Carbuncles are especially large boils or several adjacent boils, which are usually deeper and more painful. If you suspect a carbuncle, be sure to consult your doctor, because inflammation can enter the bloodstream, and then you may need antibiotics.
Causes of boil
Boils occur when bacteria invade the hair follicle. The skin tissue swells and a red, pus-filled, painful swelling appears.Until the boil is opened and emptied (the pus contained in it will not come out), the boil will hurt and it will be unpleasant to touch it.
At the first small boil that appears, accompanied by soreness, redness, swelling and itching, you can try to cope with the problem yourself.
If the boil does not form a head or does not improve within three days, or if the boil is very painful, with a lot of pus, if the pain that occurs interferes with movement, or if the boil has arisen in the face, spine or rectal area, if at the same time the temperature rises or red stripes are visible diverging from the boil (lymphangitis), as well as with the frequent appearance (furunculosis) of even small boils, you should definitely consult a doctor
Complications with boils
- spread of boils to other parts of the body;
- septicemia (blood poisoning).
What You Can Do
Wash your hands with antibacterial soap before touching the boil and after contact with the boil (it does not matter, with a wound or a purulent head).
Gently apply antibacterial agent to the affected area 3-4 times a day. Apply a warm compress for 15 minutes 3-4 times a day to relieve pain and accelerate the maturation of the purulent head. Then you should cover the boil with a thick layer of gauze and keep the dressing dry. Do not under any circumstances scratch or pick the boil, do not squeeze out or open the boil yourself, because.because it can spread the infection. If the boil opens on its own, carefully remove the pus, then carefully treat the area with hydrogen peroxide. Then apply a dry bandage. Repeat the procedures every day until complete healing. Take a pain reliever to relieve pain and reduce inflammation. Do not use over-the-counter medications (creams, ointments) that contain antibiotics without consulting your doctor. Never try to open a boil yourself without a doctor’s permission.
Wash your hands thoroughly before preparing food.because bacteria from the boil can cause food contamination. Diabetics should consult a doctor immediately if a boil occurs.
What a doctor can do with boils
Your doctor may open the boil by making a small incision with a surgical blade so that the pus can escape, remove the pus, and apply a dry bandage. Prescribe suitable antibiotics (including ointments) if necessary. With frequent boils (furunculosis), prescribe tests (including to make sure that you do not have diabetes).
Take a bath or shower at least once a day. Do not scratch the itchy area on your skin, as this can provoke infection into the damaged area.
Apply an antiseptic lotion to keep infection out.
Attention! Symptom chart is for educational purposes only. Do not self-medicate; for all questions regarding the definition of the disease and methods of treatment, contact your doctor.Our site is not responsible for the consequences caused by the use of information posted on the portal.
Nasal furuncle: symptoms, diagnosis, treatment of nasal furuncle
Furuncle is an inflammatory process of the skin, which is caused by the penetration of infection (bacteria) into the structures of the hair follicle. The vestibule of the nose is lined with skin with a large number of hair follicles. Therefore, if an infection gets into them, a boil may occur.
Furuncle of the vestibule of the nose is a rather serious disease, which should be treated with great caution and in no case self-medicate. If you suspect you have a nasal boil, be sure to consult a doctor, you need qualified help.
Causes of nasal furuncle
The causes of nasal furuncle include:
- instability of the skin to pathogens,
- vitamin deficiency,
- metabolic failure in the body,
Please note that a boil in the nose may indicate diabetes.
Symptoms of a nasal boil include:
- slight itching and (or) feeling of a foreign body in the vestibule of the nose,
- painful sensations (pain can be moderate and severe), pain can occur when touching a sore spot, it can be constant,
- swelling and redness of soft tissues in the nasal region of various prevalence,
- temperature (up to 38 – 38.5 degrees C).
Do not try to treat the boil of the nose on your own! Seek immediate medical attention for surgical or conservative treatment.
Diagnostics of the nasal furuncle includes:
- medical examination of the patient,
- a study of blood and daily urine for sugar to exclude diabetes (in patients with recurrent and prolonged furuncle),
- blood test for sterility (with a strong rise in temperature),
- smear from purulent discharge to determine microflora and its sensitivity to antibiotics,
- Sounding of the boil apex.
A mild form of nasal boil disease is on an outpatient basis (the doctor prescribes antibiotics, vitamins, as well as the treatment of the boil itself).
Conservative treatment of the nasal furuncle involves the use of: antibacterial, anti-inflammatory, anti-allergic drugs, physiotherapy procedures.
Surgical treatment is the opening of the boil. The opening of the boil, as a rule, is performed under local anesthesia and is painless for the patient.
Treatment of complicated forms of nasal furuncle is performed only in a hospital setting.
Carbuncle: Causes, Symptoms, Treatment | doc.ua
The cause of a carbuncle, as a rule, is a neglected boil. There are cases when the furuncle that has arisen does not really need treatment and after a while it passes. However, against the background of reduced immunity, in conditions of contact with clothing, the inflammation begins to progress, while the skin becomes purple-cyanotic, fistulas are formed through which a greenish liquid is separated.
In the absence of proper treatment, a large (up to 10 cm) skin defect may form, after which, together with particles of the epidermis, purulent contents begin to be rejected. This process is also accompanied by a rather strong unpleasant odor.
In order to avoid this, it is necessary to abandon self-medication, the use of folk methods and squeezing the boil.
The consequences of improper treatment of a boil can be: the formation of a carbuncle, sepsis and meningitis.The danger of non-traditional methods of treatment lies in the inability to independently determine the stage of the inflammatory process. In the event of a boil that does not pass and does not decrease in size within 1-2 days, and at the same time there is a general deterioration in well-being, it is recommended to consult a qualified surgeon.
Carbuncle is a disease that does not often affect the face and limbs, usually it occurs on the back of the neck or between the shoulder blades, it can also occur on the lower back and buttocks.As a rule, we are talking about a single copy. This kind of inflammation is characterized by gradual development.
The main stages of development of the carbuncle include:
- Formation of a cone-shaped serous infiltrate reaching a diameter of 1.5 cm;
- The purulent-necrotic stage of inflammation is characterized by the appearance of a purulent pustule at the apex of the carbuncle;
- Healing stage, during which the necrotic rod is rejected and a skin defect is formed in the form of a retracted scar.
The first two stages pass, accompanied by an increase in body temperature up to 40 ° C, fever, headache, disorders of the gastrointestinal tract (nausea and vomiting, loss of appetite), lack of healthy sleep and heart palpitations, chills. The main symptom is considered to be sharp bursting pains at the site of inflammation of the skin.
The course of inflammation largely depends on what kind of microbes became its pathogens. Most often, they are microbes of the streptococcal or staphylococcal family.They cause a severe course of the disease and its complications such as lymphangitis – inflammation of the lymphatic vessels; or lymphadenitis – inflammation of the lymph nodes. Among the rare, but the most dangerous and even fatal complications of the carbuncle are basal purulent meningitis, thrombophlebitis, sepsis and arachnoiditis.
If the disease is relatively mild and no complications are observed, then improvement can be observed on the 3-5th day of correct treatment. The carbuncle enters the final stage: the wound is cleared of pus and dead tissue, the affected area of the skin is filled with newly formed tissue, otherwise called granulation, and the formation of a scar begins.
Making a diagnosis upon examination by a doctor is not difficult due to the specific clinical picture of the disease. Further diagnostics are used to determine the type of pathogen in order to prescribe effective antibiotic therapy, as well as to determine the severity of the disease and the degree of intoxication of the patient. For this, pus is taken from the patient’s wound and subjected to bacteriological examination, during which it is possible to find out the type and susceptibility of the pathogen to various types of antibiotics.A general blood and urine test is mandatory to determine the level of leukocytes and ESR.
If the carbuncle proceeds against the background of chronic diseases, then consultation of narrow specialists is necessary. For example, with diabetes mellitus, it is important to consult an endocrinologist. It is necessary to determine the level of glucose in the blood and, if necessary, to stabilize the patient’s condition.
Treatment of carbuncle is carried out, as a rule, on an outpatient basis with the use of antibiotics and pain medications.In the absence of symptoms of intoxication and a small size of the focus of inflammation, physiotherapy and a dairy-plant diet are prescribed. In no case should you carry out an independent opening of the carbuncle. The surface of the abscess is treated with alcohol and a dry sterile dressing is applied. In such cases, the treatment period is about 3 days.
In a severe course of the disease: severe intoxication, localization of the carbuncle on the face, the patient is admitted to the hospital. Frequent and thorough treatment of the wound with alcohol, iodine, brilliant green solution is carried out; a course of anti-inflammatory and antibiotic therapy based on the results of bacteriological research.
The most advanced cases of carbuncle require surgery. Removal of the carbuncle is carried out by cruciform excision and removal of pus and dead tissue. The use of antibiotics continues until the wound is completely scarred.
Treatment of acute inflammation of the outer and middle ear
Acute otitis media
Among the total number of people with pathology of ENT organs, acute otitis media (AOM) is diagnosed in about 30% of cases .The course of acute otitis media depends on the etiology, a combination of predisposing factors, the specifics of morphological manifestations, and functional disorders.
Etiology and pathogenesis. A key role in the etytopathogenesis of acute otitis media is played by the transition of the inflammatory process from the nasopharynx to the mucous membrane of the middle ear – indirectly through the pharyngeal opening of the auditory tube. As a result of obturation of the auditory tube in the tympanic cavity, the pressure drops sharply. This leads to the formation of an effusion in the lumen of the middle ear.The latter, in turn, becomes infected due to invasion by the microflora of the nasopharynx. Thus, the prevailing mechanism of infection penetration into the middle ear cavity is tubogenic – through the auditory tube. There are other ways of penetration of infection into the tympanic cavity: traumatic, meningogenic – retrograde spread of the infectious meningococcal inflammatory process through the cerebrospinal fluid system of the ear labyrinth into the middle ear, finally, the fourth route is relatively rare – hematogenous (sepsis, scarlet fever, measles, tuberculosis, typhus).
AOM can be caused by bacterial and viral pathogens, the relative frequency of which varies depending on the age of the patients and the epidemiological situation. Today, the role of intracellular pathogens such as
is debatable. The main causative agents of AOM in more than 80% are S. pneumoniae and H. influenzae untyped strains , less often M. catarrhalis . Moreover, it should be noted that more than 34% of strains H. influenzae and 70% of M.catarrhalis produce b-lactamase, an enzyme that cleaves the b-lactam ring of antibiotics, belonging to the group of penicillins and cephalosporins. In less than 10% of cases, AOM is caused by GABHS (S. pyogenes), S. aureus , or an association of these microorganisms . There is no strict correspondence between the etiology of CCA and the clinical picture of the disease; however, it should be noted that pneumococcal CCA usually proceeds more severely, often leads to the development of complications and is not prone to self-resolution.
Acute otitis media is a disease with a fairly pronounced staging course. Most authors distinguish 3 stages (phases): catarrhal, purulent and reparative. However, it seems more appropriate to distinguish between 5 stages of acute inflammation of the middle ear :
I. Stage of acute eustachitis, when there is inflammation of the mucous membrane of the auditory tube and dysfunction of the latter.
II. Stage of acute catarrhal inflammation in the middle ear – characterized by plethora of vessels of the mucous membrane of the middle ear and tympanic membrane due to a significant decrease in pressure in the middle ear cavities.There is aseptic inflammation of the mucous membrane of the middle ear with the formation of serous exudate.
III. The pre-perforative stage of acute purulent inflammation in the middle ear is caused by tubogenic infection of the middle ear and the release of corpuscles, mainly neutrophils, from the capillaries of the mucous membrane of the tympanic and other middle ear cavities and, thus, suppuration of exudate.
IV. Postperforated stage acute purulent inflammation in the middle ear – the appearance of a perforation of the tympanic membrane and the outflow of pus into the external auditory canal.
V. Reparative stage. Symptoms of acute inflammation are relieved, the perforation is closed with a scar.
Treatment. It is necessary to systematize the treatment of acute otitis media according to the staging of the pathological process in the middle ear and the identified features of the pathogenesis.
At the stage of acute eustachitis (stage I) we perform catheterization of the auditory tube and pneumomassage of the tympanic membrane according to Siegle.A mixture of 0.05% or 0.1% naphthyzine solution and a water-soluble (but not suspension) corticosteroid (solucortef, dexazone, dexamethasone) is injected through the catheter. The use of a suspension disrupts the function of the ciliated epithelium of the tube. Politzer blowing of the auditory tube should be handled with caution due to the likelihood of infection (through the nasopharynx) of the healthy auditory tube.
From the means of drug treatment for patients at this stage of the disease, we recommend vasoconstrictor or astringent (with abundant nasal secretion) nasal drops, nasal topical steroids.
With the development of acute catarrhal inflammation in the middle ear (stage II) we also carry out catheterization of the auditory tube (and administration of drugs) according to the method described above. At this stage of the disease, pneumomassage of the tympanic membrane must be abandoned due to the painfulness of the procedure. Along with this, the patient undergoes an endaural microcompress according to M.F. Tsytovich. The technique for performing the compress is simple: a thin cotton or gauze turunda moistened with osmotol (a mixture of 70 ° or 90 ° ethyl alcohol and glycerin in a 1: 1 ratio) is inserted into the external auditory canal, and then the auditory meatus is sealed from the outside with a cotton swab with vaseline oil.Thus, the turunda moistened with osmotol does not dry out, and the mixture used has a dehydrating, warming and analgesic effect. We leave the compress in the ear for 24 hours. Among medications, nasal drops with a vasoconstrictor or astringent effect, nasal topical steroids, are also used.
III stage of inflammation in the middle ear – stage of acute purulent preperforative inflammation caused by suppuration of exudate. The pain at this stage increases sharply, acquiring an intolerable character, while radiating along the branches of the trigeminal nerve to the teeth, neck, pharynx, eyes, etc.n. (the so-called distant otalgia). Otoscopically, along with bright hyperemia and edema, a bulging of the tympanic membrane of varying severity is determined. The general condition of the patient deteriorates sharply. Body temperature reaches febrile numbers. The patient undergoes catheterization of the auditory tube with the introduction of drugs and an endaural microcompress with an osmotol or other osmotically active agent according to the described scheme. After waiting 20-30 minutes, you can be sure of the effectiveness of the treatment.In the event that there is an effect, we carry out a treatment similar to that carried out for acute catarrhal inflammation of the middle ear. If the effect does not occur, it is necessary to perform paracentesis or tympanopuncture. Indications for emergency paracentesis are signs of irritation of the inner ear or meninges (nausea, vomiting, headache), as well as symptoms of facial nerve damage. From medications, rather strong analgesics are necessarily prescribed, containing paracetamol or drugs, the analgesic properties of which are enhanced by combining the latter with other drugs (caffeine, codeine, etc.).NS.).
At stage IV of acute purulent postperforated otitis media , an additional route of drug administration appears – transtympanic (through natural or artificial perforation of the tympanic membrane). For all patients in this phase of acute otitis media, we necessarily carry out catheterization of the auditory tube and administration of drugs, use vasoconstrictor and astringent nasal drops, nasal topical steroids. Transtympanic – solutions of broad-spectrum antibiotics that do not have an ototoxic effect (cephalosporins, etc.)and the ability to crystallize. In the event that suppuration persists, it is necessary to resort to a study of the microflora of purulent exudate for sensitivity to antibiotics and continue local treatment, taking into account the data obtained.
Finally, Stage V of acute otitis media – the stage of recovery. However, it should be noted that it is this stage that is fraught with the danger of chronicity of an acute process or the development of an adhesive process. In this regard, at the end of acute adhesive inflammation of the middle ear, it is necessary to control the scarring of the perforation.Locally, tinctures of iodine and lapis (40%) can be used to cauterize the edges of the perforation. It must be remembered that the formation of persistent perforations and chronicity of acute inflammation in the middle ear are usually caused by insufficient attention to the function of the auditory tube and transtympanic administration of boric alcohol in the perforated phase of inflammation. In the event that conservatively it is not possible to restore the integrity of the tympanic membrane, it is necessary to resort to myringoplasty.
Antibacterial therapy. The question of the advisability of using systemic antibiotic therapy in acute otitis media remains controversial. It should also be borne in mind that up to 75% of cases of AOM caused by M. catarrhalis , and up to 50% of cases caused by H. influenzae , resolve on their own (without antimicrobial therapy for 24 – 72 hours). Subsequent resorption of effusion in the tympanic cavity takes place over the next 2 weeks. However, most otiatrists recommend the use of systemic antibiotics in all cases of CCA due to the risk of intracranial complications .Systemic antibiotics should be used with caution, taking into account the severity of the course, the stage of the disease and the age of the patient. Thus, systemic antibiotic therapy can be recommended for patients in stages III and IV of CCA with moderate and severe forms of its course. Also, the use of antibiotics is necessary in patients with severe somatic pathology (diabetes mellitus, kidney and blood diseases).
The leading drugs for empiric treatment of CCA in outpatient practice should be considered amoxicillin, since it is the most active against penicillin-resistant pneumococci, as well as macrolide antibiotics (rovamycin, azithromycin, clarithromycin, etc.)) to be used for β-lactam allergies. With the resistance of pathogens to amoxicillin (with persistent, recurrent otitis media) – amoxicillin with clavulanic acid, ceftriaxone, cefuraxim ascetil and the last generation of fluoroquinolones .
The use of fluoroquinolones in uncomplicated forms of acute otitis media should be treated with caution. We must not forget that they are still considered reserve drugs. In this regard, it is possible to propose the following scheme of antibacterial therapy for complicated forms of acute otitis media: amoxicillin-clavulanate – 650 mg 3 times a day (1000 mg 2 times a day), for 48 hours., with a positive effect – continuation of the specified treatment, otherwise – levofloxacin 0.5-2.0, once a day, moxifloxacin 400 mg, once a day.
Ear drops. The greatest number of questions is caused by the validity of the use of ear drops for otitis media [3-5].
The antibacterial effect of ear drops is significant only in perforated forms of otitis media, since neither antibiotics nor antiseptics penetrate through the intact tympanic membrane.At the same time, most of the currently existing ear drops contain aminoglycosides, the penetration of which into the tympanic cavity is unacceptable due to their ototoxic effect .
Thus, for perforated forms of otitis media (acute and chronic), transtympanic administration of drops that do not contain ototoxic antibiotics – rifamycin (otofa), ciprofloxacin, norfloxacin are indicated.
It is known that bacterial contamination of the middle ear in acute otitis media is no more important than the condition of the auditory tube and the mucous membrane of the tympanic cavity, as well as the possibility of reinfection.Accordingly, in pre-perforative forms of otitis media, the fight against severe pain syndrome is an important component in the complex therapy of acute otitis media. Thus, anti-inflammatory, dehydrating and analgesic therapy is becoming no less relevant than the fight against infection.
In this regard, the most adequate application seems to be the use of otofas in non-perforated acute otitis media as a drug with the listed effects.
The action of the otof drug is determined by the presence in its composition of rifamycin, a semi-synthetic antibiotic with a broad spectrum of action.The drug has a pronounced bactericidal effect primarily on gram-positive bacteria, including strains resistant to other antibiotics. Rifamycin is active against staphylococci, hemolytic streptococcus, pneumococci, mycobacterium tuberculosis, and in higher concentrations against Escherichia coli, Proteus [5, 6]. The variety of action of the drug described above is explained by the presence in its composition of excipients (macrogol, ascorbic acid, disodium edetate, potassium disulfite, lithium hydroxide).Numerous reviews indicate that otof drops relieve acute pain and bring significant relief immediately upon the first application [3, 7].
Acute external ear inflammation
Inflammatory diseases of the external ear are widespread among people of different ages. The general condition of the body plays a significant role in the etiopathogenesis of this group of diseases: they are more common in patients with diabetes mellitus, patients with impaired immune status.The species composition of causative agents of diseases of the external ear is quite diverse. Furuncles of the ear canal are most commonly caused by S. aureus . Diffuse otitis externa can be caused by gram-negative bacilli, for example E. coli, P. vulgaris and P. aeruginosa, and S. aureus , and fungi. Beginning as otitis externa caused by Pseudomonas aeruginosa, malignant otitis externa can progress to pseudomonas osteomyelitis of the temporal bone.
In the area of the auricle, erysipelas and perichondritis may develop. Differentiating them among themselves is not difficult. So, in the case of erysipelas, the entire auricle is usually affected, hyperemia and edema have clear boundaries in the form of “tongues of flame” and can pass to the underlying tissues. With perichondritis, inflammatory diseases are localized in the area of the cartilage of the auricle.
Penicillin antibiotics are used to treat erysipelas. The affected areas are extinguished with 5% iodine tincture.With perichondritis, in addition to antibiotic therapy, surgical treatment is used: opening and drainage of subperichondral abscesses, removal of necrotic areas of cartilage.
In both cases, it is possible to use antibacterial ointments, physiotherapy.
Treatment of the boil of the external auditory canal – complex. Often it is necessary to open the boil, while carefully removing pus and necrotic tissue. With furuncles of the external auditory canal, local use of antibiotics is ineffective, and their systemic administration is usually not necessary.In the presence of symptoms of intoxication, antibiotics are indicated, usually by mouth: oxacillin, amoxicillin / clavulanate, or cephalosporins (cephalexin, cefadroxil).
External diffuse otitis media – polyetiological diseases. Differentiate the bacterial, fungal and allergic nature of the process. Clinical manifestations are common for them – itching of the skin, putrid discharge, soreness when pressing on the tragus, etc. Otoscopically, hyperemia and infiltration of the skin of the membranous-cartilaginous part of the ear canal is determined, its lumen sometimes narrows to such an extent that the tympanic membrane becomes immense.Desquamated epithelium mixes with pus, forming a mushy mass with a pungent putrid odor.
Nitrofungin is used for mycotic otitis externa. It is used for various types of fungal skin lesions: trichophytosis, fungal eczema, epidermophytosis, candidiasis. In the latter case, nitrofungin treatment with clotrimazole can be combined. Amphotericin B, amphoglucamine, mycoheptin are effective in cases of mold infestation .
For malignant otitis externa, antibiotics active against P.aeruginosa: penicillins (azlocillin, piperacillin), cephalosporins (ceftazidime, cefoperazone, cefepime), aztreonam, ciprofloxacin. All these antibiotics should preferably be prescribed in combination with aminoglycosides (gentamicin, tobramycin, netilmicin, amikacin). All antibiotics are used in high doses, the duration of therapy is 4-8 weeks (with the exception of aminoglycosides). With stabilization of the condition, it is possible to switch to oral therapy with ciprofloxacin.
In addition, symptomatic and hyposensitizing therapy is carried out for all forms of otitis externa.Various physiotherapeutic methods are effectively used: tube-quartz, irradiation of the skin of the ear canal with a helium-neon laser, UHF (at the stage of resolving the process).
Treatment of bacterial otitis externa begins with local antibiotic therapy in the form of various ointments that affect as many microorganisms as possible, for example, containing mupiracin. It is possible to use antiseptics (3% boric alcohol, 2% acetic acid, 70% ethyl alcohol). Systemic administration of antibiotics is rarely required, except in cases of spread of the process outside the ear canal.In this case, amoxicillin / clavulanate or I-II generation cephalosporins (cephalexin, cefadroxil, cefaclor, cefuroxime axetil) are used internally.
Ear drops occupy a special place in the treatment of otitis externa (see table). In diffuse otitis externa, therapy begins with topical application of drugs containing antibacterial drugs (neomycin, gentamicin, etc.) and anti-inflammatory drugs. The use of glucocorticoids for diffuse otitis externa is based on their local anti-inflammatory, anti-allergic, antipruritic action.Of the antibacterial agents, aminoglycosides are most often used, since these drugs quite completely cover the spectrum, primarily of gram-negative microorganisms that cause otitis externa, and provide a good application effect. With staphylococcal infection, currently, preference is given to drugs containing fusidic acid.
Thus, with diffuse otitis externa, it seems reasonable to use combined ear drops containing the above active substances.
In our opinion, ear drops of Polydex [3, 7] are among the most effective for the treatment of diffuse otitis externa [3, 7], which are just a combination drug, which, along with powerful antimicrobial action, neomycin and polymyxin B also includes dexamethasone. Neomycin has a bactericidal effect against a wide range of pathogens, aerobes and anaerobes and is well combined with the features of the action of polymyxin B, in particular its effectiveness against Pseudomonas aeruginosa.Dexamethasone is characterized by a pronounced local anti-inflammatory and hyposensitizing effect.
The uniqueness and effectiveness of Polydexa, in contrast to similar drugs, is explained by the presence of polymyxin in the drops. Polymyxins are a group of antibiotics synthesized by a specific strain of the spore-forming bacillus: in terms of chemical composition, they are cyclic peptides. Systemic use of polymyxins is limited due to their high toxicity. At the same time, side effects with topical application of polymyxin are extremely rare.The main indications are severe infections caused by pseudomonads and Klebsiella (pneumonia, lung abscess, sepsis, endocarditis, meningitis). The unique spectrum of antibacterial activity against gram-negative bacteria and, above all, against most strains of Pseudomonas aeruginosa and Escherichia coli makes polymyxin the drug of choice for the treatment of otitis externa [5, 6].
A contraindication for the use of the drug is the presence of a perforation of the tympanic membrane, since the penetration of the drug into the tympanic cavity threatens with a possible ototoxic effect of the aminoglycoside included in its composition.
In conclusion it should be noted that the best method of prevention of otitis media is the timely treatment of acute respiratory viral infections, diseases of the nose, paranasal sinuses and nasopharynx, as well as observance of the rules of hygiene of the outer ear.
Antibiotics for boils on the face and groin in tablets
Comprehensive treatment of boils will never be effective without the use of antibacterial drugs. What kind of antibiotics you need to drink with boils is determined by the doctor, assessing the patient’s condition and the stage of the disease.Furunculosis is characterized by multiple purulent inflammations of the hair follicles, in which the surrounding tissues are also affected – first, their melting and suppuration occurs, and then necrosis.
Localization of boils on the body – back, chest, groin, armpits, often boils are on the butt. But the greatest danger is posed by abscesses and abscesses on the face, head and neck, since there is a high risk of infection spreading to the brain.
The causative agent of the inflammatory process in this case is Staphylococcus aureus – one of the most toxic microbes, rapidly moving along with the bloodstream throughout the body.That is why antibiotics for boils are indispensable – no other medications or folk remedies can stop the growth of pathogenic bacteria and the progression of furunculosis.
Peculiarities of treatment of pathology
There is a proven and effective treatment regimen for furunculosis. The main tasks of therapy are to block the growth of bacteria and eliminate the focus of inflammation and infection, that is, the purulent core of the chirium and the surrounding dead tissues. Antibiotics with advanced furunculosis (dilution) destroy the causative agents of the disease, but if the abscesses are not removed, the infection will still remain in the body. And vice versa, if the abscess is removed, but the microbes are not affected, it is pointless to treat the pathology further with surgery or folk remedies.
The main stages and moments of treatment of furunculosis are as follows:
- A novocaine blockade is performed with the introduction of an antibacterial drug for boils, an injection or a few are made around the abscess. Such measures allow you to stop pain and stop the spread of infection.
- Keratolytic preparations are applied to the boil, stimulating the maturation and discharge of the purulent core.Surgical removal of an abscess is not always carried out, especially if it is localized on the face – after a mini-operation, scars remain. First, the doctor tries to solve the problem by using a suitable boil remedy.
- If the boil has transformed into an abscess and suppuration has begun around it, surgical methods of treating furunculosis are indicated. The doctor opens the abscess, removes its core and cleans out the abscess cavity.
- The wound is then disinfected and a topical antibiotic bandage is applied.
- Antibiotics are also required for systemic furunculosis.
What antibiotics to take, in what dosage, the duration of treatment can only be accurately determined by a doctor.
Ointments and gels for external use
In the course of complex treatment, it is very important to observe personal hygiene and keep the affected areas clean. In addition, boils are treated with antibacterial ointments and creams. The most commonly used are the following:
A remedy proven for decades, contains two active substances of different actions: chloramphenicol, which inhibits the growth of Staphylococcus aureus, and methyluracil, which helps to restore and strengthen the body’s natural defenses.Levomekol acts on aerobic and anaerobic gram-positive and gram-negative microorganisms, while stimulating the regeneration of the affected tissues. The ointment is widely used to treat a wide variety of skin pathologies associated with inflammation and suppuration – trophic ulcers, gangrene, burns.
Mupirocin (or Bactroban containing the same active ingredient)
It is a broad spectrum antibiotic obtained from living microorganisms. Most of the strains of staphylococci, including golden one, are sensitive to it.
The drug is effective in all forms of furunculosis and folliculitis, as well as in recurrent infections of the skin and subcutaneous tissue.
For the treatment of abscesses and abscesses, the ointment is applied to the cleaned wounds twice a day and covered with a sterile bandage.
The drug is produced in the form of a gel, it is prescribed if other antibacterial agents are ineffective. In the composition of the gel, the main active substance is fusidic acid; glycerin, zinc oxide and other auxiliary components complement its action.The drug is able to penetrate the membranes into the cells of pathogens and suppress protein synthesis in them. Due to this, cells are destroyed and bacteria die. The drug is also available in the pharmacy in pill form.
The product can be purchased in the form of an ointment or powder for the treatment of purulent wounds and boils. The preparation contains two antibacterial substances at once: bacitrocin and neomycin. They also block protein synthesis and destroy bacterial cell membranes.Baneocin is quite effective for furunculosis, but it can cause allergic reactions.
Along with these drugs in the complex therapy of furunculosis, classic, inexpensive and affordable ointments are used – erythromycin, tetracycline, levomycytin. Appointments should only be made by a doctor based on a study of the patient’s history and an assessment of the effectiveness of the therapy. Not all medicines are equally well suited to different patients, and sometimes prescriptions have to be adjusted during treatment.
In parallel with ointments, gels and powders for external use in the treatment of boils, the doctor often prescribes tablets for internal use. It is necessary to take antibiotics in tablet form in cases where, despite the use of topical agents, boils appear again and again, while the place of their localization is the head and upper body.
If boils recur, this indicates that the microbes have already developed resistance to the antibacterial drugs used.To find an effective drug, you first need to conduct a sensitivity test. For this purpose, the doctor will take a scraping from the abscess and send it to the laboratory for bacteriological examination. Based on the results of bacteriological culture, the doctor will be able to choose the most effective antibiotic to suppress pathogenic microbes.
In modern medicine today, more than twenty types of various antibacterial drugs are used that can stop the growth of Staphylococcus aureus and cure furunculosis at any stage.Here are the most common and available ones:
Ceftriaxone and Cephalexin
These antibacterial drugs in tablets belong to the class of cephalosporins and can destroy almost all types of bacteria from the staphylococcus group. On the market, you can find medicines in the form of tablets, capsules or powder for the preparation of a suspension. The active components are rapidly absorbed in the digestive tract and enter the bloodstream, the drug begins to act 45-60 minutes after ingestion.
You need to take the remedy every six hours at the dosage set by the doctor – it depends on the patient’s weight, age and physiological characteristics, and the severity of the disease. The recommended daily dose of this antibiotic is 1 to 4 mg. Side effects are possible: trembling of the limbs, attacks of dizziness and weakness, disorders in the digestive system. The discomfort goes away after adjusting the dosage, in rare cases you have to look for an analogue of the drug.
The most powerful antibiotic of the new generation, belongs to the group of penicillins.The drug contains two active substances: amoxicillin and clavulonic acid. Amoxicillin interferes with the vital processes of pathogenic microorganisms and destroys the membranes of their cells. Clavulonic acid has protective functions, preventing premature decomposition of amoxicillin and enhancing its effect.
This drug has a prolonged action and a cumulative effect. For the treatment of boils and abscesses, one 375 mg tablet is usually prescribed every 8 hours.
It is recommended to chew the tablet thoroughly and drink it with plenty of clean water. Or dissolve the medication in a small amount of water, swallow the resulting suspension and also drink it with water. Amoxiclav can cause disorders of the digestive tract, allergic reactions like urticaria – skin rashes, redness, itching, edema.
In rare cases, patients complain of migraines, convulsions, insomnia, with prolonged use and overdose, the drug can provoke the development of anemia.
Fusidin (analogue of Ramycin)
It is used as an alternative drug if all other drugs that can act on staphylococcus strains are ineffective. A single dose of the drug is from 0.5 to 1.0 mg three times a day at regular intervals. It is recommended to drink the tablets with plenty of milk or water. The drug also often provokes diarrhea, vomiting, heartburn, abdominal cramps, can cause bouts of nausea, weakness and dizziness, an allergic rash on the skin.Therefore, treatment should be strictly under the supervision of a physician.
Each of the listed drugs has its own analogues and can be replaced, but only a doctor always prescribes, especially when it comes to treating a child.
Antibacterial drugs for children
The drug of choice for the treatment of various infectious diseases of the skin in a child is sumamed – an antibiotic effective for furunculosis, belonging to a number of penicillins. In most cases, it is well tolerated, the expected effect begins to manifest itself on the second day of therapy, and the full course of treatment lasts no more than 5-7 days.The drug can be freely purchased in a pharmacy without a doctor’s prescription, great convenience in a variety of pharmaceutical forms of release.
For children, a powder is used to prepare a thick suspension with a sweetish taste, which makes it easier to take the drug. For convenient dispensing, a special plastic syringe or cap with labels is provided. Dosage is determined according to the weight of the child and the severity of the lesions. If necessary, the doctor selects antibacterial drugs from other groups, also in the form of suspensions.
With a mild degree of the disease, folk remedies are effective in combination with pharmacy ointments – for example, viburnum or aloe are excellent against inflammation, as lotions and compresses.
Very often you can hear complaints from patients: “I drank the antibiotic prescribed by the doctor and it didn’t help me, but it only got worse, so it’s better to be treated with folk remedies and not trust the doctors”. This is a fundamentally misconception. Antibacterial drugs are ineffective only if the patient does not adhere to the established treatment regimen and dosage or has an individual drug intolerance.Furunculosis should not be treated on your own – this can lead to fatal consequences.
Antibiotic from boils – When the patient is at home – Catalog of articles
The common name of the boil is an abscess. This name is due to the fact that the boil is the cause of an increase in body temperature, pain and tissue edema. In appearance, a boil resembles a large pimple. The development of a boil is associated with an infection, which can be staphylococcus aureus.
Antibiotics for boils
The choice of one or another antibiotic for the treatment of a boil depends on the exact type of staphylococcus, to determine which the doctor needs to sow the pathogenic flora. Usually, boils are treated with dicloxacillin, an antibiotic of the penicillin group, ideal precisely for combating staphylococci.
Boils localized in the armpits or in the genital area are often not infectious inflammations, but a special type of acne.A characteristic feature of such acne is the high frequency of their formation. For the treatment of acne, antibiotics with a prolonged effect are used. Antibiotics of the penicillin group are not used. Their place is taken by tetracyclin, erythromycin, minocycline.
There are times when the whole family is infected. If such a situation arises, the doctor is obliged to sow the culture, establishing the exact causative agent of the disease, and also prescribe nasal drops containing an antibiotic to all family members.Instilling such drops should stop the transmission of infection from one family member to another.
Antibiotics for the treatment of boils, carbuncles, treatment regimens
Antibiotics are prescribed systemically for boils and carbuncles associated with cellulite of the surrounding tissue or with fever and located on the forehead, nose, cheeks or upper lip. Patients with recurrent furunculosis and immunodeficiency are also prescribed systemic antibiotics.
When choosing a treatment, it is advisable to know the body’s sensitivity to antibiotics.If unknown, it is advisable to start treatment with a semi-synthetic penicillin resistant to penicillinase, such as cloxacillin 250 mg every 4-6 hours or dicloxacillin 500 mg every 6 hours for 10 days. For penicillin-sensitive patients, erythromycin or clindamycin are suggested. I prefer to start with azithromycin, one of the relatively new macrolides, at 500 mg on day 1 and then 250 mg on days 2-5. This regimen is more convenient for patients.If the organism is resistant to macrolides, systemic therapy with a cephalosporin such as cefaclor or one of the newer quinolones such as ciprofloxacin is recommended.
In case of recurrent furunculosis, which is a complex therapeutic problem, the body’s sensitivity to antibiotics should be assessed. The appropriate drug, often semi-synthetic penicillin, is usually given for 1–3 months, but can be used for a longer period if necessary.Along with semi-synthetic penicillin, rifampin or rifabutin can be prescribed for 7-10 days, since rifampin has a lower potential for drug-drug interactions and better tissue permeability. In especially torpid cases, it is possible to recommend prescribing these drugs for a longer period, both as monotherapy and in combination with other antibiotics.
Edited by A.D. Katsambasa, T.M. Lottie
Antibiotics for the treatment of boils, carbuncles, treatment regimens article from the section Dermatology
Treatment of a boil with antibiotics
Antibiotics are widely used in the treatment of boils.Without preventing relapses, they contribute to a faster resolution of boils and eliminate complications. Benzylpenicillin is used intramuscularly at 100,000 IU every 3 hours or in the form of durant drugs, as well as in a mixture with autologous blood – a total dose of up to 15,000,000-2,000,000 IU.
In addition to biosynthetic penicillins, oxacillin, methicillin, chlortetracycline, oleandomycin, oletetrin, metacyclin can be prescribed. With single uncomplicated boils, antibiotic treatment is not necessary.Only with boils of the skin of the face, both uncomplicated and especially complicated, with boils complicated by lymphangitis and lymphadenitis, is it absolutely indicated, and with “malignant boils” it responds to vital indications. Antibiotics are also used for furunculosis during the period of multiple rashes of boils. In the absence of antibiotics, sulfonamides are prescribed.
In addition, for chronic furunculosis, as well as for single recurrent boils, to increase the body’s resistance and prevent relapses, non-specific stimulating therapy is recommended, as well as specific immunotherapy in the form of injections: a) staphylococcal vaccine is administered subcutaneously or intradermally in doses from 0.1-0 , 2 to 1 ml at intervals of 2-3 days, a total of 8-10 injections; b) staphylococcal toxoid or drug A2 is injected subcutaneously, starting with 0.5 ml, then 1.0-1.5-2.0 ml at intervals of 2-3 days, a total of 6-8 injections; c) staphylococcal antifagin is injected daily subcutaneously, starting with 0.2 ml, with each subsequent injection, the dose is increased by 0.1 ml to a maximum dose of 1 ml; 10 injections per course.
In chronic furunculosis, the patient is carefully examined to identify the causes predisposing to the disease and the appointment of appropriate individual treatment.
What antibiotics to take for boils
Furunculosis is a serious disease, the size of abscesses can reach 6-7 cm. When to seek the help of a surgeon and what antibiotics are taken for boils.
When should I see a doctor?
• If the immune system is weakened and the abscess is accompanied by severe swelling and redness.
• If a furuncle is formed in the area of the nasolabial triangle or near the eye, it is dangerous, because venous blood enters the brain, and this is fraught with meningitis and encephalitis.
• If the patient has a high temperature and weakness.
Why are antibiotics needed?
• Erotrimycin, oleandomycin, methicillin, seporin, oxacillin, kefzol, cephalexin, augmentin – one of these antibiotics can be prescribed by a doctor in the treatment of furunculosis. In addition to antibiotics, the doctor will prescribe vitamin complexes and immunomodulators.
• Antibiotics block the growth and reproduction of bacteria, thereby giving the person’s own immune system time to defend itself.
• Between the human body and the microflora inhabiting it, there is a constant struggle, microbes deliver attacking blows, and if the immune system is weakened, inflammation or disease occurs. How, in turn, is the body protected? In his arsenal: a strong immune system, proper metabolism and the integrity of the mucous membranes and skin.
Antibiotics for furunculosis
Treatment of furunculosis, the appearance on the body of several purulent inflammations of hair follicles, depends on their localization, stage of development and mainly consists in treating the skin with local preparations.Antibiotics for furunculosis help prevent the risk of infection. since the most common cause of the development of the disease is a bacterial infection.
This infectious disease is more often observed in childhood, but often develops in adults. The causal factors for the development of furunculosis include a weak immune system, damage to the skin, illiterate hygiene, vitamin deficiency.
Furunculosis can be acute or chronic. Local treatment works well for single boils.With localized furunculosis, profuse rashes, general therapy consists in the appointment of antibacterial drugs.
- Antibiotics for boils
- Antibiotics for pyelonephritis
- Treatment of prostatitis with antibiotics
- Antibiotics for syphilis
- Effective remedy for thrush
- Drops with sinusitis
- Adult atopic dermatitis
Antibiotics for furunculosis are considered the only effective method of combating purulent inflammation.The use of antibacterial drugs supplanted the previously used method of immunocorrective therapy, autohemotherapy. Immunization with staphylococcal toxoid, which does not bring the desired results, is also not used today.
For furunculosis, a fairly wide range of various antibiotics is used. in addition to the above funds, Methicillin, Erythromycin, Zeporin, Oleandomycin, Metacyclin and a number of other drugs are also prescribed. In addition to antibiotic therapy, the patient is prescribed vitamin complexes, fortifying agents, special dietary supplements and antibacterial local drugs, such as Bactroban.Sulfanilamide drugs can be used.
In the acute course of furunculosis, Penicillin is prescribed, applied at a certain time interval, established by the doctor. Course doses of drugs such as Bicillin, Ekmonovocillin are also attributed, since often other antibiotics do not give a positive result.
The complex of treatment also includes nutritional adjustments. Doctors usually recommend, instead of a shower, warm disinfectant baths with potassium permanganate, treatment of the skin with salicylic or camphor alcohol.
It is important to remember that antibiotic treatment for single uncomplicated boils is not necessary. Antibiotic treatment is justified only with boils appearing on the skin of the face, with boils complicated by lymphadenitis or lymphangitis.
In chronic furunculosis, it is necessary to conduct a full examination of the patient to identify the predisposing causative factors of the disease and undergo appropriate individual treatment.
Sources: www.doctor-derm.ru, www.primamunc.ru, medicalinfos.ru, venero-pro.ru, skoraya-03.ru
90,000 Nasal furuncle: causes, diagnosis and treatment
What is a nasal furuncle
Purulent inflammations on the skin are of several types. But it is with furunculosis that purulent inflammation is not limited only to the hair follicle, the process involves the tissues that surround the focus of inflammation.
The causative agent of the disease is Staphylococcus aureus or epidermal staphylococcus.Under unfavorable external circumstances or a decrease in the body’s immune forces, the protective barrier of the skin weakens. Harmful microorganisms penetrate through external damage to the inner surface of the nostrils or the outer skin. After all, when a person’s immunity is reduced, the protective properties of the skin also weaken. That is, human sweat and sebum secreted from the pores no longer have sufficient protective properties.
An infection enters the mouth of the hair follicle and triggers a painful and dangerous inflammatory process.The site of inflammation suppurates and fills with a mixture of white blood cells, bacteria and skin cells. Further, the infection descends along the hair root into the follicle. The surrounding tissues become inflamed, purulent masses are formed. Purulent contents accumulate under the layer of skin that surrounds the mouth of the hair.
Important! The venous network on the face is designed so that inflammation can spread to literally all tissues. In this case, thrombosis of the cavernous sinus may occur – a blockage of the vessels of the sinus of the brain.
Why does a boil appear in the nose
The main reason is the activity of pathogens of the disease, staphylococci and streptococci. In most people, these microorganisms constantly live on the mucous membranes – including the nose, but a healthy body keeps their vital functions under control. In order for a colony of microorganisms to begin to grow and harm the body, predisposing factors are necessary:
- cracks, abrasions and other mechanical damage to the nasal mucosa.These can be micro-injuries of the skin with increased sweating, itchy scratching with eczema and dermatitis. As well as scratches, cuts and even internal hairs inaccurately removed from the nostrils;
- foci of chronic infection – caries, chronic tonsillitis, sinusitis, tonsillitis;
- hypothermia of the body;
- lack of vitamins, unbalanced diets, physical overload;
- transferred stress;
- severe chronic diseases – oncology, HIV, diabetes mellitus;
- violation of the rules of personal hygiene – rare washing of the face, life in unsanitary conditions, the habit of touching the face with dirty hands, self-squeezing of pustules;
- difficult working conditions, hazardous production, frequent contact with polluted air, aggressive chemicals;
- hormonal disruption.
90,023 pustular eruptions on the nose and cheeks;
How does the disease proceed
A furuncle of the nose can occur on its wings or tip, the vestibular part of the nasal cavity, the anterior part of the septum.
The disease goes through the same stages, regardless of where in which part of the nose the furuncle is localized and what pathogenic microorganisms cause the inflammation. The stages of development of pathology are as follows:
- Initial stage. A portion of the nose suddenly swells.It turns red, the borders of the spot do not have a clear shape. The place where the boil will soon appear hurts a lot, the discomfort intensifies when you try to feel it. Soon, the puffiness spreads to the adjacent tissues – the cheek, lip, area under the nose.
- Infiltration stage. A cone-shaped tubercle – an infiltration – grows on the painful area. It constantly causes pain: aching – in any position of the patient’s body and sharp – when pressing on the tubercle. The swelling increases.The stage lasts 1-3 days.
- Stage of abscess formation. Comes after 3-7 days from the moment the first painful signs appear. At the top point of the infiltrate, through the thinned skin, you can see a rod – a yellowish abscess. In the next 2-3 days it will form into the “head” of the abscess, the boil softens. The maturation process is accompanied by severe tension in the soft tissues of the nose and constant pain. All this time, the patient experiences increasing weakness, his temperature rises, joint aches and headaches may occur.These are symptoms of general intoxication.
The pain is worse when the jaws move: talking or eating. At night, the patient cannot fully rest, as the pain becomes stronger.
- Resolution stage. The abscess is opened: independently or after the intervention of the surgeon. A certain amount of pus flows out, a rod comes out, compressed from dead cells, and dead hair. The organism cleans and fills the formed “crater” with young connective tissue.The first 3-4 days a scar is visible at the site of the boil, but after a few weeks it becomes less noticeable.
Sometimes the boil “gets sick” and dissolves on its own, without opening and extracting the contents.
At this stage, the patient gets better, the general symptoms subside.
A laboratory blood test performed at the infiltration stage will indicate an inflammatory process. With an instrumental examination, the doctor will reveal:
- thrombus formation in the area of the angular vein – at the edge of the orbit of the eye in the direction of the cavernous veins of the dura mater;
- enlarged lymph nodes;
- swelling of the eyelids, blood overflow of the blood vessels of the mucous membrane of the eye, obstructed movement of the eyeballs;
- visual impairment.
Attention! Do not, under any circumstances, open the nasal boils yourself.
The blood flow in the tissues of the head is intense and the causative agent of inflammation in a matter of minutes can enter the main circulation or tissue of the head. And this is an emergency situation that will lead to the development of sepsis and, possibly, death.
What complications can there be
Furuncles of the nose are accompanied by complications in 20-25% of cases.The main reasons are as follows:
- attempts to squeeze out the boil on their own;
- inadequate treatment, including self-help, folk remedies;
- accidental injury, including in a dream.
The contents of the boil contain pathogenic microorganisms that infect adjacent tissue sites. The most dangerous and unpleasant thing is when several abscesses merge into one extensive purulent skin lesion.Several boils, simultaneously appearing on the patient’s body – this is a more serious disease – furunculosis.
Among the complications of the disease:
- Eye pathologies. These are changes in venous outflow and conjunctival edema, displacement of the eyeball forward (bulging eyes), inflammation of the orbit, blindness.
- Phlebitis of the veins of the face, acute chronic vascular inflammation that destroys the venous walls. Phlebitis symptoms: pain and redness in the place where the affected vessel is located, swelling of the upper and lower eyelids and soft tissues (sac) under the eye.The zone of inflammation is compacted, the patient’s body temperature rises to an average of 38.5 C, chills and general muscle weakness.
- Septic venous sinus thrombosis. At the same time, the temperature rises, chills and sweating appear, there is a violent infectious syndrome – nausea and vomiting, dizziness, loss of consciousness. Generalized sepsis with nasal furuncle is less common.
- Local complications – sinusitis, frontal sinusitis and inflammation of the nasal septum.
- Inflammation of the meninges – arachnoiditis, meningitis, brain abscess.
How to make a diagnosis
In most cases, the diagnosis can be made on the basis of an external examination and rhinoscopy, as well as after listening to the patient’s complaints. Even at the initial stage, edematous-infiltrative changes in the tissues of the nose and face are easily distinguishable. The patient complains of pain in the area where the boil begins to develop, headache and malaise.
During the examination, the doctor will try to identify possible initial signs of sepsis.Among the first anatomical risk areas are the eyelids, orbits, the base of the skull, and intracranial veins.
In order to confirm the diagnosis, the doctor will prescribe laboratory tests:
- general blood test with determination of the number of neutrophils and ESR;
- analysis of blood and urine for carbohydrate content. Thus, the possibility of diabetes mellitus will be excluded;
- Antibiotic susceptibility nasal swab test.
It may be that it is not possible to pinpoint the exact cause of the disease, or it is possible that the infection will spread to the sinuses. Then the patient is supposed to x-ray of the facial skeleton, or CT of the facial skeleton and MRI of the brain.
In case of a difficult medical history, the doctor will refer the patient for consultation to doctors of related specialties.
How to treat a boil in the nose
At the infiltration stage, the doctor will prescribe conservative drug treatment.According to a certain scheme, it will be necessary to take:
- antihistamines, they will reduce swelling and eliminate possible manifestations of allergies;
- pain relievers and antipyretics;
- ointments with anti-inflammatory and antimicrobial action;
- anticoagulants – they are designed to prevent the development of intracranial complications;
- vitamin complexes that help to strengthen the immune system.
In addition, the doctor will draw up a proper nutritional regimen and recommend physiotherapy procedures. For example – dry heat, UHF therapy.
When a dense purulent core forms at the boil, by the decision of the attending physician, it is possible to perform a surgical opening of the abscess and remove the purulent masses. Then a drain is placed in the wound and an antiseptic bandage is applied. The drainage will remain at the site of resection for a while, until the discharge of pus stops and the boil cavity is cleared.After that, the drainage will be removed, but they will continue to apply bandages with antiseptic ointments. This will help the body to cope with the pathology as quickly as possible.
If the necrotic rod leaves hard, the patient is shown proteolytic enzymes – special substances that break down the peptide bonds between amino acids in proteins and peptides.
If the doctor prescribes a surgical opening of the boil, do not worry. The site of manipulation will be anesthetized with local anesthetics or short-term anesthesia will be administered.
After opening the abscess, the patient should continue to take antibiotics and other drugs according to the established schedule.
With a relapse of the disease, treatment is aimed at strengthening the immune system. For applies:
- Autohemotherapy – the injection of a patient’s own blood under the skin or into a muscle.
- Laser or ultraviolet irradiation of blood.
- Introduction of special immunomodulatory vaccines – gamma globulin.staphylococcal toxoid. Therapy can be prescribed after an immunogram (testing based on the results of analysis of venous or arterial blood).
- Systemic antibiotic therapy. It is carried out according to special indications if the disease is difficult or the boil is located in a particularly dangerous place. For example, in the area of the nasolabial triangle.
- Correction of chronic and concomitant pathologies.
Treatment of a boil during pregnancy
In the body of the expectant mother, hormonal changes take place, the immunity decreases.With errors in personal hygiene, a boil may develop in the nose.
Such a focus of inflammation threatens the health of both mother and baby. Therefore, it is necessary to visit a doctor and select medications that are allowed to be used during pregnancy. These can be antibiotics, ointments, and antiseptics.
When the boil enters the abscess stage, the doctor may suggest a surgical opening of the abscess.
During pregnancy, it is much more dangerous to treat yourself or try to squeeze out a boil.Features of the hormonal status during this period can lead to an avalanche-like development of complications.
Furuncle in the nose of a child
If inflammation occurs in a child’s nose, be sure to see a doctor. The disease may indicate hidden pathologies. They need to be identified as early as possible, since it depends on how successful the treatment will be.
Important! Never use traditional medicine on a child or buy medicine on the advice of a friend.In an effort to protect the child from “chemistry” and antibiotics, you can provoke the development of sepsis.
A boil in a baby develops in the same way as in an adult. The principles of treatment are similar. If the doctor considers it necessary, the abscess will be opened under short-term anesthesia, plunging the baby into a short sleep.
If the patient turns to the clinic on time and follows the doctor’s recommendations, the prognosis for the cure of the disease is favorable.Perhaps you will never face this disease again.
If a complication occurs – intracranial pathology, severe, decompensated disease – recovery depends on the patient’s condition and the effectiveness of treatment.
To prevent the development of a boil, it is important to avoid injuries to the nose and adjacent tissues, observe the rules of personal hygiene, and treat any purulent diseases in time.