Boils caused by: Boils and carbuncles – Symptoms and causes
Boils & Carbuncles: Symptoms, Treatment & Prevention
What are boils and carbuncles
A boil (or furuncle) is a skin infection that is usually caused by the bacteria Staphylococcus aureus (staph). Other bacteria or fungi can also cause boils.
A boil forms a lump that goes deep into the skin. It may have a central “head” filled with pus. Boils usually occur on the face, neck, armpits, buttocks, and thighs, but can appear anywhere on the body. They can be painful.
In most boils, the bacteria also infect hair follicles, the sacs that contain the roots of hair and oil glands. An infection of the hair follicles is called folliculitis. A boil can also develop from a cut in the skin.
A carbuncle is a group of boils located in one area of the body. Carbuncles may have more than one head that fills with pus. Some people can get boils or carbuncles over and over in one spot of the body.
People with certain illnesses like diabetes are more likely to get boils. Another risk factor is having another skin condition such as eczema, or conditions that reduce the skin’s ability to fight germs.
This skin infection can be spread to other people. On rare occasions, it can be serious, and cause infection of the bloodstream, infection of other body parts, or general infection of the body (sepsis). A serious infection with MRSA (methicillin-resistant Staphylococcus aureus) can also occur.
Symptoms and Causes
What are the symptoms of a boil?
A boil may start out as a sore, raised area that is pinkish red in color. Over time, the boil may fill with clear liquid or pus, and grow in size.
Symptoms of a boil include the following:
- Swollen, red lump deep in the skin (Sometimes, a hair will grow from it.)
- Painful, especially when touched, and in certain places on the body (such as the nose or ear)
- Size can vary from pea to golf ball
- May develop a central, whitish-yellow “head” that may break and release pus
- May “weep” or ooze clear fluid, or develop a crust
- May spread to surrounding skin, creating a carbuncle
What are the symptoms of carbuncles?
Carbuncles cause a deeper and more serious infection than boils, so their symptoms may be more severe. In addition to the same symptoms as seen in boils, carbuncles may also:
- Cause fever and chills or other symptoms
- Heal more slowly
- Scar the skin
Management and Treatment
How is a boil or carbuncle treated?
A boil or carbuncle should never be squeezed or pricked with a pin or sharp object to release the pus and fluid. This can spread the infection to other parts of the skin.
If left alone, a boil will break and drain on its own over time. In certain cases, a doctor may need to cut into the skin to drain the pus. Once the fluid and pus drains from the boil or carbuncle, it will heal. The doctor may also prescribe antibiotics if there is a serious infection.
If you have a boil, you can do the following:
- Apply warm, moist compresses (such as a damp washcloth) several times a day. This can speed healing and relieve some of the pain and pressure caused by the boil. A separate washcloth (and towel) should be used.
- See a healthcare provider if the boil persists or comes back, or if it is located on the spine or on your face.
- If you have a fever or other serious symptoms with the boil, see your doctor. Patients who have diabetes or who have a condition that affects the immune system should see a doctor for the treatment of the boil.
How can I prevent a boil or carbuncle?
A boil or carbuncle can happen despite the best hygiene. However, you can prevent boils if you:
- Avoid close contact with someone who has a staph infection, boil, or carbuncle;
- Wash your hands frequently with antibacterial soaps and gels, which can help prevent the spread of bacteria;
- Bathe regularly with soap;
- Don’t share or re-use washcloths, towels, and sheets.
How can I keep my carbuncles from spreading to others?
If you have a carbuncle:
- Wash your hands often.
- Do not share washcloths and towels with family members.
- Don’t let others lie on your bed sheets.
- Use antibacterial soap, especially if you have touched your carbuncle.
- Do not squeeze or prick the head of your carbuncle.
- Do not hug or have close contact of your carbuncle with another person.
- Carefully bag and dispose of dressings and bandages that cover your carbuncle.
Boils, Carbuncles and Furunculosis | Causes and Treatment
Small boils are very common and often go away without any treatment. But they can be irritating and can also cause distress if they are in a prominent position such as on your face. Larger boils usually need treatment. If you get lots of boils that keep coming or don’t go away then you may need some tests to check if there is any underlying cause.
Hidradenitis suppurativa is a long-term (chronic) skin condition, leading to painful and repeated lumps of pus (boils or abscesses).
Drvgaikwad, CC BY 3.0, via Wikimedia Commons
By Drvgaikwad, CC BY 3. 0, via Wikimedia Commons
See the link for Dermnet NZ in Further Reading below for further images of boils.
Who has boils?
A boil looks like a small red lump on the skin that is tender. The surrounding skin may be swollen and inflamed. Thick, infected fluid called pus fills the centre of the boil. Boils can develop in any hairy area of skin. In particular, in sites where there is friction, or where the skin is sweaty. For example, they can appear on the neck, face, armpits, arms, and buttocks and around the back passage (anus). A boil in the ear canal may be very painful. Carbuncles most commonly develop on the back of the neck or on the thighs.
A boil or carbuncle can occur in anyone at any age. However, they are uncommon in children and most common in teenagers and young adults. You have a higher risk of developing a boil or carbuncle if you:
- Have other skin conditions that may cause you to scratch and damage the skin – for example, eczema or scabies.
- Are very overweight (obese).
- Have a poor defence against infections (immune system).
- Have an illness making you frail or generally unwell.
- Are a carrier of staphylococcal germs (bacteria).
What causes boils?
Boils are caused by germs (bacteria) multiplying below the skin surface. Your immune system is important in helping you to fight off infection. That means you have a higher risk of developing a boil or carbuncle if germs get under your skin and your immune system does not kill them quickly enough to stop them multiplying.
If you develop recurring boils (chronic furunculosis), your doctor may suggest some tests to look for an underlying cause. For example, to check if you have a poor immune system. You may be prone to boils just because you’re generally run down and tired. But it’s important to check there isn’t any underlying problem, such as type 2 diabetes.
One cause of recurring boils if you are otherwise healthy is that you, or someone in your family or household, may be a carrier of staphylococcal germs (bacteria). This means that a certain number of these bacteria live harmlessly on your skin, or in your nose. If you are a carrier, you tend to be more prone to skin infections and boils. In particular, these bacteria may quickly invade and multiply in broken skin following a minor cut or injury.
Treatment with antibiotics and/or antibiotic nasal cream may clear staphylococcal bacteria from carriers and reduce the chance of boils, or other types of skin infection, from coming back.
What is the treatment for a boil or carbuncle?
- Small boils (furuncles) may subside and go without any treatment. You can ease pain by covering the boil with a flannel soaked in hot water. Do this for 30 minutes, 3-4 times a day. (Be very careful that the water is not too hot. It is important to avoid the risk of burns from hot water.)
- Larger boils and carbuncles are best treated by letting the infected fluid (pus) out. Sometimes this is done by a doctor who drains the pus, using a needle and syringe. Sometimes a small cut in the skin is needed to let out the pus (incision and drainage). The wound is covered with a dressing until the skin heals. The skin usually heals quickly once the pus has been drained.
- A course of an antibiotic medicine, such as flucloxacillin, is sometimes prescribed to help clear the infection from the skin.
What will happen if I do nothing?
Typically, after several days (sometimes after a week or more) the boil will burst and pus will leak on to the skin. The pain tends to ease when the boil bursts. Once the pus has gone, the infection in the surrounding skin tends to fade away gradually over several days. A scar may be left at the site of the boil.
A carbuncle tends to increase in size for a few days – up to 3-10 centimetres across, sometimes more. After 5-7 days, various pus-filled lumps appear on the surface and pus leaks on to the skin. It then may break down and form an ulcer on the skin surface before the infection gradually subsides. The skin then gradually heals leaving a deep scar.
While infection and pus are in the skin, there is a risk that some germs (bacteria) may spread in the bloodstream to cause infections in other parts of the body. This is uncommon but, if it happens, it can lead to serious infections of a bone, the brain, or other parts of the body.
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
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
- 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.
Seattle Children’s Urgent Care Locations
If your child’s illness or injury is life-threatening, call 911.
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.
Last Reviewed: 10/05/2021
Last Revised: 09/30/2021
Copyright 2000-2021. Schmitt Pediatric Guidelines LLC.
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Boils | Ministry of Health NZ
A boil is usually caused by Staphylococcus aureus bacteria. Many healthy people have these bacteria on their skin. Boils occur when bacteria get through broken skin and start as a red lump or pimple with red skin around it.
How are boils spread?
Boils are spread by fluid, blood or pus from a boil touching other skin.
Boils are not usually a serious problem, but if the infection spreads you can get sicker and need to see your doctor.
Time off from kura or school
If your child is feeling well they can go to kura or school but keep boils covered with plasters or dressings.
A hard, painful, pimple-like sore that is filled with white or yellow pus.
- Go to the doctor immediately if a boil is near the eye.
- Check and clean the boils every day.
- Soak the boil in a warm bath or put a towel soaked in warm water on the boil for 20 minutes.
- If the boil bursts, wipe away pus, fluid or blood with clean cotton wool or a cloth soaked in water and antiseptic.
- Wash cloths and towels after each use.
- Make sure your child wears clean clothes every day.
- Wash your hands before and after touching the boil.
- Check the rest of your family for boils.
What to do if the boil gets worse
A large, deep boil is called an abscess (you say, ab-ses).
Go to the doctor immediately if the boil is near the eye.
Go to the doctor if any of these things happen:
- the boil is bigger than a 10 cent coin
- the boil lasts longer than a week
- the boil is very painful
- red streaks start to appear on the skin around the boil
- there are a lot of boils or you have boils regularly
- if you have a fever.
A doctor might:
- drain the pus from a boil
- give you antibiotic tablets or a cream to put on the boil.
It is important to take the antibiotics each day until they are finished, even if the boil has got better. The antiobiotics need to keep killing the infection in the body after the skin has healed.
Call Healthline 0800 611 116 if you are unsure what you should do.
You can help prevent boils spreading or developing by:
- washing your hands regularly
- eating well
- bathing or showering regularly
- keeping any cuts clean.
Folliculitis, Boils and Carbuncles – Conditions and Treatments
Key points about folliculitis, furuncles and carbuncles
- Folliculitis, furuncles (or boils) and carbuncles are skin infections caused by bacteria.
- Any child can get these infections. A child with diabetes or weak immune systems is more at risk.
- Folliculitis and mild furuncles may go away with no treatment.
- Moderate to severe furuncles and carbuncles are treated with incision and drainage. They are also often treated with antibiotic medicine.
What are folliculitis, furuncles and carbuncles?
Bacteria on the skin can cause an infection of one or more hair follicles. A hair follicle is the base or root of a hair. There are three different kinds of infections:
- Folliculitis. This is inflammation of a hair follicle.
- Furuncle. This is an infection of the hair follicle that goes into the deeper layers of skin. A small pocket of pus (abscess) forms. It’s also known as a boil.
- Carbuncle. This is a group of infected hair follicles with pus. A carbuncle is larger and deeper than a furuncle.
These can occur anywhere on the skin where there is hair. They happen most often where there may be rubbing and sweating. This includes the back of the neck, face, armpits, waist, groin, thighs or buttocks.
What are the causes of folliculitis, furuncles and carbuncles?
Bacteria called Staphylococcus aureus (staph) are the most common cause of these infections. But other kinds of bacteria can also cause them.
Who is at risk for folliculitis, furuncles and carbuncles?
Anybody can develop folliculitis, furuncles or carbuncles. A child may be more at risk if he or she:
- Has diabetes or a weak immune system
- Has other skin infections
- Has close contact with someone with a skin abscess, furuncle or carbuncle
- Has skin injuries, such as scrapes, cuts or insect bites
- Is getting IV medicine
- Has been in hot tub or spa water that is not properly treated
What are the symptoms of folliculitis, furuncles and carbuncles in a child?
Symptoms can occur a bit differently in each child. They can include:
- A single lump or bump (skin lesion)
- Groups of skin lesions
The lesions may be:
- Leaking fluid (pus)
Symptoms that affect the whole body can include:
- Fever and chills
- Fast heart beat
- Low blood pressure
The symptoms of folliculitis, furuncles, and carbuncles can be like other health conditions. Make sure your child sees his or her health care provider for a diagnosis.
How are folliculitis, furuncles and carbuncles diagnosed ?
The health care provider will ask about your child’s symptoms and health history. He or she will give your child a physical exam.
Your child may need to see a specialist to treat a moderate to severe furuncle or carbuncle. A sample of the pus from the infection may be sent to a lab. This is called a culture. It’s done to see what type of bacteria caused the infection. It can help the doctor decide the best antibiotic for treatment.
How are folliculitis, furuncles and carbuncles treated?
Treatment will depend on your child’s symptoms, age and general health. It will also depend on how severe the condition is.
Folliculitis and mild furuncles may go away with no treatment. Warm cloths (compresses) may help easy symptoms and speed healing.
Moderate to severe furuncles and carbuncles are often treated by draining. A health care provider cuts into the lesion and drains the fluid (pus) inside. This is called incision and drainage. Your child may also need to take antibiotic medicine by mouth (oral) or in a vein (IV). You may also need to apply antibiotic ointment or cream on your child.
What can I do to prevent folliculitis, furuncles and carbuncles?
To help to prevent these infections:
- Make sure you clean and protect any skin injuries.
- Make sure your child washes his or her hands often.
- Keep your child’s nails cut short.
- Encourage older children and teens to keep their faces clean, use clean razors, don’t share razors and bathe often.
- Use only well-maintained spas or hot tubs.
- Try to have your child stay away from others with these infections.
What are possible complications of folliculitis, furuncles and carbuncles ?
Possible complications may include:
- Infection spreading to other parts of the body
- Return of the infection
When should I call my child’s health care provider?
Call the health care provider if your child has:
- Symptoms that affect a large area
- Symptoms that get worse
- New symptoms
Does Diet Play a Role in Preventing or Treating Boils?
You may be more likely to develop boils and other skin infections if you have diabetes.
Image Credit: microgen/iStock/GettyImages
If you’ve ever had a boil, then you know just how unpleasant these pus-filled bumps can be. Once they develop, they often become larger and more painful over time — and are equally unpleasant when they rupture and drain. But do the foods you eat play any role in prevention and healing of boils?
Read more: 8 Nasty Skin Infections You Can Catch at the Gym (and How to Avoid Them)
According to the Mayo Clinic, boils are typically caused by a bacterial infection, most commonly the Staphylococcus aureus, or staph, infection. However, there are a number of different ways that you may end up with a staph infection in the first place.
Diabetes and compromised immunity, for example, are circumstances that might make you more likely to develop a staph infection and boils. “Diabetics are more prone to boils and other skin infections, particularly if their blood sugar is uncontrolled,” says Nadia M. Khan, MD, a doctor of internal medicine at Northwestern Medicine Central DuPage Hospital in Winfield, Illinois.
You’re also more likely to develop boils, according to Mayo Clinic, if you have other skin conditions or if you come into close contact with someone who already has boils. Staphylococcus bacteria are also one of the most common causes of food poisoning, Mayo Clinic notes.
Boils also can be an issue for anyone with hidradenitis suppurativa, a chronic inflammatory skin condition. If you have this condition, according to the Cleveland Clinic, you can develop bumps and, ultimately, boils around your hair follicles and sweat glands, which become clogged from an abnormal overgrowth of cells.
More on Hidradenitis Suppurativa
Treatments that can help manage the condition, the Cleveland Clinic says, include using topical cleansers, soaking in warm baths or applying warm compresses to the area (for 10-minute sessions), taking anti-inflammatory medications like ibuprofen, wearing loose-fitting clothing to limit rubbing and maintaining weight to minimize friction in areas prone to lumps from the condition.
Additionally, Mayo Clinic suggests that eating a healthy, balanced diet can help by preventing weight gain (and thus limiting friction) and helping with weight loss to lower hormonal activity influencing the condition — thus making diet an important step in preventing boils, if you have hidradenitis suppurativa.
Mayo Clinic further notes that research has also identified specific foods that could be triggers for boils related to hidradenitis suppurativa — specifically dairy products like milk and cheese. Eating these foods can raise insulin levels, which, in turn, can cause your body to overproduce hormones known as androgens, possibly leading to outbreaks of boils and other skin lesions related to hidradenitis suppurativa.
Another potentially risky ingredient to consume if you have hidradenitis suppurativa is brewer’s yeast, which is present in pizza dough, bread, cake and other baked goods. Mayo Clinic recommends avoiding foods that contain brewer’s yeast in an effort to help heal skin lesions. Mayo also suggests limiting foods with added sugars to try to reduce insulin levels, potentially easing symptoms of the condition.
One final thing to consider when it comes to your diet and boils is whether you have any food allergies, as an allergy to a particular food can result in skin issues.
“Although dietary modifications have not been well-researched for the prevention and treatment of boils, it has been found that decreasing refined sugar consumption and avoiding allergenic foods may be worthwhile,” says Mary Opfer, RD, CDN, a dietitian and nutritionist in Westchester County, New York.
Read more: What Can I Eat to Help Fight Infection?
Boils, felon, ingrown nail – “Golden glow”
Furuncle – inflammation of the hair follicle and the adjacent sebaceous gland, characterized by an acute character. As the progression progresses, the inflammatory process passes to the surrounding tissue of the disease.
Localized mainly in open areas of the body.
The causative agent in the overwhelming majority of cases is Staphylococcus aureus.
Men are 10 times more susceptible to the disease than women of the opposite sex.
Metabolic disorders (diabetes mellitus, hypo- and avitaminosis), severe concomitant diseases, and poor hygiene predispose to the occurrence of furunculosis.
An attempt at a premature self-mechanical removal of the boil rod (extrusion) can lead to the spread of infection throughout the body.The use of warming compresses is contraindicated.
In order to prevent the development of complications, treatment is recommended under the supervision of a surgeon.
Treatment tactics depend on the stage of the disease itself and the reasons that led to its occurrence. In some cases, treatment is possible without surgery, but only a doctor should make such a decision.
Panaritium is an acute purulent process localized in the soft tissues of the palmar surface of the fingers, in the area of the nail and nail fold, as well as in the bones and joints of the fingers.
According to the location and degree of damage to the tissues of the finger (hand) by a purulent process, superficial and deep forms are distinguished.
The anatomical features of the fingers and the enormous functional significance of the hand for human life presupposes the earliest possible surgical treatment!
The postoperative period will also require regular medical monitoring of the healing process in order to prevent the development of complications.
Antibacterial agents may be prescribed.The wound is treated daily, with subsequent dressings.
Removal of boils in a clinic in Kazan – “Golden glow”
Furuncle (in everyday life – “ boil “, “ abscess “) – a manifestation of the pustular inflammatory process caused by staphylococcus.
Furunculosis – a disease characterized by the appearance of a large number of boils and constant relapses (some heal, others appear).The course of furunculosis is more severe: there is general malaise, an increase in body temperature.
Reasons for the appearance of boils
features of the skin (excessive sweating, frequent skin damage, constant contact with discharge from the nose and ears in chronic diseases, professional frequent interaction with aggressive chemicals, poor hygiene)
hormonal disorders (diabetes mellitus, adrenal dysfunction, increased content of the male sex hormone – testosterone – in the blood)
How is a boil treated?
As a rule, the treatment of an uncomplicated boil does not require surgical intervention, conservative methods are used.But only a doctor should determine the state and stage of development of the boil!
Treatment of boils in the clinic “Golden Glow”
The clinic offers surgical treatment of a complicated boil – a purulent abscess, when the contents of the abscess spreads into the subcutaneous fat. The abscess is subject to mandatory autopsy.
!!! Treatment of a complicated boil is carried out exclusively by a specialist surgeon. With complicated boils, frequent relapses, the doctor conducts drug therapy – antibiotic therapy.
Do not self-medicate and self-diagnose!
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90,000 Treatment and removal of boils in Moscow, the price for removal in the MC “Health”
A furuncle is an acute purulent formation on the skin caused by inflammation of the sebaceous gland, capturing adjacent tissues.In common usage, it is called chiriy. Furuncle is a type of staphyloderma (skin disease caused by staphylococci). Normally, staphylococci are present on the body of any person, posing no danger. Furuncles most often appear in areas with a hairline: on the neck, face, back, thighs.
Reasons for the appearance of boils:
- Low immunity
- Hormonal disorders
- Features of the skin
- Injury to the skin
The boil develops in the following order:
- Infiltration: the appearance of redness around the hair follicle
- Suppuration and necrosis: formation of necrotic contents rising above the surface of the skin
- Breakthrough of the papule: a ripe abscess bursts, the contents come out.The wound heals
Treatment of a boil is advisable to start at the initial stage. This will avoid the development of the pathological process and dispense with conservative treatment methods.
Should I see a doctor?
It is important to understand that treating chiria with folk remedies at home can lead to a number of complications. The most harmless is the formation of scars and scars. The use of traditional medicine is dangerous with complications and relapses.
An advanced inflammatory process requires surgical intervention.An autopsy of the formation can only be carried out by a doctor. The surgeon makes a small incision in the area of inflammation, allowing the pus to drain out. After treatment continues with medicinal ointment.
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How to quickly cure a boil and carbuncle at home
Inflammatory processes on the skin can have various causes, nature and appearance.Furuncles or carbuncles may appear in places where clothes rub against the body. These purulent lesions are very painful and require immediate assistance. One of the best methods of treating such a skin disease is the treatment of the affected area with Solnyshko devices.
How to distinguish a boil from a carbuncle?
Furuncle is a purulent inflammation that forms around the hair root. Redness appears on the skin, pus accumulates. The boil can have a diameter of 0.5-3 cm.Frequent formation of such skin lesions is called furunculosis.
Carbuncle is an inflammation of several hair follicles at once. The defeat affects the sebaceous gland and even the subcutaneous tissue. Carbuncle refers to a more serious disease. Outwardly, such a lesion is the formation of a focus with many heads. Treatment of the carbuncle is performed by addition, rather than eliminating the consequences of boils.
The main difference between a boil and a carbuncle is the affected area.In the first case, the lesion is small and consists of inflammation around one hair follicle. With carbuncle, general health worsens, fever and muscle pain appear. It is possible to improve the condition and speed up the process of restoring the normal structure of the skin with the help of the “Sun” devices. For the treatment of carbuncle, models OUFv-02 and OUF-10-2, which have a bactericidal effect, are suitable.
Attention: Experts have found that male adolescents are more susceptible to furunculosis.Carbuncles appear more often in middle-aged and elderly men. The disease is provoked by wearing tight clothes, poor hygiene and decreased immunity. At risk are people suffering from diabetes and other chronic diseases.
The lesions of both types of skin diseases referred to in this article are formed on parts of the body that have hair follicles, come into contact with clothing or are subject to friction with other parts of the body:
- face and neck;
- leg bends;
- groin area.
There are several options for treating a boil at home. You can use traditional medicine, special ointments from a pharmacy and hardware treatment of the affected area.
The main reasons for the appearance of boils
The main reason for the formation of boils is the pathogenic activity of pathogenic bacteria from the genus Staphylococci. Staphylococcus aureus “succeeded” especially strongly in such work. These bacteria are present in the human body, but the immune system can easily deal with them.With a decrease in protective functions, as well as the appearance of external favorable factors (skin damage due to friction against clothing), the risk of lesions increases significantly.
To answer the question of how to get rid of a boil, it is important to exclude the factors of its formation:
- External. Rubbing the skin with clothes, shoes or other parts of the body, rubbing cuts and pimples.
- Internal. Decrease in the protective functions of the body. Due to the weakening of immunity, staphylococcus bacteria begin to multiply actively, causing inflammatory processes.
The provoking factor of furunculosis includes physical and psychological exhaustion of the body, vitamin deficiency, cancer, AIDS and the use of certain antidepressants.
How to identify a boil? Signs and symptoms of illness
Specific signs of furuncle formation:
- Localization. The problem manifests itself only in those parts of the body where there is hair. This is especially true in the armpits, chin, neck and genitals.Here, a favorable environment for microorganisms is created, caused by increased sweating.
- Pus at the site of inflammation. In the center of the lesion, a solid, homogeneous rod of purulent mass is formed.
- Inflammation around the affected area. Redness takes up a few centimeters around the purulent head.
- Pain in the affected area. Especially if the place continues to be exposed to friction or contact with other parts of the body.
- Temperature over 38 degrees.Often the appearance of a boil is accompanied by weakness and headache.
Stages of development of defeat
The formation of a boil goes through several stages. The main ones are:
- Skin lesions. Edema forms around the hair, provoking itching and twitching.
- Suppuration. A day later, a purulent head begins to form at the site of the lesion. This process is often accompanied by fever and tissue necrosis around the boil.
- Healing.After the breakthrough of the boil and the release of pus, wound healing begins. The patient’s condition is improving.
Funds from boils, which can be purchased in pharmacies today, can speed up the process of pus release and wound healing.
What is the danger of a “simple” boil?
Boils and carbuncles are purulent diseases that can lead to sepsis. Therefore, experts advise not to self-medicate, but immediately when symptoms of such a disease appear, seek professional help. If this is not done, soon the patient may face blood poisoning. So, you will have to look for an answer to the question of how to treat an abscess.
The danger of boils is the risk of infection entering the brain. It is especially dangerous if a boil appears on the face or neck. That is, where the veins that supply the brain with blood pass. Scientists have found that furunculosis is one of the causes of meningitis. Also, severe skin lesions with the formation of pus increase the risk of thrombosis and other dangerous diseases.
Features of the course of the disease in children and pregnant women
Since children have not yet fully developed immunity, the appearance of a boil can lead to serious consequences. Most of them are described above. Therefore, do not try to cure the boil at home. It is better to immediately go to the clinic to see your pediatrician. He will select the treatment for the child.
The formation of a boil during pregnancy affects the health of not only the woman, but also the fetus. The risk increases also because when a woman is carrying a child, the hormonal background changes.This also affects the normal functioning of the immune system. Experts have established a link between furunculosis and mastitis.
Formations of severe skin lesions are dangerous during the entire period of pregnancy. But this disease has the biggest problems in the first weeks, the risk of infection of the membranes increases.
Treatment of boils with “Solnyshko” devices
Devices “Solnyshko” provide antibacterial treatment of the affected area. The design of such devices includes UV lamps.They emit a spectrum that destroys the RNA of bacteria. Treatment of the boil with the “Sun” apparatus leads to relief of symptoms and acceleration of the healing process of the affected area.
In addition to anti-inflammatory actions, general strengthening actions are carried out with the help of such devices. Solnyshko devices are used to restore various injuries, diseases of the oral cavity and acute respiratory infections.
The most popular models of Solnyshko devices:
- OUFK-01.A quartz device, the power of which is specially designed to be able to treat children.
- OUFB-04. A device with a bactericidal effect. The lamps emit a spectrum that is highly destructive to various types of microbes. It can be used for the treatment and prevention of diseases in children from 3 years of age.
- OUFv-02. Universal device. Has a wide range of actions. It can be used for the treatment and prevention of diseases in children from 3 years of age.
If a person is susceptible to furunculosis, then he needs to regularly carry out preventive actions.The best solution would be to strengthen the immune system. To do this, it is necessary to conduct a course of vitamin complexes twice a year. It is advisable to regularly walk in the fresh air and diversify your diet. Increase the amount of vegetables and fruits in it.
To reduce the risk of scalding, it is important to pay more attention to hygiene. It is necessary to exclude the formation of an environment that provokes the activity of staphylococcal bacteria.
It is also possible to carry out the prophylaxis of a boil with the help of the “Solnyshko” devices.It is necessary, even before the onset of symptoms of boil, to treat the areas of the skin most susceptible to the appearance of lesions.
Sextaphage ® Polyvalent pyobacteriophage
Polyvalent pyobacteriophage has the ability to specifically lyse bacteria of staphylococci, streptococci (including enterococci), Proteus, Klebsiella pneumonia, Pseudomonas aeruginosa and Escherichia coli
Form of issue
Solution for oral administration, local and external use.20 ml in vials. 4 or 10 vials of 20 ml in a cardboard box together with instructions for use.
The drug is a sterile filtrate of phagolysates of bacteria Staphylococcus, Streptococcus, Proteus (P. vulgaris, P. mirabilis), Pseudomonas aeruginosa, enteropathogenic Escherichiacoli, Klebsiellapneumoniae.
Preservative – 8-hydroxyquinoline sulfate monohydrate – 0.0001 g / ml (calculated content).
Indications for use
Treatment and prevention of pyoinflammatory and enteral diseases caused by staphylococci, streptococci, Proteus, Klebsiella, Pseudomonas aeruginosa and Escherichia coli:
- diseases of the ear, throat, nose, respiratory tract and lungs – inflammation of the sinuses of the nose, middle ear, tonsillitis, pharyngitis, laryngitis, tracheitis, bronchitis, pneumonia, pleurisy;
- surgical infections – wound suppuration, burns, abscess, phlegmon, boils, carbuncles, hydroadenitis, panaritium, paraproctitis, mastitis, bursitis, osteomyelitis;
- urogenital infections – urethritis, cystitis, pyelonephritis, colpitis, endometritis, salpingo-oophoritis;
- post-traumatic conjunctivitis, keratoconjunctivitis, purulent corneal ulcers and iridocyclitis;
- enteric infections – gastroenterocolitis, cholecystitis, dysbiosis;
- generalized septic diseases;
- purulent-inflammatory diseases of newborns – omphalitis, pyoderma, conjunctivitis, gastroenterocolitis, sepsis, etc. ;
- other diseases caused by bacteria staphylococci, streptococci (including enterococci), Proteus, Klebsiella pneumonia, Pseudomonas aeruginosa and Escherichia coli.
In severe manifestations of infections caused by staphylococci, streptococci, Proteus, Klebsiella pneumonia, Pseudomonas aeruginosa and Escherichia coli, the drug is prescribed as part of complex therapy.
For prophylactic purposes, the drug is used for the treatment of operating and freshly infected wounds, as well as for the prevention of nosocomial infections for epidemic indications.
An important condition for effective phage therapy is a preliminary determination of the phage sensitivity of the pathogen.
Dosing regimen and method of administration
Before use, the vial with the bacteriophage must be shaken and viewed. The preparation must be transparent and free of sediment.
Attention! Do not use the drug in case of turbidity!
Due to the content of the nutrient medium in the preparation, in which bacteria from the environment can develop, causing turbidity of the preparation, it is necessary to observe the following rules when opening the bottle:
- wash your hands thoroughly;
- treat the cap with an alcohol-containing solution;
- remove the cap without opening the plug;
- Do not place the cork with its inner surface on a table or other objects;
- do not leave the bottle open;
- only in the refrigerator.
Store the opened bottle
When using small doses (2-8 drops), the drug must be taken with a sterile syringe in a volume of 0.5 – 1 ml.
The drug from the opened bottle, subject to the storage conditions, the above rules and the absence of turbidity, can be used throughout the shelf life.
Treatment of pyoinflammatory diseases with localized lesions should be carried out simultaneously both locally and by taking the drug inside for 7-20 days (according to clinical indications).
Depending on the nature of the focus of infection, the bacteriophage is used:
- Topically in the form of irrigation, lotions and packing with liquid phage in an amount of up to 200 ml, depending on the size of the affected area. In case of abscesses, a bacteriophage is injected into the cavity of the focus after removal of pus by puncture. The amount of the injected drug should be slightly less than the volume of removed pus. In osteomyelitis, after appropriate surgical treatment, a bacteriophage is poured into the wound, 10-20 ml each.
- Introduction into cavities – pleural, articular and other limited cavities up to 100 ml of bacteriophage, after which a capillary drainage is left, through which the bacteriophage is reintroduced within several days.
- For cystitis, pyelonephritis, urethritis, the drug is taken orally. If the cavity of the bladder or renal pelvis is drained, the bacteriophage is injected through the cystostomy or nephrostomy 1-2 times a day, 20-50 ml into the bladder and 5-7 ml into the renal pelvis.
- For purulent-inflammatory gynecological diseases, the drug is injected into the cavity of the vagina, uterus in a dose of 5-10 ml once daily.
- For purulent-inflammatory diseases of the ear, throat, nose, the drug is administered in a dose of 2-10 ml 1-3 times a day. The bacteriophage is used for rinsing, washing, instilling, introducing moistened turundas (leaving them for 1 hour).
- For conjunctivitis and keratoconjunctivitis, the drug is instilled 2-3 drops 4-5 times a day, with a purulent corneal ulcer – 4-5 drops, for purulent iridocyclitis, the drug is used 6-8 drops every 3 hours in combination with oral administration.
- In the treatment of stomatitis and chronic generalized periodontitis, the drug is used in the form of rinsing the mouth 3-4 times a day at a dose of 10-20 ml, as well as injecting turunda impregnated with pyobacteriophage into periodontal pockets for 5-10 minutes.
- For intestinal forms of the disease, diseases of internal organs, dysbiosis, bacteriophage is used by mouth and in the form of enemas for 7–20 days. Through the mouth, the bacteriophage is given 3 times a day on an empty stomach 1 hour before meals.In the form of enemas, it is prescribed once a day instead of one dose by mouth.
Recommended dosage of the drug
|Dose per dose (ml)|
|Inside||In an enema|
|0 – 6 months||5||ten|
|6 – 12 months||ten||twenty|
|1 to 3 years old||15||20-30|
|3 – 8 years old||twenty||30-40|
|8 years and older||20 – 30||40-50|
If chemical antiseptics were used to treat wounds prior to using the bacteriophage, the wound should be thoroughly washed with a sterile 0. 9% sodium chloride solution.
Application of bacteriophage in children (up to 6 months). With sepsis, enterocolitis of newborns, including premature babies, bacteriophage is used in the form of high enemas (through a gas tube or catheter) 2-3 times a day (see table). In the absence of vomiting and regurgitation, the drug may be administered by mouth. In this case, it is mixed with breast milk. A combination of rectal (in enemas) and oral (through the mouth) administration of the drug is possible. The course of treatment is 5-15 days. With a recurrent course of the disease, repeated courses of treatment are possible.In order to prevent sepsis and enterocolitis in case of intrauterine infection or the risk of nosocomial infection in newborns, bacteriophage is used in the form of enemas 2 times a day for 5-7 days.
In the treatment of omphalitis, pyoderma, infected wounds, the drug is used as applications twice daily (a gauze napkin is moistened with a bacteriophage and applied to the umbilical wound or to the affected area of the skin).
Precautions for use
Shake the bottle with liquid bacteriophage before use.If cloudy, do not use!
Possible side effects
Interaction with other drugs
The use of the drug is possible in combination with other drugs, including antibiotics
Use during pregnancy and breastfeeding
It is advisable to use the drug during pregnancy and during breastfeeding if
infections caused by phage-sensitive strains of bacteria (as recommended by a doctor)
Dispensed without a prescription
Furunculosis (furuncle) | Symptoms | Diagnostics | Treatment
Furunculosis (furuncle) – the appearance on the body of multiple boils or, as they are colloquially called, boils. A boil is an acute purulent-necrotic inflammation of the hair follicle, sebaceous gland, and the surrounding connective tissue. It is caused by pyogenic bacteria, primarily Staphylococcus aureus. For the treatment of furunculosis, you must consult a dermatologist.
Causes of furunculosis
The main cause of this disease is the activation of staphylococcal microflora, which can be caused by various circumstances. It provokes a purulent-inflammatory process.
The development of furunculosis is usually associated with the presence of immunodeficiency. Most often it is provoked:
- diabetes mellitus;
- foci of chronic infection;
- chronic intoxication;
- violation of the diet;
- metabolic disorders.
The reason for the introduction of staphylococcus into the hair follicle can be trauma to the skin, hypothermia or pollution.Often, several factors affect the development of the disease. Micro-trauma to the skin in men caused by careless shaving, especially often cause the appearance of boils.
Furunculosis can be divided into acute and chronic. In acute furunculosis, rashes on the body occur almost simultaneously or for a short time, accompanied by malaise, headache, fever. In a chronic type of the disease, such outbreaks occur with some frequency over many months and even years.
Symptoms and manifestations of furunculosis
The disease begins with the formation of a purulent-inflammatory infiltrate around the hair follicle. After a few days, the inflammatory process covers the entire hair follicle, after which the inflammation affects the adjacent sebaceous gland and connective tissue. Often, before the appearance of boils, a person experiences itching in the place where inflammation will subsequently develop.
Externally, a furuncle is a cone-shaped knot that rises above the surface of the skin.At first, it may not be felt in any way and not cause any discomfort, but as the focus of inflammation forms, soreness increases: a person can feel both swelling and pain of a pulsating or twitching nature. With furunculosis of the face and neck around the infiltrate, as a rule, there is extensive edema.
On the third or fourth day, a fluctuation zone is formed in the center of the infiltrate. If you press it, you can feel the movement of purulent masses in the follicle cavity.In this case, a small focus of purulent fusion of tissues appears around the hair, a fistula begins to form.
This disease does not have a clear localization in a certain part of the body, but it usually affects areas of problem skin, prone to oily. Therefore, most often people are faced with furunculosis under the arm, on the face, forearms, back of the neck, buttocks and thighs.
A single boil in the overwhelming majority of cases does not cause any serious deterioration in the patient’s health.The body temperature remains normal, nothing interferes with the previous way of life.
If the boil is opened, viscous pus is released, accumulated on the surface of the inflammatory element, after which a small ulcer forms, at its bottom you can see a green rod – it is considered one of the most characteristic symptoms of furunculosis. In most cases, it is rejected after about 5 days with a slight admixture of blood and pus.
After rejection of the rod, the process of inflammation stops, pain decreases, tissue edema subsides, and the affected area becomes less sensitive to palpation.The resulting ulcer is filled with granulation tissue, in its place a retracted scar appears, the size and depth of which depends on the size of the area of necrosis in the central part of the boil.
Another development of events is possible: pus and necrotic masses remaining after opening the boil lead to the development of chronic furunculosis.
Furunculosis of the face can lead to an increase in body temperature, headache, various manifestations of intoxication. The likelihood of such a development of events is especially high if boils arise in the area of the nasolabial triangle or the external auditory canal.At the same time, the skin of the face becomes crimson, puffiness develops, and when pressed on the skin, a person will experience painful sensations.
Damage to boils on the face during washing or shaving, as well as attempts to squeeze out boils on your own, can cause thrombophlebitis of the veins.
Furunculosis is especially dangerous in children. In addition to the already mentioned thrombophlebitis (which can cause the inflammatory process to enter the cranial cavity, which contributes to the development of meningitis, which can be fatal), it can lead to the development of other dangerous diseases, including:
- lymphangitis – inflammation of regional lymphatic vessels;
- lymphadenitis – inflammation of the regional lymph nodes;
- phlegmon – acute inflammation of the surrounding adipose tissue;
- abscess – a process in which the adjacent tissues become inflamed, melting to form cavities containing pus.
If you experience similar symptoms, see your doctor immediately. It is easier to prevent a disease than to deal with the consequences.
Differential diagnostics with fungal skin lesions, hydradenitis, systemic vasculitis is carried out.
Undesirability of self-medication
How to cure furunculosis? In order to get rid of boils, you need to see a dermatologist.Often people resort to self-medication, use ointment from boils – for example, Vishnevsky’s ointment – but this can lead to unpleasant consequences: both to the further development of the process and to the occurrence of phlegmon. The fact is that Vishnevsky’s ointment is used only at the granulation stage, after the resolution of the purulent capsule.
Self-extrusion of boil rods is also undesirable, regardless of whether it is done by hand or using vacuum cans. Extrusion can lead to premature opening of the boil, as a result of which nearby skin areas are exposed to pathogenic microflora.Often in this case, part of the rod remains inside, which leads to the chronization of the process.
Treatment of furunculosis
In order to cope with the disease, be sure to contact a specialist and follow all his instructions.
During the treatment of furunculosis, the patient will have to limit water procedures or even completely abandon them. An exception is extensive furunculosis: in this case, warm baths with potassium permanganate are recommended to disinfect the skin.Instead of washing and taking a bath, visiting a bath, washing in the shower, you will need to wipe healthy skin with non-aggressive antiseptic solutions, for example, salicylic alcohol or furacilin solution.
Personal hygiene during the treatment of furunculosis is extremely important – it has already been said more than once that skin microtrauma can lead to the further development of this disease. Therefore, it is necessary to frequently change underwear and bedding, treat any, even the smallest cuts and scratches with a solution of brilliant green.
At the stage of maturation of boils, the skin around them must be treated with antiseptics. Chipping of the affected area with a solution of novocaine with antibiotics is also used: antibiotics for furunculosis help relieve pain and prevent the spread of the purulent process to healthy tissues. Usually, substances such as penicillin, ekmonovicillin, bicillin are used – other antibiotics are much less effective.
To prevent complications such as phlegmon or abscess, experts recommend electrophoresis in combination with antimicrobial drugs.
If the fluctuation zone has already been identified, an application can be used for treatment: crystalline salicylic sodium is applied to the center of the furunculosis elements, which is then fixed with a dry bandage. This contributes to the accelerated rejection of the rod.
If, as a result of the disease, an abscess develops, the boil must be opened under local anesthesia, while the purulent-necrotic masses are removed. After opening the wound is washed with 3% hydrogen peroxide, it will need to be bandaged with a bandage with one of the proteolytic drugs: it can be either Levomikol or synthomycin or erythromycin ointment.Dressings need to be changed every other day. After the process enters the granulation stage, Vishnevsky liniment or ichthyol-based ointment is applied – this ensures better healing.
Ultraviolet irradiation and UHF therapy are used at all stages of furunculosis.
Antibiotics for furunculosis are also used – in cases of abscesses and in the chronic course of the disease. If general diseases are diagnosed, the patient is exhausted, the immune status is low, a specialist can prescribe antibiotics in the form of intramuscular injections.
The body’s resistance in case of furunculosis can be increased with the help of gamma globulin and ozone therapy, vitamin therapy, autohemotransfusion, general strengthening drugs are also prescribed.
Regardless of the stage at which furunculosis is, it is necessary to correct the concomitant pathology: to sanitize chronic infectious foci, treat diseases of the gastrointestinal tract, endocrine disorders, and so on.
During treatment, it is necessary to exclude spicy and fatty foods from the diet, eat more food rich in vitamins and protein, which promotes tissue regeneration. Foods with a high fiber content promote good gastric emptying, which avoids dysbiosis, and this is very important with furunculosis. Instead of tea and coffee, it is better to drink rosehip broth, compote or fruit drink.
If the furuncle is removed at home, bacteria from the lesion can enter the bloodstream, causing lymphadenitis, phlegmon, sepsis, staphylococcal meningitis. Home dissection of abscesses on the face above the upper lip is especially dangerous.
The risk group includes people:
- with low immunity;
- carriers of pathogenic staphylococcus;
- people who neglect the rules of personal hygiene.
Prevention of furunculosis
To avoid the occurrence of the disease, it is necessary to observe personal hygiene, timely treat systemic diseases, pustular rashes, and prevent the appearance of chronic foci of infection. It is also extremely important to lead a healthy lifestyle, monitor nutrition.
This article is posted for educational purposes only and does not constitute scientific material or professional medical advice.
Buruli ulcer (infection with Mycobacterium ulcerans)
Buruli ulcer, caused by the bacterium Mycobacterium ulcerans , is a chronic, disabling disease that mainly affects the skin and sometimes bone tissue. This microorganism belongs to the family of bacteria that cause tuberculosis and leprosy, therefore the fight against Buruli ulcer can be carried out in conjunction with programs for these two diseases.The bacterium M. ulcerans , however, is found in the environment and produces the unique toxin mycolactone. The mode of transmission of infection to humans remains unknown. Currently, timely diagnosis and treatment of disease is critical to minimize morbidity, reduce financial costs, and prevent long-term disability.
Magnitude of the problem
Buruli ulcer has been reported in 33 countries in Africa, America, Asia and the Western Pacific.Most cases occur in tropical and subtropical areas, with the exception of Australia, China and Japan. Fourteen out of 33 countries regularly provide data to WHO.
Until 2010, approximately 5,000 cases of Buruli ulcer were reported annually in the world; then their number decreased until 2016, when the minimum was recorded, amounting to 1,961 cases. In subsequent years, the incidence increased again and in 2018 reached 2,713 cases. There were 1,258 cases in 2020, up from 2,271 in 2019.The decline in 2020 may be due to the impact of the COVID-19 pandemic on activities to identify active cases.
M. ulcerans grows between 29-33 ° C ( M. tuberculosis grows at 37 ° C) and requires a low (2.5%) oxygen concentration to grow. The microorganism produces a unique toxin, mycolactone, which causes tissue damage and suppresses the immune system.
Precise transmission method M.ulcerans is still unknown.
Signs and symptoms
Buruli ulcer often begins with a painless lump (node), a large painless area of induration (plaque), or diffuse painless swelling on the legs, arms, or face (edema). The disease can progress without pain or fever. After four weeks, if left untreated, and sometimes during antibiotic treatment, an ulcer will form on the nodule, plaque, or edema. Sometimes bone tissue is affected, which leads to deformities.
There are three categories of the disease in terms of severity: category I – one small lesion (32%), category II – non-ulcerative and ulcerative plaque and edematous forms (35%) and category III – disseminated and mixed forms, such as osteitis, osteomyelitis and joint damage (33%).
Lesions often develop on the limbs: in 35% of cases, the upper limbs are affected, in 55% – the lower limbs and in 10% – other parts of the body. Health care professionals should be careful in diagnosing Buruli ulcer in patients with lower extremity lesions to rule out other causes of ulceration such as diabetes, arterial and venous insufficiency.
In most cases, experienced medical professionals in endemic areas can provide a reliable clinical diagnosis, but their level of training is crucial.
Other pathologies should be ruled out in the diagnosis, including trophic phagedenic ulcers, chronic leg ulcers due to arterial or venous insufficiency (common among the elderly and the elderly), diabetic ulcers, cutaneous leishmaniasis, extensive yaws and Haemcreiophilic ulcers …
Nodular lesions in the early stages are sometimes mistaken for boils, lipomas, ganglia, lymph node tuberculosis, onchocerciasis nodes, or deep fungal subcutaneous infections.
In Australia, papular lesions in the early stages can be mistaken for insect bites.
Cellulitis may look like swelling caused by infection with M. ulcerans , but in the case of cellulitis, the affected areas are painful and the patient is unwell and feverish.
The presence of HIV infection complicates the treatment of the patient, making the clinical course of Buruli ulcer more aggressive, and the outcome of treatment less favorable.
Four standard laboratory methods can be used to confirm Buruli ulcer: IS2404 polymerase chain reaction (PCR), direct microscopy, histopathology, and bacterial culture.
In 2019, WHO launched the Buruli Ulcer Laboratory Network 1 for Africa to help improve PCR confirmation of infection in nine endemic African countries. The network of 13 laboratories is supported by the American Leprosy Missions, the ANESWAD Foundation, the Raul Follero Foundation and the Foundation for Innovative Diagnostics and Coordination from the Pasteur Center in Cameroon.
Treatment is carried out with a combination of antibiotics and adjunctive therapy. The WHO publication, Treatment of mycobacterium ulcerans disease (Buruli ulcer), provides guidance for healthcare professionals on how to treat the disease.
According to a recent study, the current recommended treatment regimen is combination therapy with rifampicin (10 mg / kg once daily) and clarithromycin (7.5 mg / kg twice daily).
Standard combination therapy with rifampicin (1 mg / kg once daily) and moxifloxacin (400 mg once daily) has been used successfully in Australia, but has not been scientifically proven to be effective.
Telasebek is a new anti-tuberculosis drug developed by the Korean company “Curient” 2 . In animal studies, the drug proved to be extremely potent against Mycobacterium ulcerans 3, 4 , which shortened the duration of treatment from eight to two weeks.In January 2021, the FDA registered telasebek as an orphan drug for the treatment of Buruli ulcer 5 . The use of the drug for the treatment of patients is planned to be evaluated in the framework of a clinical trial.
In order to accelerate healing and, accordingly, shorten the period of hospitalization, such measures as treatment of wounds and lymphatic edema and surgical operations (mainly debridement of the wound cavity and skin grafting) are carried out.In addition, in severe cases, physical rehabilitation of the patient is necessary to prevent disability. Persons left with disabilities need long-term rehabilitation. The same measures apply to other neglected tropical diseases such as leprosy and lymphatic filariasis.
Prevention and control of Buruli ulcer
Currently, there are no methods of primary prevention of Buruli ulcer. The mode of transmission remains unknown.Partial protection against infection is reportedly provided by the BCG (bacillus Calmette-Guerin) vaccine.
The fight against Buruli ulcer aims to minimize suffering, disability and socioeconomic burden. The main directions of the strategy of combating the disease are its timely detection and treatment with antibiotics.
WHO provides technical advice, policy direction and coordination of disease response and research.WHO meets with all major Buruli ulcer stakeholders to share information, coordinate disease control and research efforts, and monitor progress.
WHO promotes research on three priority issues:
- study of mode of transmission;
- development of rapid diagnostic tests;
- Determination of the best antibiotic therapy.