A 52-year-old female presents to your free clinic. She states that she is currently homeless and usually sleeps in the park. She states it has a large lump on her shoulder and thinks she has a spider bite. You determine that it is a Furuncle. You also notice a couple of additional small open lesions. What else is going on here? How will you proceed with treatment?
After the physical assessment, the patient presents with a large lump on her shoulder, which is determined to be a Furuncle. A couple of additional small open lesions are also noticed. Based on this subjective data, the patient may have a carbuncle, which is in its early stages. A carbuncle is a cluster of Furuncles that form a connected area of infection under the skin. Bacteria cause the infection. The most common cause of this infection is Staphylococcus aureus, commonly found on the skin (Van Wyk, 2019).
Furuncles may develop at sites where the skin has been compromised through an insect bite or injury. The furuncle and multiple lessons are noted around the same area in the current patient. Besides, the patient reports to be homeless: the unhygienic environment and exposure to insect bites increase the risk for carbuncle. Besides, the location of the furuncle makes carbuncle a likely diagnosis. Carbuncle most likely affects the skin surrounding the back, neck, shoulders, face, thighs, buttocks, and armpits (Buckley, 2021).
A sample of the pus from the furuncle will be sent to the lab for testing to confirm the diagnosis. Lab testing will also help determine what type of antibiotic would work best in the current situation by determining the specific causative bacteria. Many bacteria that cause carbuncle have become resistant to certain types of antibiotics (Rabbets, 2021).
Treatment will entail incision and drainage of the carbuncle by making an incision in it. The procedure helps remove the infections and avoid the spread of the infection that usually occurs when the boil rapture. It also helps relieve pain since the boil is most painful when rapture. Then, an antibiotic will be prescribed to help heal the infection causing the carbuncle (Lin et al., 2021). The patient should be advised to avoid squeezing the boil to avoid spreading the infection and wash hands thoroughly to prevent contamination.
Buckley, D. (2021). Common Bacterial Skin Infections in General Practice. In Textbook of Primary Care Dermatology (pp. 235-241). Springer, Cham. https://link.springer.com/chapter/10.1007/978-3-030-29101-3_30
Lin, H. S., Lin, P. T., Tsai, Y. S., Wang, S. H., & Chi, C. C. (2021). Interventions for bacterial folliculitis and boils (furuncles and carbuncles). Cochrane Database of Systematic Reviews, (2). https://doi.org/10.1002/14651858.CD013099.pub2
Rabbets, W. (2021). Treating skin infections in the pharmacy. SA Pharmacist’s Assistant, 21(3), 13-14. https://hdl.handle.net/10520/ejc-mp_sapa_v21_n3_a4
Van Wyk, H. (2019). Bacterial and fungal skin infections. SA Pharmacist’s Assistant, 19(3), 6-8. https://hdl.handle.net/10520/EJC-195ac6843c