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Carbuncle in Child
Other Resources UpToDate PubMed

Carbuncle in Child

Contributors: Rajini Murthy MD, Noah Craft MD, PhD, Lindy P. Fox MD, Susan Burgin MD
Other Resources UpToDate PubMed

Synopsis

A carbuncle is a bacterial infection resulting from staphylococcal bacteria. This condition is the result of 2 or more contiguous furuncles, enlarging into a multiheaded giant furuncle (boil). Alcohol use disorder, malnutrition, impaired circulation, diabetes mellitus, and other forms of immunosuppression predispose an individual to infection. Symptomatic relief is provided by warm compresses. Antibiotics are used to clear the infection.

Methicillin-resistant Staphylococcus aureus (MRSA) first emerged as an important nosocomial pathogen in the 1960s. In more recent years, community-acquired outbreaks of MRSA have been described increasingly among prisoners, military recruits, athletes, intravenous (IV) drug users, and men who have sex with men. Community-acquired MRSA (CA-MRSA) has also been identified in otherwise healthy individuals lacking these risk factors. In a recent study of emergency department visits for purulent skin and soft tissue infections, MRSA was identified as the etiologic agent in the majority (59%) of cases. Furthermore, this study determined that 57% of patients with MRSA did not receive the appropriate initial antibiotic therapy.

Codes

ICD10CM:
L02.93 – Carbuncle, unspecified

SNOMEDCT:
416893007 – Carbuncle

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Dermatophyte infections such as Tinea barbae, Kerion, or Majocchi granuloma can mimic a carbuncle.
  • Furunculosis
  • Skin bacterial abscess
  • Actinomycosis typically occurs in the neck region.
  • Atypical mycobacterial infection or Sporotrichosis can occur as indurated pustular plaques.
  • Inflamed or infected Epidermoid cyst
  • Medium vessel vasculitides may present with tender nodules; Livedo reticularis or livedo racemosa may also be seen.
  • Dissecting cellulitis of scalp
  • Acne keloidalis nuchae
  • Hidradenitis suppurativa
  • Pilonidal cyst
  • Oral squamous cell carcinoma can mimic a carbuncle and should be considered if not responding to appropriate antibiotic therapy.

Best Tests

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Management Pearls

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Therapy

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References

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Last Reviewed:03/19/2023
Last Updated:03/26/2023
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Carbuncle in Child
A medical illustration showing key findings of Carbuncle
Clinical image of Carbuncle - imageId=235068. Click to open in gallery.  caption: 'A pink nodule with a central crust behind the ear.'
A pink nodule with a central crust behind the ear.
Copyright © 2024 VisualDx®. All rights reserved.