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| Carbuncle |
Carbuncle
CARBUNCLE= this is infective gangrene of subcutaneous tissue caused by staph. aureus. Commonly occurs in diabetic pts, poor immunity, radiotherapy pts. A)sites- nape of neck is commonest followed by back, shoulder region. B) PATHOLOGY= 1- initial lesion is in d form of hair follicle infection with perifolliculitis. 2-infection take virulent course n results in necrosis of subcutaneous fat wich give rise to multiple absbesses. 3- these abscesses r intercommunicating n open to exterior by multiple openings. 4- this appearance is called cribriform appearance. C)CLINICAL FEATURES= 1- typically pt is diabetic. 2- severe pain n swelling in nape of neck. 3- fever with chills n rigors r severe. 4- surface is read, angry looking like red hot coal. 5- surrounding area is indurated. 6-cribriform apperance., 7-end result is development of crateriform ulcer with central slough. D) TREATMENT= 1- diabetes control with injectible insulin.. 2- parenteral antibiotics given..cloxacillin, flucloxacillin, erythromycin n some cephalosporins.. 3- improve gen health of pt. 4- surgery required whn thr is pus. Cruciate incision is taken. Edges of skin flap r excised. Pus is drained. Loculi r broken down, slough is excised n cavity treated wid antiseptic agents.. E)COMPLICATIONS=1- worsening of diabetic status. 2-extensive necrosis of skin.. 3-septicemia, toxaemia.
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