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carbuncle, carbunculus (kar'bung?k'l) (kar-bung'ku-lus) [L. carbunculus, small glowing ember]
Staphylococci, including methicillin–resistant staph, are the usual cause. They may be introduced into the skin by chafing, pressure, shaving, or by pits or cracks that result from dermatitis and commonly occur on the neck, face, axillae or buttocks.
The lesions are often tender, red, warm, and swollen, enlarge over a period of days, then may rupture, exuding pus and necrotic material.
Warm compresses, incision and drainage, and topical, and/or systemic antibiotics (sulfa drugs, cephalosporins, or clindamycin are usually effective). Recurrence is an indication that the patient should be assessed for some underlying disease or immunodeficiency.
Patients and caregivers are taught proper hand and skin hygiene and to change the dressings at least twice a day to remove infected material, and to prevent the spread of infection in the home by avoiding contact with wound drainage, disposing of dressings in sealed bags, and washing contaminated linens separately in very hot water.