Furuncles And Carbuncles

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 she 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?

In this case, the patient doesn’t have a puncture site present; a potential diagnosis is a furuncle, also known as a boil, which is a pus-filled hair follicle that is 1-2cm in diameter. The furuncle usually presents when there is staphylococcal folliculitis. These are usually found in places where hair growth occurs, such as the face, neck, axillae, groin, thighs, and buttocks (Spelman & Baddour, 2021). It is superficially under the skin with a white head appearance, but it can burst and turn into an open sore. It is like a pimple appearance and requires extraction of the bacteria. If with multiple open lesions, this is considered a carbuncle. Besides being in the base of the hair, the appearance of a furuncle is red, inflamed, and painful and is superficially under the skin. It will then be considered an abscess if it goes deeper into the skin, such as the subcutaneous area. Staph aureus is the most common cause, and depending on the appearance and severity, the treatment may require an incision and drainage (I&D) with antibiotics. The patient’s homeless living situation needs to be factored in when designing a treatment plan. The I&D appears to be the most appropriate treatment for care, and wound care may consist of packing and weekly dressing changes. In a randomized trial including 1220 patients >12 years of age (median 35 years) with abscesses 2 to 5 cm in diameter who underwent incision and drainage, treatment with TMP-SMX (320 mg/1600 mg twice daily) resulted in higher cure rates 7 to 14 days after treatment than placebo (80.5 versus 73.6 percent) (Talan et al., 2016).

References

Spelman, D., & Baddour, L. (2021). UpToDate. Uptodate.com. https://www.uptodate.com/contents/cellulitis-and-skin-abscess-in-adults-treatment? search=skin-abscesses-furuncles- andcarbuncles&topicRef=6336&source=see_link#H3649077324

Talan, D., Mower, W., Krishnadasan, A., Abrahamian, F., Lovecchio, F., Karras, D., Steele, M., Rothman, R., Hoagland, R., & Moran, G. (2016). Trimethoprim–Sulfamethoxazole versus Placebo for Uncomplicated Skin Abscess. New England Journal of Medicine, 374(9), 823–832. https://doi.org/10.1056/nejmoa1507476

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Furuncle case study: A 52-year-old female presents to your free clinic. She states that she is currently homeless and usually sleeps in the park.

Furuncles And Carbuncles

She states she has a large lump on her shoulder and thinks she has a spider bite. You determine that it is a Furuncle (include reference). You also notice a couple of additional small open lesions. What else is going on here? Carbuncle. How will you proceed with treatment (include reference for treatment)

Expectations

APA format with intext citations

Word count minimum of 250, not including references.

References: 2 high-level scholarly references within the last 5 years in APA format.

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