Carbuncle

Carbuncle

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Encyclopedia
A carbuncle is an abscess
Abscess
An abscess is a collection of pus that has accumulated in a cavity formed by the tissue in which the pus resides due to an infectious process or other foreign materials...

 larger than a boil
Boil
A boil, also called a furuncle, is a deep folliculitis, infection of the hair follicle. It is always caused by infection by the bacterium Staphylococcus aureus, resulting in a painful swollen area on the skin caused by an accumulation of pus and dead tissue...

, usually with one or more openings draining pus
Pus
Pus is a viscous exudate, typically whitish-yellow, yellow, or yellow-brown, formed at the site of inflammatory during infection. An accumulation of pus in an enclosed tissue space is known as an abscess, whereas a visible collection of pus within or beneath the epidermis is known as a pustule or...

 onto the skin
Skin
-Dermis:The dermis is the layer of skin beneath the epidermis that consists of connective tissue and cushions the body from stress and strain. The dermis is tightly connected to the epidermis by a basement membrane. It also harbors many Mechanoreceptors that provide the sense of touch and heat...

. It is usually caused by bacteria
Bacteria
Bacteria are a large domain of prokaryotic microorganisms. Typically a few micrometres in length, bacteria have a wide range of shapes, ranging from spheres to rods and spirals...

l infection
Infection
An infection is the colonization of a host organism by parasite species. Infecting parasites seek to use the host's resources to reproduce, often resulting in disease...

, most commonly Staphylococcus aureus
Staphylococcus aureus
Staphylococcus aureus is a facultative anaerobic Gram-positive coccal bacterium. It is frequently found as part of the normal skin flora on the skin and nasal passages. It is estimated that 20% of the human population are long-term carriers of S. aureus. S. aureus is the most common species of...

. The infection is contagious
Contagious disease
A contagious disease is a subset category of infectious diseases , which are easily transmitted by physical contact with the person suffering the disease, or by their secretions or objects touched by them....

 and may spread to other areas of the body or other people. Because the condition is contagious, family members may develop carbuncles at the same time.

Causes


Often, the direct cause of a carbuncle cannot be determined. Things that make carbuncle infections more likely include friction from clothing or shaving
Shaving
Shaving is the removal of hair, by using a razor or any other kind of bladed implement, to slice it down to the level of the skin. Shaving is most commonly practiced by men to remove their facial hair and by women to remove their leg and underarm hair...

, generally poor hygiene
Hygiene
Hygiene refers to the set of practices perceived by a community to be associated with the preservation of health and healthy living. While in modern medical sciences there is a set of standards of hygiene recommended for different situations, what is considered hygienic or not can vary between...

 and weakening of immunity
Immunity (medical)
Immunity is a biological term that describes a state of having sufficient biological defenses to avoid infection, disease, or other unwanted biological invasion. Immunity involves both specific and non-specific components. The non-specific components act either as barriers or as eliminators of wide...

. For example, persons with diabetes and immune system diseases are more likely to develop staphylococcal infections.

Presentation


A carbuncle is made up of several skin
Skin
-Dermis:The dermis is the layer of skin beneath the epidermis that consists of connective tissue and cushions the body from stress and strain. The dermis is tightly connected to the epidermis by a basement membrane. It also harbors many Mechanoreceptors that provide the sense of touch and heat...

 boils. The infected mass is filled with fluid
Fluid
In physics, a fluid is a substance that continually deforms under an applied shear stress. Fluids are a subset of the phases of matter and include liquids, gases, plasmas and, to some extent, plastic solids....

, pus
Pus
Pus is a viscous exudate, typically whitish-yellow, yellow, or yellow-brown, formed at the site of inflammatory during infection. An accumulation of pus in an enclosed tissue space is known as an abscess, whereas a visible collection of pus within or beneath the epidermis is known as a pustule or...

, and dead tissue
Tissue (biology)
Tissue is a cellular organizational level intermediate between cells and a complete organism. A tissue is an ensemble of cells, not necessarily identical, but from the same origin, that together carry out a specific function. These are called tissues because of their identical functioning...

. Fluid
Fluid
In physics, a fluid is a substance that continually deforms under an applied shear stress. Fluids are a subset of the phases of matter and include liquids, gases, plasmas and, to some extent, plastic solids....

 may drain out of the carbuncle, but sometimes the mass is so deep that it cannot drain on its own.
Carbuncles may develop anywhere, but they are most common on the back and the nape
Nape
The nape is the back of the neck. In technical anatomical/medical terminology, the nape is referred to by the word nucha, which also gives the adjective corresponding to "nape" in English, "nuchal"....

 of the neck
Neck
The neck is the part of the body, on many terrestrial or secondarily aquatic vertebrates, that distinguishes the head from the torso or trunk. The adjective signifying "of the neck" is cervical .-Boner anatomy: The cervical spine:The cervical portion of the human spine comprises seven boney...

.

The carbuncle may be the size of a pea
Pea
A pea is most commonly the small spherical seed or the seed-pod of the pod fruit Pisum sativum. Each pod contains several peas. Peapods are botanically a fruit, since they contain seeds developed from the ovary of a flower. However, peas are considered to be a vegetable in cooking...

 or as large as a golf ball
Golf ball
A golf ball is a ball designed to be used in the game of golf.Under the Rules of Golf, a golf ball weighs no more than 1.620 oz , has a diameter not less than 1.680 in , and performs within specified velocity, distance, and symmetry limits...

. It may be red and irritated, and might hurt when touched. It may also grow very fast and have a white or yellow center. It may crust or spread to other skin areas. Sometimes, other symptoms may occur, such as fatigue, fever
Fever
Fever is a common medical sign characterized by an elevation of temperature above the normal range of due to an increase in the body temperature regulatory set-point. This increase in set-point triggers increased muscle tone and shivering.As a person's temperature increases, there is, in...

 and a general discomfort or sick feeling. Itching may occur before the carbuncle develops.

Etymology


The word is believed to have originated from the Latin: carbunculus, originally a small coal; diminutive of carbon-, carbo: charcoal or ember, but also a carbuncle stone
Carbuncle (gemstone)
A carbuncle is an archaic name given to any red cabochon cut gemstone. The name applied particularly to red garnet. The word occurs in four places in most English translations of the Bible...

, "precious stones of a red or fiery colour", usually garnet
Garnet
The garnet group includes a group of minerals that have been used since the Bronze Age as gemstones and abrasives. The name "garnet" may come from either the Middle English word gernet meaning 'dark red', or the Latin granatus , possibly a reference to the Punica granatum , a plant with red seeds...

s.

Treatment


Carbuncles usually must drain before they will heal. This most often occurs on its own in less than two weeks. Placing a warm moist cloth on the carbuncle and soaking the affected area several times each day helps it to drain, which speeds healing. Squeezing the carbuncle, or cutting it open without medical supervision can spread and worsen the infection.

Treatment is needed if the carbuncle lasts longer than two weeks, returns frequently, is located on the spine or the middle of the face, or occurs along with a fever or other symptoms. Treatment helps reduce complications related to an infection. A doctor may prescribe antibacterial soaps and antibiotics applied to the skin or taken by mouth. Deep or large lesion
Lesion
A lesion is any abnormality in the tissue of an organism , usually caused by disease or trauma. Lesion is derived from the Latin word laesio which means injury.- Types :...

s may need to be drained by a health professional. Proper excision, by cruciate incision
Cruciate incision
A cruciate incision is a cross-shaped surgical cut made in skin or flesh....

, under strict aseptic conditions will treat the condition effectively.

Proper hygiene
Hygiene
Hygiene refers to the set of practices perceived by a community to be associated with the preservation of health and healthy living. While in modern medical sciences there is a set of standards of hygiene recommended for different situations, what is considered hygienic or not can vary between...

 is very important to prevent the spread of infection. Hands should always be washed thoroughly, preferably with antibacterial soap, after touching a carbuncle. Washcloths and towels should not be shared or reused. Clothing, washcloths, towels, and sheets or other items that contact infected areas should be washed in very hot (preferably boiling) water. Bandages should be changed frequently and thrown away in a tightly-closed bag. If boils/carbuncles recur frequently, daily use of an antibacterial soap or cleanser containing triclosan
Triclosan
Triclosan is an antibacterial and antifungal agent. It is a polychloro phenoxy phenol. Despite being used in many consumer products, beyond its use in toothpaste to prevent gingivitis, there is no evidence according to the American Food and Drug Administration that triclosan provides an extra...

, triclocarban
Triclocarban
Triclocarban , or 3,4,4'-trichlorocarbanilide, is a substance with anti-bacterial and anti-fungal properties that is used in disinfectants, soaps and other household products....

 or chlorhexidine, can suppress staph bacteria
Staphylococcus
Staphylococcus is a genus of Gram-positive bacteria. Under the microscope they appear round , and form in grape-like clusters....

 on the skin.

Monstrous carbuncle


In 1984 Charles, Prince of Wales
Charles, Prince of Wales
Prince Charles, Prince of Wales is the heir apparent and eldest son of Queen Elizabeth II and Prince Philip, Duke of Edinburgh. Since 1958 his major title has been His Royal Highness The Prince of Wales. In Scotland he is additionally known as The Duke of Rothesay...

 famously described the proposed Sainsbury Wing extension to the National Gallery
National Gallery, London
The National Gallery is an art museum on Trafalgar Square, London, United Kingdom. Founded in 1824, it houses a collection of over 2,300 paintings dating from the mid-13th century to 1900. The gallery is an exempt charity, and a non-departmental public body of the Department for Culture, Media...

 in London as a "monstrous carbuncle on the face of a much-loved and elegant friend", a term now widely used to describe architecture, particularly modernist
Modern architecture
Modern architecture is generally characterized by simplification of form and creation of ornament from the structure and theme of the building. It is a term applied to an overarching movement, with its exact definition and scope varying widely...

architecture, unsympathetic to its surroundings.