Furuncle , Boil or Pigsa

A 20 year old ,male , consulted for a swollen firm area in the left buttocks with associated pain and tenderness of 3 days duration. A day prior to consultation, there was passage of pus and blood. Patient also complained that the problem was recurrent wherein the last episode was about a year ago.

Patient was given Cloxacillin 500mg capsules every 6 hours(4xday), for 10 -14 days and advised to apply Povidone 10% soln(Betadine) 2-3xday. Mefenamic acid 500mg capsule 3xday was given for inflamation and pain management.

The patient's condition is known as Furuncle, Furunculosis, Skin Boil, Pigsa. It usually starts as an infection of the hair follicle that spreads to deeper tissue or can be a walled-off nodule of purulent infection. When there is a coalition or a group of furuncles , it is called Carbuncle, which has a deeper and extensive involvement.
Risk factors includes increase weight or obesity, diabetes mellitus, impaired neutrophil function, or sometimes prolonged intake of corticosteroids. The most common etiologic agent or cause is Staphylococcus aureus,but may also be caused by Streptococcus or mixed bacterial infection.
Usual management includes a trial of warm compress for small abcess but considerable size may require incision and drainage.Recurrent condition warrants giving oral antibiotics ,while opened lesion may necessitate application of Povidone I2 10% solution or application of Mupirocin cream. Some clinicians give high doses of ascorbic acid 1gm daily if they suspect an impaired neutrophil function.
It should also be emphazised that proper and careful hygiene is very important.Clean draining lesions or boils often and wash hands after touching a boil since it is contagious and can be transferred to other parts as well as other individuals.



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