Abscesses Furuncles and Carbuncles

Furuncles, or "boils," are small abscesses in the skin. Patients present with a painful, often fluctuant swelling in areas of friction, the nasal area, or the external ear. A carbuncle is a collection of furuncles and usually occurs on the back of the neck in middle-aged and older men. Treatment often requires drainage of the lesion. Antibiotic therapy should be considered if the furuncle is not yet fluctuant, there is evidence of surrounding cellulitis or lymphadenitis, or the lesion is on the face. Carbuncles have many interconnecting sinuses and tend to recur despite drainage and antibiotics. Surgical drainage and resection of the lesions are often necessary. Many abscesses are now caused by MRSA, but the primary treatment is still incision and drainage.

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