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Furunculosis

Furunculosis is a topic covered in the 5-Minute Clinical Consult.

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Basics

Description

  • Acute bacterial abscess of a hair follicle (often Staphylococcus aureus)
  • System(s) affected: skin/exocrine
  • Synonym(s): boils

Epidemiology

Incidence
  • Predominant age
    • Adolescents and young adults
    • Clusters have been reported in teenagers living in crowded quarters, within families, or in high school athletes.
  • Predominant sex: male = female

Prevalence
Exact data are not available.

Etiology and Pathophysiology

  • Infection spreads away from hair follicle into surrounding dermis.
  • Pathogenic strain of S. aureus (usually); most cases in United States are now due to community-acquired methicillin-resistant S. aureus (CA-MRSA), whereas methicillin-sensitive S. aureus (MSSA) is most common elsewhere (1).

Genetics
Unknown

Risk Factors

  • Carriage of pathogenic strain of Staphylococcus sp. in nares, skin, axilla, and perineum
  • Rarely, polymorphonuclear leukocyte defect or hyperimmunoglobulin E–Staphylococcus sp. abscess syndrome
  • Diabetes mellitus, malnutrition, alcoholism, obesity, atopic dermatitis
  • Primary immunodeficiency disease and AIDS (common variable immunodeficiency, chronic granulomatous disease, Chédiak–Higashi syndrome, C3 deficiency, C3 hypercatabolism, transient hypogammaglobulinemia of infancy, immunodeficiency with thymoma, Wiskott-Aldrich syndrome)
  • Secondary immunodeficiency (e.g., leukemia, leukopenia, neutropenia, therapeutic immunosuppression)
  • Medication impairing neutrophil function (e.g., omeprazole)
  • The most important independent predictor of recurrence is a positive family history.

General Prevention

Patient education regarding self-care (see “General Measures”); treatment and prevention are interrelated.

Commonly Associated Conditions

  • Usually normal immune system
  • Diabetes mellitus
  • Polymorphonuclear leukocyte defect (rare)
  • Hyperimmunoglobulin E–Staphylococcus sp. abscess syndrome (rare)
  • See “Risk Factors.”

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Citation

Stephens, Mark B., et al., editors. "Furunculosis." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2019. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116235/6/Furunculosis.
Furunculosis. In: Stephens MB, Golding J, Baldor RA, et al, eds. 5-Minute Clinical Consult. 27th ed. Wolters Kluwer; 2019. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116235/6/Furunculosis. Accessed June 27, 2019.
Furunculosis. (2019). In Stephens, M. B., Golding, J., Baldor, R. A., & Domino, F. J. (Eds.), 5-Minute Clinical Consult. Available from https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116235/6/Furunculosis
Furunculosis [Internet]. In: Stephens MB, Golding J, Baldor RA, Domino FJ, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2019. [cited 2019 June 27]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116235/6/Furunculosis.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Furunculosis ID - 116235 ED - Stephens,Mark B, ED - Golding,Jeremy, ED - Baldor,Robert A, ED - Domino,Frank J, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116235/6/Furunculosis PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -