Furunculosis is a deep infection of the hair follicle leading to abscess formation with accumulation of pus and necrotic tissue. Furuncles appear on the hair-bearing parts of the skin and the infectious agent is Staphylococcus aureus. However, other bacteria may also be causative. Furunculosis occurs independently of methicillin resistant S. aureus (MRSA) infection, which has become endemic in some countries. MRSA are more difficult to treat with standard antibiotics and hence pose a specific clinical and microbiological problem, which is dealt with in great detail elsewhere.
SIGNS AND SYMPTOMS: -
Clinically, furuncles present as red, swollen, and tender nodules of varying size and at times with an overlying pustule. Fever and enlarged lymph nodes are rare. If several adjacent follicles are infected they may coalesce and form a larger nodule, known as a carbuncle. Furuncles most frequently appear on the extremities and they may lead to scarring upon healing. Most patients present with one or two boils and after clearing experience no recurrences. However, furunculosis has a propensity to recur and in such cases they often spread among family members.
Recurrent furunculosis is generally defined as three or more attacks within a 12-month period. Colonization of S. aureus in the anterior nares plays a definite role in the etiology of chronic or recurrent furunculosis. Besides the nares, colonization also occurs in warm, moist skin folds such as behind ears, under pendulous breasts, and in the groin. Bacteria other than S. aureus may also be pathogenic, especially for furuncles in the vulvovaginal and perirectal area, and on the buttocks. Especially, enteric species such as Enterobacteriaceae and Enterococci are often present at these sites. Corynebacterium, S. epidermidis, and S. pyogenes may also be present in furunculosis. Immunodeficiency is rarely the primary cause.
Quality of life in patients with recurrent furunculosis has, to our knowledge, not been investigated. However, decreased quality of life was found in MRSA positive patients who were isolated in palliative institutions and in patients with other recurrent boil diseases like hidradenitis suppurativa.
HOMEOPATHIC MANAGEMENT OF RECURRENT FURUNCULOSIS
The medicines that can be thought of are:-
- Hepar sulph
- Merc sol.