- What is a Carbuncle?
- Causes for Carbuncles
- Risk Factors in Acquiring Carbuncles
- Clinical Presentation and Manifestations
- Carbuncles: Their Areas of Predilection
- Some more Pictures on Carbuncle
- Diagnosing Carbuncles
- Home Remedies for Carbuncles
- Medical and Surgical Modalities as Treatment
- The Carbuncles’ Complications
- Preventing Carbuncles
Etymology: Where Does the Word Carbuncle Come From?
The term Carbuncle is believed to have originated from the Latin word Carbunculus, meaning small coal. It was also said to be derived from the words carbon, carbo and charcoal. 
What is a Carbuncle?
A carbuncle is an erythematous, tender, group of swollen lesions, each known as a furuncle. In turn, a furuncle, is a boil, or an infection of the hair follicle, containing a collection of pus beneath the skin layer. Simply put, a group of boils, or a collection of multiple infected hair follicles, corresponds to a carbuncle. [2, 3]
Picture 1 : Carbuncle: collection of multiple furuncles or boils
Image Source: www.fromyourdoctor.com
Causes for Carbuncles
Carbuncles are usually caused by the bacteria Staphylococcus aureus, Streptococcus pyogenes, and Methicillin Resistant Staphylococcus aureus (MRSA). These organisms usually are inhabitants of the surface of the integuments, the nasal passages and the throat. They enter the skin by penetrating through a hair follicle, a puncture, or an abrasion. [1, 2]
Can These Carbuncles Be Transmitted From One Person To Another?
Carbuncles can be contagious. These can spread to the other parts of the patient’s body, and can infect other people as well. The latter is usually done through direct skin to skin contact, or by using the patient’s personal items. 
Risk Factors in Acquiring Carbuncles
The following factors are associated with increased risk of having the said skin lesions: 
- Older age group
- Poor hygienic practices
- Presence of skin lesions, affecting the integument’s protective function
- Decreased immune system
- Renal disease
- Hepatic disease
- History of diabete mellitus
- Poverty and low socioeconomic status
- Shaving or plucking of body hair
Clinical Presentation and Manifestations
- Carbuncles consist of fluid, pus and dead tissue. These skin lesions usually start as bumps, which are tender and erythematous. Eventually, they become filled with pus, having white or yellowish tips, which then weep, ooze and encrust. After a few days, these may then rupture, releasing a white of pinkish, creamy fluid. [1, 2]
- Their sizes may range from a small pea to a large ping-pong ball. They can appear erythematous and be tender, grow rapidly with a white or yellowish central core. Usually, they are associated with symptoms such as fever, body malaise, fatigue and severe discomfort. Pruritus can usually occur prior to the development of a visible carbuncle. [1, 4]
Picture 2 : Carbuncle can be described as a tender, red mass, with a central yellow core of pus.
Image Source: www. contentwithpictures.com
Carbuncles: Their Areas of Predilection
These lesions are most likely to occur on the areas where hair and thick skin layers are present. They are usually located at the back, nape, gluteal region, inguinal area, thigh, and under the arms. 
Picture 3 : An area of predilection, the nape has thick skin layers and is an area in near proximity of hair. Thus, it is usually a site where carbuncles are formed.
Image Source: www.howtogetridofstuff.com
Some more Pictures on Carbuncle
Picture 4: Carbuncle (back of neck)
Picture 5 : Carbuncle(near chin)
- Physical examination is of extreme importance. Carbuncles are diagnosed and assessed based on their appearance and pertinent physical examination findings.
- To determine the specific bacterial etiology causing the carbuncle, both culture and gram stain of the pus within the said skin lesion can be performed. These procedures would not only determine the carbuncle’s particular causative agent, but also could help in choosing the specific antibacterial treatment sensitive for the suspected organism. 
Home Remedies for Carbuncles
The following may be done as supportive therapies in managing carbuncles: [2, 4]
- Warm compress application
- Soak the carbuncle in warm water.
- Apply warm, moist washcloth for twenty minutes daily.
- Washing of the skin lesion and covering it with a sterile bandage may also be done to drain, heal and prevent further spread of infection.
- Avoid squeezing and frequent touching of the carbuncle to prevent further irritation.
- Clothes, towels and beddings of the infected person should be meticulously washed to avoid further transmission of the bacterial infection.
- Strict handwashing should be implemented.
- Non steroidal anti inflammatory drugs (NSAIDs) and other pain relievers may be taken for severe discomfort.
Medical and Surgical Modalities as Treatment
- A consult to a physician is advised if the carbuncle is persistent, or if it does not drain nor heal. It is also warranted if it develops in the face, particularly in the eyes and nose, and if it is located at the region of the spine. One should never attempt to drain and force the carbuncle to release its pus, for doing so may further spread and aggravate the infection. 
- The physician, upon diagnosis, may remove the carbuncle via incision and drainage. The procedure not only gets rid of the pus, but it also washes the affected area with sterile solution for further antisepsis. The pus extracted from this method can then be used for culture and sensitivity studies. 
- If surgery and drainage is not opted, antibacterial medications may be administered for certain cases. This includes carbuncles infected with Methicillin Resistant Staphylococcus aureus (MRSA), those with incomplete drainage, those who are immunocompromised, with presence of infection of the surrounding tissues, and with spread of infection to other parts of the body.
- Most of these treatment courses are given ten to fourteen days, with the carbuncles completely healing after two to three weeks. Medications are either oral or topical, depending on the severity of the infection. [1, 2]
The Carbuncles’ Complications
- If not properly managed, these carbuncles may lead to serious sequelae. Bacteria may be absorbed in the circulation and consequently cause sepsis. This is an overwhelming infection of the body characterized by fever, tachycardia, and chills. If untreated, it may lead to fatality. 
- Less serious complications include infections of the lungs, joints, heart, bones, blood and central nervous system. To be more specific, this skin condition, if neglected, may lead to complications: encephalitis, meningitis, endocarditis, osteomyelitis, and abscess formation. 
The following may prevent occurrence, or recurrence of carbuncles, hence are recommended to be adhered on to: 
- Regular and thorough washing of hands with mild soap should be done.
- Wounds should be washed daily with antimicrobial solutions, or even soap and water, and kept covered with sterile, dry bandages for antisepsis.
- Personal items should be maintained to be personal. Avoid using and sharing other person’s items such as towels, sheets, clothing, and even razor.
- The infected individual’s personal items and clothing should be washed with detergent, hot water, and even bleach.
- They should be dried under the sun or with the use of a hot dryer.