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Furunculosis


Multiple lesions with boils that appear simultaneously or sequentially one after the other in different parts of the body are called furunculosis. When it lasts with small remissions for several years, it is chronic, recurrent.
In places devoid of hair (palms and palms of the fingers, soles) boils do not develop. Most often observed on areas of skin that are exposed to contamination (forearm, rear brush) and friction (back of the neck, lower back, buttocks, thighs). FURUNCULE usually does not cause significant disruption of well-being. The pains are mild, but when localized, for example, in the external auditory canal, in the nose - significant. In the area of ​​the face (lips, forehead), and also on the scrotum, boils are accompanied by a significant swelling of the surrounding tissues, which is explained by the looseness of the subcutaneous tissue here.
Severe clinical course is often observed with boils of the upper lip, nasolabial folds, nose, suborbital (eye) region. Features of the development of the venous and lymphatic network on the face contributes to the rapid spread of germs. Thrombophlebitis of the veins with a boil of the face can spread through the anastomoses to the venous sinuses of the dura mater, which leads to their thrombosis, creating the threat of purulent basal meningitis. The edema of the face quickly increases, dense painful veins are palpated, the general condition of the patient deteriorates, body temperature reaches a high level (40-41 ± C), stiff neck and visual impairment (loss of chiasm) can be expressed.
Complications of boils include lymphangitis and regional lymphadenitis.
Of particular danger are rapidly progressing acute thrombophlebitis and sepsis. Acute thrombophlebitis usually develops with boils located near the large saphenous veins, and sepsis - with boils. They are often the result of attempts to squeeze the contents of the boil, cutting it during shaving, injury during a massage. The prognosis for these complications is very serious.
Treatment:
Careful toilet of the skin around the source of inflammation: rubbing with 70% alcohol, 2% salicylic alcohol, or lubrication with 1-3% alcohol solution of methyl blue, brilliant green, etc. Hair around the infiltrate is carefully trimmed. At the very beginning of the process, the abortive effect is sometimes rendered by repeated lubrication of the pustules with tincture of iodine. Ointments with various antiseptics are used only when the focus has been opened and emptied of pus. In the presence of necrotic masses, hypertonic solutions of sodium chloride are advisable.
Dry heat (hot-water bottle, solux, Minin's lamp), and also UHF is shown, which has an analgesic effect.
Compresses should not be done, as they contribute to the formation of multiple infiltrates. When boils of the trunk, neck and limbs should be applied stickers that protect the skin in the area of ​​inflammation from friction. Sometimes in the early stage, a furuncle is cut off with an antibiotic with novocaine or electrophoresis is done with it, however many surgeons prefer intramuscular injections.
For boils of the face, dressings are usually not applied. It is strictly forbidden to squeeze the contents of the boil and massage in the area of ​​inflammation. At high temperatures prescribed strict bed rest, liquid food, the patient is forbidden to talk, chew. It is necessary to start vigorous antibiotic treatment as early as possible, and it is advisable to combine them with oral sulfanilamide preparations. Surgical intervention is rarely used. However, with the development of phlegmon, it is subject to immediate opening.
In case of recurrent boils, non-specific stimulation therapy is carried out in the form of autohemotherapy (intramuscular injections of augrovia 5-10 ml in 1-2 days, only 3-5 injections), transfusions of small doses of canned blood are made. In chronic furunculosis, immunization with staphylococcal toxoid, administration of hyperimmune serum, gamma globulin and repeated transfusions of small doses of blood are effective.