Furunculosis L02.93

Precise data on incidence/prevalence are not known. However, it appears that an increase in prevalence has been demonstrated in recent years. Here, the "Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA)" seems to play a pathogenetic role (Demos M et al. 2012).

S. aureus has been shown to be the main risk of recurrent furunculosis (Demos M et al. 2012). In addition, there is a weakness of the immune system, e.g. as a result of metabolic diseases, diabetes mellitus, gastrointestinal disorders, chronic nephritis, diseases of the haematopoietic system with immune deficiency states and dysprotein anaemia. Tight-fitting, moisturising clothing can also be a cause.

In the intertrigines, disinfectant measures several times a day, e.g. polihexanide (Serasept, Prontoderm), quinolinol (e.g. quinosol or R042 ), cadexomer iodine (Iodosorb ointment), polyvidon iodine (Betaisodona), ethacridine lactate (e.g. 1% zinc paste containing ethacridine lactate); gauze strips). Local antibiosis of the nose with mupirocin (e.g. Turixin ointment).

In case of detection of Staphylococcuss aureus: Clindamycin: 2x 300mg p.o./day in combination with Rifampicin 2x300mg/day p.o. over 12 days.

Alternative: Trimethoprim/Sulfamethoxazole (TMP/SMX) 160/800 mg - 320/1600 mg 2x/day

Patients with fever receive trimethoprim/sulfamethoxazole 160/800 mg - 320/1600 mg 2x/day plus rifampicin 300 mg 2x/day for 10 days. Repeat the antibiotic cycle if necessary.

In case of signs of diabetes mellitus strict diabetes control.

1. Demos M et al (2012) Recurrent furunculosis: a review of the literature. Br J Dermatol 167:725-732.