Honeycomb - Anthrax: S. Aureus skin lesions

Definition of honeycomb-carbuncle

The honeycomb or staphylococcal carbuncle (from the English term carbuncle) - not to be confused with anthrax-anthrax - is a "pyogenic infection of the skin, often involving a group of hair follicles; the infected material favors the formation of an accumulation of pus deep, the presence of which is perceived as a solid lump or boil.

Staphylococcal carbuncle is often uncomfortable, and the pain continues until the pus-filled boil erupts. However, the rarity of an "unpaired" carbuncle should be underlined: often, in fact, a single boil infects the adjacent hair follicles, spreading the infection and creating a sort of multiple follicular eruption.


The skin blisters caused by carbuncle are the immediate consequence of a skin infection sustained by the bacterium Staphylococcus aureus, the same implicated in more complex diseases, such as pneumonia and endocarditis. Bacteria infect the skin through cuts, scrapes or lacerations; as soon as the staphylococcus comes into contact with the organism, the neutrophils are activated to fight the infection. This mechanism leads to inflammation and the formation of pus, a mixture of bacteria, dead cells and old white blood cells common to the various forms of staph anthrax.
Ideally, honeycombs can form anywhere, even if they opt for the back and nape of the neck as preferential targets; staphylococcal carbuncles are observed to develop more frequently in men than in women.
The people most at risk of honeycombs are diabetics, the immunocompromised and all those sensitive to dermatitis: diabetes - as well as the alteration of the immune system - weakens the body, reducing its ability to fight infections, while other diseases skin (eg dermatitis) weaken and damage the natural protective barrier that each individual has: the skin. Among other risk factors, we cannot forget poor personal hygiene, shaving and cuts on the skin. Close contact with a person with anthrax increases the risk of direct contamination.


The staphylococcal carbuncle appears as a set of boils and boils, of extremely variable size: some patients develop small carbuncles, comparable in size to that of a pea; others, on the other hand, expand exaggeratedly, taking the shape of a walnut or golf ball. The honeycomb causes pain, discomfort, local irritation and itching, which tend to be accentuated by rubbing or, simply, by brushing. The staphylococcal carbuncle can grow very fast or reach a certain size and never grow anymore; typically, these pus-filled blisters have a whitish or yellowish core, which tends to release liquid onto the skin, to subsequently form a solid crust. But the symptoms that staphylococcal carbuncle involves do not stop only at the skin: in fact, patients who are affected often complain of fatigue, chills, fever and general malaise.

  • The staphylococcal honeycombs differ from normal boils because, in addition to growing over time, they heal very slowly and often leave a more or less evident scar after the removal of the pathogen and the outbreak of the carbuncle.


Even staphylococcal anthrax can be potentially serious and create more or less serious complications. Following the formation of an anthrax bubble, the infecting staphylococcus can pass into the blood and create bacteremia or septicemia, thus also causing deep infections to the various districts and organs, such as endocarditis and osteomyelitis. The intrusion of staphylococcus into the blood can promote septic shock, putting the affected patient's survival at serious risk.


The diagnosis is made through the physical examination of the patient's lesions: through the scrupulous observation of the skin sores, the specialist is able to conjecture a first diagnosis, which will subsequently be ascertained with the laboratory examination carried out on a sample of pus The analysis of the sample is useful to determine with certainty the bacteria involved in the infection, therefore, only later, it will be possible to establish a precise pharmacological treatment.

Treatments and cures

Pharmacological treatment is not always essential for the treatment of staphylococcal carbuncle: in some mild forms, the application of hot cloths directly on the lesion is sufficient, in order to favor its outbreak, which marks the removal of the disease. In general , for non-pharmacological healing it takes two weeks for complete recovery. It is recommended NOT to squeeze the pus-filled boil with your hands, rather to let the lesion take its course: a similar behavior favors the spread of the infection , worsening the conditions.
For larger carbuncles, warm compresses are not enough: in this case, the doctor drains the pus through an "incision made directly on the tip of the staphylococcal carbuncle. This practice, although rather annoying, shortens the healing time. , minimizing the risk of scarring.
If the staphylococcal honeycomb does not regress within 14 days of the onset of symptoms, systemic pharmacological treatment and / or topical application of specific antibacterials is recommended.
Sometimes, treatment for staph anthrax can be complicated due to the resistance the bacterium produces to many antibiotics, such as methylcillin; starting from these assumptions, the need arose to devise new molecules - or in any case to choose alternative drugs - to ward off bacterial strains of staphylococcus resistant to certain antibiotics. Vancomycin, amoxicillin, cefazolin, ciprofloxacin and moxifloxacin , for example, they are the most effective and most used antibiotic drugs in therapy for the treatment of staphylococcal carbuncle.

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