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PubMed1998

Phagocytosis and oxidative burst by neutrophils in patients with recurrent furunculosis.

Neutrophil phagocytosis of fluorescently labelled Staphylococcus aureus and oxidative burst by the neutrophils were assessed by flow cytometry in 22 patients with recurrent furunculosis and in 17 controls. Phagocytosis and oxidative burst were not found to be significantly different between the patients and controls. Low serum iron concentrations were demonstrated in six patients (27%). In these patients with hypoferraemia, oxidative burst was significantly lower than in the patients without hypoferraemia and in the controls. These data suggest that hypoferraemia may be an important predisposing factor in a subgroup of patients with recurrent furunculosis in impairing oxidative killing by neutrophils.

Adult↗
PubMed2006

Five cases of bacterial endocarditis after furunculosis and the ongoing saga of community-acquired methicillin-resistant Staphylococcus aureus infections.

Bacterial endocarditis secondary to Panton-Valentine leukocidin producing community-acquired methicillin-resistant Staphylococcus aureus (MRSA) infections is rare. We report 5 previously healthy patients who presented with endocarditis after developing furunculosis due to CA-MRSA. A retrospective chart review of all patients with MRSA positive blood cultures was conducted over a 12-month period. Patients with multiple positive blood cultures within 72 h of admission and who had no risk factors for MRSA acquisition were included. Modified Duke's criteria were used to define bacterial endocarditis. PCR detection of Panton-Valentine leukocidin (PVL) genes as well as SCCmec typing was performed. In addition, strain typing of MRSA isolates was performed utilizing pulsed-field gel electrophoresis. Five out of a total of 193 patients had features consistent with CA-MRSA infections and met modified Duke's criteria for bacterial endocarditis. Blood culture isolates were found to be PVL gene positive and carried the type IV SCCmec element. PFGE confirmed that skin isolate was identical to the isolate cultured from his blood. Bacterial endocarditis in patients with CA-MRSA furunculosis is an emerging entity. In areas where CA-MRSA skin infections are prevalent, inappropriate initial antibiotics remain a major problem and may result in significant morbidity.

Adult↗
PubMed1996

Vitamin C for the treatment of recurrent furunculosis in patients with imparied neutrophil functions.

The effect of vitamin C treatment on 23 patients with a history of recurrent furunculosis with negative nasal cultures was studied. Neutrophil functions (chemotaxis, phagocytosis, or superoxide generation) of 12 patients were significantly lower than those of the matched controls. In this group, treatment with vitamin C (1 g/day) caused a dramatic clinical response as well as a significant improvement of neutrophil functions, reaching values similar to those of the controls. Two patients remained vitamin C-dependent. In the patients with normal neutrophil functions, vitamin C treatment neither affected neutrophil activity nor caused a clinical response. Therefore, patients suffering from recurrent furunculosis with defective neutrophil functions may be treated successfully with vitamin C, contributing to both neutrophil function recovery and a dramatic clinical response.

Adolescent↗
PubMed2005

Efficacy of furunculosis vaccines in turbot, Scophthalmus maximus (L.): evaluation of immersion, oral and injection delivery.

The commercial furunculosis vaccine Aquavac Furovac 5 and an autogenous vaccine, based on the challenge strain, induced immune protection in turbot, Scophthalmus maximus (L.), as shown in challenge tests 120 days post-immunization by injection (relative percentage of survival, RPS = 72-99%). This protective effect lasted for at least 6 months post-immunization at appreciable levels (RPS = 50-52%). Neither the autogenous vaccine nor the commercial vaccine was able to induce significant levels of protection against Aeromonas salmonicida in turbot when administered by immersion. Antibody levels were high or moderate in fish vaccinated by injection with the different vaccines and very low in fish vaccinated by immersion. The field results show that delivering an oral boost after the primary vaccination by injection did not enhance protection of turbot against furunculosis and that water-based (autogenous vaccine) and oil adjuvanted (Alpha Ject 1200) vaccines administered by injection conferred similar levels of protection (RPS > 80%) in turbot.

Administration, Oral↗
PubMed1993

Successful treatment of a patient with recurrent furunculosis by vitamin C: improvement of clinical course and of impaired neutrophil functions.

BACKGROUND: Neutrophils play a critical role in host defense against a variety of microbial pathogens. There is much information to suggest a role for vitamin C in the physiology of neutrophils. Thus, the effects of vitamin C treatment were studied in a patient with a history of recurrent furunculosis who showed altered neutrophil functions. METHODS: Superoxide generation was measured by cytochrome C reduction. Phagocytosis of opsonized zymosan by neutrophils and chemotaxis on agarose plates were determined. RESULTS: Chemotaxis, phagocytosis, and superoxide generation of the patient's neutrophils were significantly lower than those of the matched control. Treatment with vitamin C (500 mg/day) for 30 days caused a dramatic clinical response and a significant improvement of all three neutrophil functions to values similar to those of the controls. CONCLUSIONS: We suggest that the patient described here had a temporary defect in neutrophil functions. The treatment with vitamin C probably prevented neutrophil oxidation, thus contributing to recovery of neutrophil function and arrest of furunculosis.

Adult↗
PubMed1983

Trioleoylglycerol lipolysis by Staphylococcus aureus strains from recurrent furunculosis, pyomyositis, impetigo and osteomyelitis.

Staphylococcus aureus strains isolated from 94 patients with recurrent furunculosis, chronic osteomyelitis, tropical pyomyositis and impetigo were investigated for lipase activity after growth 1, 2 and 5 days in aerated casein hydrolysate-yeast extract. As substrate for lipase activity a tri-3H-oleoylglycerol emulsion was used. Phage group II staphylococci isolated from furunculosis had the highest lipase activity and on day 5 these strains differed significantly in activity from strains isolated from the other infections. Strains isolated from impetigo had a remarkably low lipase production. The quantitative difference in lipase production of various S. aureus strains may reflect the localization of the lesion.

Furunculosis↗
PubMed1995

Canine eosinophilic folliculitis and furunculosis in three cases.

The historical, clinical and histopathological features of three dogs with eosinophilic folliculitis and furunculosis are described. The disease was characterised by the rapid development of pruritic, papular, pustular and ulcerative lesions on the dorsum of the muzzle. Skin lesions were confined to the face in two cases. The third dog had more generalised pustular lesions. Skin biopsy specimens showed marked eosinophil infiltration particularly centred on pilosebaceous units. Dermal collagen necrosis was evident in two cases. Similar facial lesions have previously been described as 'nasal pyoderma'. The three dogs failed to respond to initial antibacterial therapy but showed a rapid clinical response when prednisolone was given orally at doses ranging from 1 to 2.2 mg/kg, in addition to the antibacterial therapy, suggesting that glucocorticoids are indicated for the treatment of eosinophilic folliculitis and furunculosis. The aetiology of the disease was not determined.

Administration, Oral↗
PubMed2005

Cyclosporine treatment of anal furunculosis in 26 dogs.

OBJECTIVES: To evaluate the effect of cyclosporine on anal furunculosis lesions in 26 dogs. METHODS: Lesions were graded as mild in 11 dogs, moderate in eight and severe in seven. Each dog was treated with approximately 4 mg/kg cyclosporine orally every 12 hours until the lesions resolved or showed no further improvement. Residual lesions were resected surgically. RESULTS: Eighteen dogs (69 per cent) experienced complete resolution, seven (27 per cent) improved but had residual lesions and one (4 per cent) showed no improvement. The mean duration of treatment until resolution or no further improvement was 8.8 weeks (range four to 24 weeks). Nine dogs (35 per cent) experienced recurrence. Six were from the group that had shown complete resolution and three were from the group that had surgery. Fifteen dogs (58 per cent) developed side effects to cyclosporine, although none required treatment to be discontinued. Mean duration of follow-up was 6.8 months (range one to 20 months). CLINICAL SIGNIFICANCE: Cyclosporine was effective at resolving or reducing anal furunculosis lesions in 25 of 26 dogs (96 per cent). However, residual or recurrent lesions remain a potential problem, and surgical resection or long-term cyclosporine treatment may be necessary in some dogs.

Animals↗
PubMed2003

Expression of cytokine mRNA in canine anal furunculosis lesions.

The pattern of expression of cytokine mRNA in the lesions of anal furunculosis was evaluated in tissue biopsies from 15 dogs, and compared with the pattern in control skin samples from 24 dogs, by reverse-transcriptase PCR using canine cytokine-specific primers and a semi-quantitative multiplex PCR assay. Interleukin-2 (IL-2) was detected in 11 of the 15 affected dogs but in only one of the controls, and interferon-gamma was detected in 14 of the affected dogs but none of the controls. In contrast, IL-4 was detected only in one of the affected dogs. Increased expression of mRNA for IL-1beta, IL-6, tumour necrosis factor alpha, IL-8, IL-10 and transforming growth factor beta1 was detected in the biopsies from the lesions of anal furunculosis relative to the control tissues (P < 0.05).

Animals↗
PubMedDate not supplied

An outbreak of furunculosis among high school athletes.

Furuncles (boils) are common among teenagers; however, few outbreaks have been documented. We investigated an outbreak of furuncles that occurred among male athletes of a Kentucky high school during the 1986 to 1987 school year. The overall attack rate was 25% (31/124). The risk of developing a furuncle increased two to three times in those who had skin injury. Athletes who sustained abrasions more than twice per week (P less than 0.01), who had a cut that required bandaging (P = 0.01), or had an unspecified injury causing a missed practice or game (P = 0.04) were at increased risk. The risk of developing furunculosis did not appear to be related to contact with formites, but rather, to contact with furuncles. Although athletes shared common areas (showers, locker rooms, practice areas, the attack rates for varsity football (36%) and varsity basketball (33%) were four times greater than for nonvarsity teams (P less than 0.01). Players who had a friend with a furuncle were more than twice as likely to also have had a furuncle (P less than 0.01). Exposure to furuncles appeared to increase the risk of furunculosis independently of reported skin injury. Control and prevention should, therefore, focus on both reducing skin injury and reducing exposure to furuncles, rather than attempting to sterilize inanimate objects.

Disease Outbreaks↗
PubMed1985

Treatment and prevention of recurrent staphylococcal furunculosis: clinical and bacteriological follow-up.

Various therapeutic and preventive methods were evaluated in 80 patients with recurrent staphylococcal furunculosis. The most appropriate treatment was peroral antibiotics for 10-14 days, mainly flucloxacillin twice daily. Fusidic acid ointment was used for prevention of relapses. Patients and healthy family members who carried the patient strain applied the ointment in nares twice daily every 4th week during 4-15 months. The method had a permanent effect in 80%. Implantation of strain 502 A was less effective when evaluated during a 2-3 yr period. 40-80 patients were checked up to 8 yr after their last furuncle. Three still had furuncles, in 2 of these cases the original strain was found in nares. 37 patients, now healthy after a mean observation time of 4.5 yr, showed either new nasal strains or negative cultures. A significantly lower frequency of phage group II strains in nares was noted in comparison to the previous findings during active furunculosis.

Adolescent↗
PubMed2004

A deterministic model for the dynamics of furunculosis in chinook salmon Oncorhynchus tshawytscha.

Studies were undertaken to determine the parameters of transmission of Aeromonas salmonicida in chinook salmon Oncorhynchus tshawytscha, and to develop a deterministic model of the dynamics of experimental furunculosis. For determination of disease transmission coefficient (beta), disease-related mortality rate (alpha) and natural mortality rate (gamma), fish in 70 tanks (approximately 42 fish tank(-1)) were each exposed to a single infectious donor fish, 7 tanks were randomly selected daily and all individuals were examined for the presence of A. salmonicida in the kidney. The proportion of susceptible (S), infected (I) and removed (R, dead) individuals were determined daily. The parameters beta, alpha, gamma, reproductive ratio (R0) and threshold density were estimated to be 0.0214 infected ind. d(-1), 0.29 infected ind. d(-1), 0.00015 ind. d(-1), 3.23 and 13.56 ind., respectively. Using these parameters, a deterministic disease model of A. salmonicida infection as a cause of furunculosis was constructed. The net rate at which new individuals became infected (the incidence rate) per unit time was proportional to S x I x beta. The model-produced data for S were significantly associated with experimental data (r2 = 0.92). In brief, a simple SIR (susceptible-infected-removed) model was successfully utilized to simulate observed data

Aeromonas salmonicida↗
PubMed2006

Efficacy of rifampicin in eradication of carrier state of Staphylococcus aureus in anterior nares with recurrent furunculosis.

OBJECTIVE: To compare the frequency of detection of Staphylococcus aureus carrier state in anterior nares of the patients suffering from recurrent furunculosis with the normal population and to determine the efficacy of rifampicin in eradication of the carrier state. DESIGN: Quasi-experimental study. PLACE AND DURATION OF STUDY: Skin Department of Combined Military Hospital, Peshawar and Multan, from March 2004 to December 2005. PATIENTS AND METHODS: The study consisted of 80 individuals. They were placed in two groups. Group I comprised of 40 patients suffering from recurrent furuncles and group II included 40 healthy adults, kept as controls. Nasal swab was taken from the individuals belonging to both the groups, when they first reported to skin OPD. The patients who were suffering from furuncles were treated with co-amoxiclav 375 or 625 mg three times a day. The patients in whom S. aureus carrier state was detected were again divided into two groups. Group 1 was prescribed rifampicin 450-600 mg daily (depending on the body weight) for 10 days, while the group 2 was not offered any treatment. After this course, a second nasal swab was taken and submitted for cultures. RESULTS: Among the 40 patients belonging to group I, S. aureus carrier state was detected in 23 (57.5%), while in group II the carrier state was found in 8 (20%) individuals (p<0.001). Among the 13 patients who received rifampicin, 10 got cured of carrier state, while in 3 patients nasal swab was still positive after a course of rifampicin. In 10 patients, who were not offered any treatment, the nasal swabs remained positive (p<0.001). These patients were followed-up in skin OPD for another 3 months, and did not develop any recurrence of the infection. CONCLUSION: Nasal swab for detection of S. aureus carrier state should be done in all patients of recurrent furunculosis. If the nasal swab culture is positive, then as the infection gets cured, the patients should receive a course of rifampicin for 10 days. This may eradicate the carrier state in majority of cases and prevent the recurrence of the infection.

Adolescent↗
PubMedDate not supplied

Repeated furunculosis in adult male with abnormal neutrophil activity.

A 21 years old male suffered from repeated furunculosis in different regions of the body over the last two years. This coincided with the start of professional activities in hospital surroundings. The purulent secretions all showed growth of Staphylococcus aureus. All laboratory tests were normal except for a decrease of the neutrophil phagocytic ingestion phase. Before the diagnosis of defective phagocytosis was made, antibiotic treatment was started about 4 to 5 days after the appearance of the infectious process and the furunculosis led to abscess formation with difficult healing and cellulitis. After the diagnosis of defective phagocytosis ingestion phase, personal hygiene was intensified during and after work shifts at the hospital and antibiotic treatment was started at the first signs of folliculitis, which showed healing.

Adult↗
PubMed2004

Cases from the aerospace medicine residents' teaching file: furunculosis.

A case is presented of an aviator with frequent dermatologic lesions concerning for recurrent furunculosis that was caused by community-acquired methicillin-resistant Staphylococcus aureus. The presentation, diagnosis, treatment, and aeromedical disposition of recurrent furunculosis are discussed.

Administration, Intranasal↗
PubMed1986

[Early and total E-rosette-forming lymphocytes in furunculosis patients].

In 228 furunculosis patients a decrease in the level of total and early E-rosette-forming lymphocytes (E-RFL) was observed. Early E-RFL underwent greater changes, as these lymphocytes, being more closely related to the clinical picture of furunculosis, better reflected the severity of the clinical course of this infection.

Adolescent↗
PubMed1984

Furunculosis in rainbow trout (Salmo gairdneri) raised in sea water.

Ulcerative skin lesions were encountered in rainbow trout raised in sea water by a commercial concern in the Western Cape, South Africa. Grossly, the lesions resembled furunculosis but, histopathologically, they differed from typical furunculosis in that bacterial colonies were rarely found in the organs, and also the kidneys and spleens were minimally involved. The causative organism was identified as an achromogenic Aeromonas salmonicida that shared characteristics with all 3 subspecies, salmonicida, masoucida and achromogenes. This is the first report of an outbreak of this disease in South Africa.

Aeromonas↗
PubMed1997

Immunization with bacterial antigens: furunculosis.

Although the nature of the antigens and the immune responses they elicit to achieve immunity to furunculosis are still not well defined, the currently available vaccines comprising A. salmonicida bacterins emulsified in oil adjuvants and delivered by intraperitoneal injection provide remarkably high levels of long-lasting protection. Despite some concern over side-effects, these vaccines have been adopted by most Atlantic salmon farmers over the last four years, transforming a situation where furunculosis outbreaks were becoming catastrophic to one where losses from the disease are negligible. Present evidence indicates that antibody responses to the polysaccharide capsule and iron regulated outer membrane proteins are associated with protection. Furthermore, cell-mediated immune responses involving antigen-induced release of cytokines from lymphocytes and the resultant activation of macrophages with the ability to kill the pathogen are also considered important protective mechanisms. Vaccines comprising whole A. salmonicida cultures grown under iron-restricted conditions and delivered by injection in an oil adjuvant are expected to induce prolonged stimulation of all the above responses. While these vaccines are suitable and effective for administration to salmon smolts there is still a need for mass vaccination by immersion or oral routes for salmonid fry. Effective means of achieving this are still required.

Aeromonas↗