Furuncle Caused by Methicillin-Resistant Staphylococcus aureus (MRSA) Infection

June 7, 2013

In the current milieu, the clinician should assume that MRSA is responsible for furuncles, until culture proves otherwise. Incision and drainage is the most important part of therapy, but oral antibiotics should be considered in large lesions, very young or very old patients, and when cellulitis surrounds the boil.

A 51-year-old man complained about a solitary painful lesion on the back. His past medical history included numerous bouts of folliculitis that involved the trunk.

Key point: A solitary, exquisitely tender bright red, fluctuant nodule was found on the back.

Treatment: Incision allowed drainage of copious seropurulent material. The patient was also given a 2-week course of oral doxycycline. Culture verified methicillin-resistant Staphylococcus aureus (MRSA).

Note: In the current milieu, the clinician should assume that MRSA is responsible for furuncles, until culture proves otherwise. Incision and drainage is the most important part of therapy, but oral antibiotics should be considered in large lesions, very young or very old patients, and when cellulitis surrounds the boil.