Careful evaluation for underlying c

Careful evaluation for underlying causes.
Systemic processes: previously discussed.
Speci c localized predisposing factors: industrial exposure to chemicals, oils; poor hygiene; obesity; hyperhidrosis; ingrown hairs; pressure from tight clothing or belts.
Sources of staphylococcal contact: pyogenic infections in the family, contact sports such as wrestling, autoinoculation.
Nasal carriage of Staphylococcus aureus: this is the site from which dissemination of the organism may occur to other body sites. The frequency of nasal carriage varies: 10%–15% in infants 1 year of age, 38% in college students, 50% in hospital physicians and military trainees.
General skin care: the aim of these measures is to reduce the numbers of S. aureus on the skin. General skin care of both hands and body with water and
soap is important (an antimicrobial soap solution,
such as 4% chlorhexidine solution, may be used to decrease staphylococcal skin colonization). The patient should avoid trauma to the skin as well as potential skin irritants such as strong soaps and deodorants. A separate washcloth (and towel) should be used and carefully washed in hot water before use.
Care of clothing: loose, lightweight, porous clothing should be worn as much as possible. Large numbers of Staphylococci are frequently present on the sheets and underclothing of patients with furunculosis and may cause reinfection of the patient and infection of other members of the family. In problem cases, it is not unreasonable to recommend that these items be carefully and separately washed in boiling water and changed daily.
Care of dressings: dressings should be changed frequently if purulent drainage collects. They should be carefully discarded in a paper bag that can be sealed and disposed of immediately.
General measures: despite the above measures,
some patients continue to have recurrent cycles of lesions. Sometimes, the problem can be ameliorated or abolished by removing the patient from the
regular routine of work. This is particularly pertinent
in individuals who are under considerable emotional stress and physical fatigue. A vacation for several weeks, ideally in a cool, dry climate, may help considerably by providing rest and also the time needed for carrying out the program of careful skin care.
Measures aimed at elimination of nasal (and skin) carriage of S. aureus (methicillin susceptible or methicillin resistant).
Local use of ointment in the nasal vestibule reduces nasal carriage of S. aureus and secondarily reduces
the “shedding” of organisms on the skin, a process
that may contribute to recurrent furunculosis. Intranasal application of a 2% mupirocin calcium ointment in a white, soft, para n base for 5 days can eliminate S. aureus nasal carriage in 70% of healthy individuals for up to 3 months. In immunocompetent staphylococcal carriers with recurrent skin infections, a 5-day course of nasal mupirocin ointment every month for 1 year resulted in positive nasal cultures in only 22% of patients as compared with 83% in the placebo group. The nasal culture-negative patients also had signi cantly fewer skin infections during the treatment period. Staphylococcal resistance to mupirocin was observed in only 1 patient out of 17. Prophylaxis with fusidic acid ointment in the nares twice daily every fourth week for the patient and family members who are nasal carriers of the infecting strain (along with peroral antistaphylococcal antibiotic for 10–14 days for the patient) has been used with some success.
Oral antibiotics (e.g., rifampin, 600 mg orally daily for 10 days) have been e ective in eradicating
S. aureus from most nasal carriers for periods of up to 12 weeks. Such a use of rifampin for a brief period to eradicate nasal carriage of S. aureus and interrupt a continuing cycle of recurrent furunculosis might be reasonable in a patient in whom other measures have failed. However, selection of rifampin-resistant strains can occur rapidly with such therapy. The addition of a second drug (dicloxacillin for methicillin- susceptible S. aureus; trimethoprim-sulfamethoxazole, cipro oxacin, or minocycline for methicillin-resistant S. aureus) has been used to reduce the emergence of rifampin resistance and to treat recurrent furunculosis.

Results (Indonesian) 1:

Hati-hati evaluasi untuk penyebab.Proses sistemik: sebelumnya dibahas.Spesimen yang terkumpul c lokal faktor predisposisi: industri paparan bahan kimia, minyak; miskin kebersihan; obesitas; ««««Hyperhidrosis; rambut tumbuh ke dalam; tekanan dari pakaian ketat atau ikat pinggang.Sumber-sumber staphylococcal kontak: cholangitis infeksi dalam keluarga, hubungi olahraga seperti gulat, autoinoculation.Hidung pengangkutan Staphylococcus aureus: ini adalah situs yang penyebaran organisme dapat terjadi ke situs tubuh lain. Frekuensi hidung pengangkutan bervariasi: 10%-15% pada bayi 1 tahun usia, 38% di mahasiswa, 50% di rumah sakit dokter maupun siswa pelatihan militer.Perawatan kulit umum: tujuan dari langkah-langkah ini adalah untuk mengurangi jumlah S. aureus pada kulit. Umum kulit perawatan tangan dan tubuh dengan air dansabun penting (solusi sabun dengan pengharum parfum,seperti 4% chlorhexidine solusi, dapat digunakan untuk mengurangi kolonisasi staphylococcal kulit). Pasien harus menghindari trauma kulit serta potensi iritasi kulit seperti sabun kuat dan deodoran. Kain lap terpisah (dan handuk) harus digunakan dan hati-hati dicuci dalam air panas sebelum digunakan.Care of clothing: loose, lightweight, porous clothing should be worn as much as possible. Large numbers of Staphylococci are frequently present on the sheets and underclothing of patients with furunculosis and may cause reinfection of the patient and infection of other members of the family. In problem cases, it is not unreasonable to recommend that these items be carefully and separately washed in boiling water and changed daily.Care of dressings: dressings should be changed frequently if purulent drainage collects. They should be carefully discarded in a paper bag that can be sealed and disposed of immediately. General measures: despite the above measures,some patients continue to have recurrent cycles of lesions. Sometimes, the problem can be ameliorated or abolished by removing the patient from theregular routine of work. This is particularly pertinentin individuals who are under considerable emotional stress and physical fatigue. A vacation for several weeks, ideally in a cool, dry climate, may help considerably by providing rest and also the time needed for carrying out the program of careful skin care.Measures aimed at elimination of nasal (and skin) carriage of S. aureus (methicillin susceptible or methicillin resistant).Local use of ointment in the nasal vestibule reduces nasal carriage of S. aureus and secondarily reducesthe “shedding” of organisms on the skin, a processthat may contribute to recurrent furunculosis. Intranasal application of a 2% mupirocin calcium ointment in a white, soft, para n base for 5 days can eliminate S. aureus nasal carriage in 70% of healthy individuals for up to 3 months. In immunocompetent staphylococcal carriers with recurrent skin infections, a 5-day course of nasal mupirocin ointment every month for 1 year resulted in positive nasal cultures in only 22% of patients as compared with 83% in the placebo group. The nasal culture-negative patients also had signi cantly fewer skin infections during the treatment period. Staphylococcal resistance to mupirocin was observed in only 1 patient out of 17. Prophylaxis with fusidic acid ointment in the nares twice daily every fourth week for the patient and family members who are nasal carriers of the infecting strain (along with peroral antistaphylococcal antibiotic for 10–14 days for the patient) has been used with some success.Oral antibiotics (e.g., rifampin, 600 mg orally daily for 10 days) have been e ective in eradicatingS. aureus from most nasal carriers for periods of up to 12 weeks. Such a use of rifampin for a brief period to eradicate nasal carriage of S. aureus and interrupt a continuing cycle of recurrent furunculosis might be reasonable in a patient in whom other measures have failed. However, selection of rifampin-resistant strains can occur rapidly with such therapy. The addition of a second drug (dicloxacillin for methicillin- susceptible S. aureus; trimethoprim-sulfamethoxazole, cipro oxacin, or minocycline for methicillin-resistant S. aureus) has been used to reduce the emergence of rifampin resistance and to treat recurrent furunculosis.