Furunculosis Of Nose (Vestibulitis)

The furuncle is an acute infection of hair follicle with Staphylococcus aureus.

Salient features

  • Severe pain and tenderness over the tip of nose.
  • There may be headache, malaise and pyrexia.
  • Examination reveals congestion and swelling of the vestibule.

Treatment

Nonpharmacological

Local application of moist heat will enhance the localization of infection
and promote drainage.

Pharmacological

  1. Cap. Amoxycillin 500 mg 8 hourly for 5-7 days.
    In Children 25-50 mg/kg/day divided in 3 doses.
    Or
    Cap. Amoxycillin 250 mg + Cloxacillin 250 mg 8 hourly for 5-7 days.
    In Children 25-50 mg/kg/day divided in 3 doses.
    Or
    Cap. Amoxycillin 250/500 mg + Clavulanic acid 125 mg 12 hourly 5- 7 days.
  2. Tab. Ibuprofen 400-600 mg 3 times a day for 5 days.
    In Children 10 mg/kg/dose.
    Or
    Tab. Paracetamol 500 mg 6 hourly for 2-3 days then SOS.
    In Children 10 mg/kg 6-8 hourly for 2-3 days and then SOS till pain
    and fever subsides.
    Usually improvement in pain, tenderness and inflammation occurs within 24-48 hours after initiation of treatment. Patient should be monitored regularly. If there is flaring of infection in the form of spreading facial cellulitis then patient should be hospitalized and shifted to systemic intravenous antibiotics.If patient is having recurrent furunculosis, then the patient should be investigated for diabetes mellitus.
Patient education

  • Do not fidget with the furuncle as this lies in the dangerous area of the face and can cause serious complications.
  • Complete antibiotic therapy to avoid risk of developing antimicrobial resistance.

References

  1. Diseases of the External Nose & Nasal Vestibule. In: Diseases of Ear, Nose & Throat, PL Dhingra’s (ed), 2nd Edition, pp 144.