Overview
A furuncle of the chest wall is an acute, painful, suppurative infection involving the hair follicle and surrounding tissue in the chest wall region, often caused by Staphylococcus aureus. 1Diagnosis
Clinical presentation includes localized pain, erythema, warmth, and swelling.
Imaging (ultrasound) may help identify the extent of the infection and rule out other conditions like abscesses or deeper infections. 1Management
Incision and Drainage (I&D): Primary treatment involves prompt surgical drainage to remove pus and reduce pressure. 1
Antibiotics: Empiric antibiotic therapy targeting Staphylococcus aureus, typically with beta-lactams or clindamycin, should be initiated based on local resistance patterns. 1
Pain Management: Ultrasound-guided serratus anterior plane block may be considered for analgesia in selected cases, particularly if pain management is challenging 1.Special Populations
Pediatrics: Specific management strategies for pediatric furuncles are not detailed in the provided abstracts. 1
Elderly: No unique considerations mentioned beyond standard management approaches. 1
Comorbidities: Management principles remain similar; however, antibiotic choice should consider underlying comorbidities and potential drug interactions 1.Key Recommendations
Perform incision and drainage promptly for optimal outcomes in managing chest wall furuncles (Evidence: Moderate) 1
Initiate empirical antibiotic therapy targeting Staphylococcus aureus for suspected furuncles (Evidence: Moderate) 1
Consider ultrasound-guided serratus anterior plane block for pain management in selected cases, particularly in emergency settings (Evidence: Weak) 1References
1 Gawel RJ, Hong JX, Hassel EE, Kramer JA. Ultrasound-Guided Serratus Anterior Plane Block for Acute Pain Management in Emergency Medicine: A Systematic Review. The Journal of emergency medicine 2025. link