Case report
Inflammatory Facial Swelling in an Elderly Male: A Rare Case of Cheek Carbuncle
PD01-PD03
Correspondence
Dr. Samir Ahmed,
Assistant Professor, Department of General Surgery, Sree Balaji Medical College and Hospital, Chennai-600044, Tamil Nadu, India.
E-mail: ufacesamir@gmail.com
Facial carbuncles are uncommon deep skin and Soft-Tissue Infections (SSTI) characterised by coalescent furuncles, extensive tissue necrosis, and multiple draining sinuses. Their occurrence on the face is clinically important because of the potential risk of spread to intracranial structures through the facial venous system. A 61-year-old male presented with a progressively enlarging painful swelling over the left cheek associated with erythema, tenderness, necrotic slough, and multiple discharging sinuses. Clinical examination and ultrasonography revealed a deep infective lesion with internal septations and surrounding soft-tissue oedema. Differential diagnoses including pyogenic abscess, infected sebaceous cyst, odontogenic infection, and soft-tissue malignancy were considered. The diagnosis of cheek carbuncle was established based on characteristic clinical features, imaging findings, intraoperative observations, and microbiological confirmation. The patient underwent surgical debridement with drainage of multiple interconnected purulent cavities followed by intravenous antibiotic therapy guided by microbiological culture findings and regular wound care. Microbiological culture demonstrated Staphylococcus aureus infection. Progressive wound healing with healthy granulation tissue formation was observed during follow-up, and no local or systemic complications developed. The present case highlights the importance of considering carbuncle in the differential diagnosis of inflammatory facial swellings, particularly in elderly patients. Early recognition, appropriate imaging, prompt surgical intervention, and targeted antimicrobial therapy are essential to achieve favourable outcomes and prevent potentially serious complications associated with facial infections.