Ayurveda Management Of Large Nape Carbuncle With Cellulitis Without Surgical Debridement: A Case Report

Abstract

Diabetic carbuncles, commonly occurring at the nape of the neck, present as large, erythematous, tender, and swollen lesions with multiple pus-discharging sinuses, often accompanied by systemic symptoms such as pain and fever. These infections, predominantly caused by Staphylococcus aureus invading hair follicles, are prevalent in diabetic patients due to compromised immunity from poor glycemic control. If untreated, they risk progressing to cellulitis, sepsis, and life-threatening septic shock. Classical Ayurvedic literature describes a similar clinical entity, Jalani Prameha Pidika, attributed to Medo Dusti (fat tissue vitiation) and Tridosha imbalance. This case report details the successful management of a large diabetic carbuncle with cellulitis located on the nape of the neck in a patient with a 10-year history of Type 2 Diabetes Mellitus, post-intensive care treatment for Diabetic Ketoacidosis and sepsis. The patient was treated exclusively with a comprehensive Ayurvedic regimen over 65 days, including Prameha Har (anti-diabetic), Jwar Har (antipyretic), Vishahar (detoxifying), Vranahar (wound healing and tissue repair), and Rasayana Chikitsa (immunomodulatory and rejuvenative therapy), without surgical debridement. The treatment resulted in complete resolution of the lesion, significant reduction in pain, swelling, and infection, highlighting the potential of Ayurvedic interventions as an effective alternative in managing diabetic carbuncles and preventing complications.