My mother has been getting boils since she was about seven. She has been in and out of the hospital for years, and all the doctors say is that she has staph in her blood and nothing can be done. Is it possible for her blood to have staph in it? Are there any treatments other than antibiotics? The last time she had a boil on her leg, it ate up the front of her leg and she was in the hospital twice. Now it's back again, plus she has one on her arm and one under her breast.

H.

Boils (furuncles) are painful bumps in the skin. They usually become filled with pus, which drains spontaneously. By far the most common organism causing furuncles is the bacterium Staphylococcus aureus, or "staph."

Most boils resolve without treatment. But sometimes, the furuncle progresses deep into the skin, connecting to other furuncles close by. It will appear as a large, inflamed mass with multiple openings that drain pus. This large infection is termed a "carbuncle." Carbuncles usually require surgery to drain them.

Furuncles and even carbuncles are usually harmless and do not cause long-term problems. Occasionally, however, the staph will get into the bloodstream. This can have dire consequences, as the bacterium can then cause infections elsewhere such as in a bone or joint. Another, fortunately rare, complication is endocarditis, an infection of a heart valve.

There is no way that your mother has had staph in her blood for any length of time. We all have small amounts of bacteria, not usually staph, that enter our blood from our intestines and mouths, but it is only temporary. While staph can cause a transient bacteremia (bacteria in the blood), persistent staph bacteremia would cause any person to seek prompt medical attention -- there would be fevers, chills, and eventually severe illness and death.

Your mother is probably "colonized" by staph. This means that in between her outbreaks of boils, the staph is still present on her body. In cases like your mother's so-called "recurrent furunculosis," the bacterium often reside in the nose. This is common in patients on dialysis for kidney failure, but it also occurs in otherwise healthy adults and children. Physicians have tried eradicating the staph by simply applying an antibiotic to the nose, and this approach sometimes is successful. Mupirocin (trade name Bactroban) is the antibiotic most commonly used, and it comes in a formulation specifically designed for nasal use. It can be applied for five days each month. Your mother should talk to her doctor about being tested to see if she is a chronic staph carrier and could benefit from this treatment.

There are a few other ways to prevent recurrent boils. Some people have a problem with neutrophils, a type of blood cell that fights certain infections. One medical-research study showed that vitamin C can help prevent boils in such patients. It is very difficult to test for this neutrophil problem, so taking vitamin C even without further testing may be a good idea if your mother does not prove to be a chronic carrier of staph.

Finally, a few oral antibiotics have also been shown to prevent disease in cases like your mother's. One approach is to give two antibiotics for 10 days in an attempt to eradicate the bacterium. A different approach is to give a single antibiotic at a low dose indefinitely.

Your mother should discuss these options with her physician. My guess is that she is a chronic carrier and may benefit from the nasal application of mupirocin.