Boil/Cyst on coxyx

  • Rowing_Ant

    Posts: 1504

    Oct 14, 2007 6:42 PM GMT
    HI

    Ive had a boil or cyst on my coxyx just above and slighty in my ass crack for two months. Ten days ago I had it lanced and stitched up, but it didnt heal properly and filled up with puss again. A week ago I had it relanced and again yesterday - its just not healing properly and keeps fillig up and leaking puss.

    Any thoughts on what this might be and how to procede?

    My Doc keeps checking it, getting the puss out, dressing it and sending me home but its not getting any better.

    Help
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    Oct 15, 2007 2:43 AM GMT
    Get another dr to look at it.
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    Oct 15, 2007 3:09 AM GMT
    Without seeing the offending object my questions would be, other than where is the abscess and what does it look like, is there a culture and what does it show, and do the ABX cover what is growing. Also you usually don't stitch something like that back up after lancing it, you pack it etc, but don't close it because that usually prevents the infected material from draining.

    Also from the location I'm wondering if this isn't a pilonidal cyst which is usually best followed and treated by a surgeon.

    Anyway hope that's helpful.
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    Oct 15, 2007 3:35 AM GMT
    I think it's your vestigial tail. icon_twisted.gif
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    Oct 15, 2007 4:53 AM GMT
    Right about that pilonidal cyst -- if that's what it is, a surgeon will need to remove all the underlying tissue. These are remnants of cells that belong someplace else that some people are born with. Not to worry, not otherwise dangerous.

    The first doctor also should not have stitched the original wound after drainage. Standard practice is after incision to let the wound open to heal from the bottom up [hence the term I&D - incision and drainage]. Closing it just allows the bacteria to fester again. Antibiotics are rarely necessary -- what matters is adequate drainage.
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    Oct 15, 2007 6:02 AM GMT
    Does indeed sound like a pilonidal cyst/sinus.

    www.pilonidal.org for more info...

    Sorry to hear it bud, but I can empathise. Luckily my pilonidal doesn't require an excision (yet)... Getting work to provide me with one of those 'kneel down' style chairs REALLY helped with managing it, so look into that if you can avoid the surgery route.

    The problem with the surgery is that there is a great deal of healing time and likely scarring involved. If surgery is the go, be sure to ask your surgeon about the possibility of primary closure with a rhomboid flap - funky scar, but beats open wound healing, which is the other option (two months of laying on your stomach, having your dressings changed daily whilst it heals from the bottom up)...!

    Send me a message if you need more info, or some images of the potential scar for the primary closure option...

    Best wishes,
    BenM
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    Oct 15, 2007 11:35 AM GMT
    yup it is .... i had one from an accident in the navy. it took 6 months. i am a medic and the doc should have packed it with packing... you should be changing it every day and taking hot sits baths.

    it has to heal from the inside out or it will continue to come back.

    mine when it happened the whole i could put my fit in it and still not touch the sides or bottom of it.. in hospital for 3 months and home for the other 3... it was not fun... it would not have happened if a drunk lady didnt fall on top of me from 20 feet above off flight deck and land ontop of me... and then i hit an eye bolt on the deck. it went in the crack and hit the sweat gland that males have there at top of crack and swelled up and burst. not fun at all..

    any questions just drop a line..

  • Rowing_Ant

    Posts: 1504

    Oct 15, 2007 12:25 PM GMT
    Yeah this one went and burst a bit like that at work. It was freaking nasty dude!

    Saw the Doc again...he recommends no dressing but keeping it absolutely scrupulously clean, shaving my ass and resting laying face down for a few days and jsut let it bleed and drain.

    The first doc packed it and I had the dressing changed every two days; the second time it was lanced again, packed and left....the third visit to the doc just a piece of gauze put on and left - the doc that time said that it shouldnt have been packed at all..

    So I have no idea how the heck Im meant to manage this at all or if I should be back at work building organs or in the gym.

    Thanks for the advice guys - better than the NHS
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    Oct 17, 2007 7:03 AM GMT
    i am a med student and i work in an ER so i am not some ass hat talking about shit i don’t know. If it keeps happening i would go to your Dr. and tell him you want him to swab it and have him culture it. I would bet A LOT of money that it is Staphylococcus epidermidis AKA a staph infection. Do you shave you ass b/c if you do i bet that is how you got it staph grows on everyone’s skin and you might have cut yourself and introduced the bacteria. But the bummer is that now(if it is a staph infection) you are more prone to staph infection so now before you shave (anywhere but the face) wash it GOOD. anyway back to the one you have now...the Dr. should lance it and get all the puss out but he should NOT suture it up that’s beyond ignorant, it does not allow for it to drain, and if it is big enough he should even pack it with iodoform packing (an antibiotic packing) also he should give you some broad-spectrum antibiotics because S epidermidis is a Gram positive coccus anyway i dont know that else to tell if you if you any questions feel free to ask(i am not an MD yet but abscess are fairly simple if your not a dumb-ass and in the medical field)(sorry about the grammar and no periods did not feel like it)
  • Rowing_Ant

    Posts: 1504

    Oct 17, 2007 11:02 PM GMT
    Thanks dude....

    I dont shave my ass at all. only my face. My Doc told me to shave down there to help hygiene wise. he put me on 500mg of fluxocillin four times a day for a week and Im going to have it checked up tomorrow or friday.

    I am just getting fucked off with it as it is just not draining away and gealing like Ive been told it should. I get it checked by the doc or the nurse and they say hmhmmh its okay but keep it very very clean, rest and keep taking the antibiotics....yet I do that and it keeps weeping puss and is still very sore on palpation and fills up a bit. Arghghg.
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    Oct 29, 2007 3:43 AM GMT
    This could be a pilonidal cyst or a sebaceous cyst- both need more than draining and packing. Both are common and should be recognized by a physician. I'm curious about the recommendation to shave- this is not routine care of an abscess, cyst, or really anything else. In fact, shaving increases the risk of spreading infection and causing folliculitis (little pimple-like infections of the hair follicle) and ingrown hairs- that's why for surgery they trim but don't shave anymore. It is probably time for a second opinion- think about having a dermatologist or surgeon take a look. Any internal medicine or family medicine doctor should be able to recognize and care for this, but it sounds like you haven't had success yet. Good luck.