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Suggest Treatment For Recurrent Abscess Near The Genitals Of A Child

Posted on Mon, 19 Sep 2016

Question: hello doctor.my daughter is 3 year old.she is suffering from recurrent abcess near her genitals.she have undergone surgery twice for abcess.we consulted a doctor in Malaysia lots of tests are done.finally they are suspecting chronic granulomacous disease.but her test results are not too bad and test results didnot confirm any disease,but they are advicing her to be on long term anti biotics and anti fungal medicines.we are back to XXXXXXX and now we are confused whom to consult.in malaysia we consulted immunologist for her.kindly advice.thanks.

Answered by Dr. Drkaushal85 (5 hours later)

Brief Answer:
Better to consult surgeon and get biopsy from the swelling.

Detailed Answer:
Thanks for your question on Healthcare Magic.
I can understand your concern.
I have gone through the reports you have attached.
In my opinion, you should consult surgeon or gynecologist and get done surgical removal of abscess and sent for histopathological examination and culture for AFB (acid fast bacilli - bacteria causing tuberculosis).
Possibility of tubercular granulomatous infection is more as she is not improving with antibiotics and antifungal.
Hope I have solved your query. I will be happy to help you further. Wishing good health to your daughter. Thanks.

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Drkaushal85 (1 hour later)

she is treated for perinial abcess and pus sent for test also.test results came as staphylococcus aerus.she was given medication for that also.my concern is to prevent recurrent infections in her.this is third abcess in last 6 months.please review all the reports once again and let me know.we were in Malaysia last month.Immunologist in malaysia conducted all the and test reports are attached.please review once again.now we are in XXXXXXX we wanted to consult again yo prevent her recurrent infections.Thanks.

Answered by Dr. Drkaushal85 (5 minutes later)

Brief Answer:
Recurrent perennial abscess is commonly seen with fistula.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
I have gone through the reports again.
I want to ask few more questions regarding this.
Recurrent perennial abscess is commonly seen with fistula.
So please let me know
1. Fistula has been ruled out?
2. Any radiological investigation done or not?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wishing good health to your daughter. Thanks.

Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar

Follow up: Dr. Drkaushal85 (56 minutes later)

in the month of February she got first abcess on her buttocks. it got drained itself. again in the month of march she got second abcess on the same side of buttocks.she got operated for it.the pus then tested resulted as mrsa.she was under medication zyvote for 15 days.later in the month of XXXXXXX she got perinial abcess.they got it operated and drained.i mean incision and drainage.this time test resulted in staphylococcus aureus. so she was done nutrophenia test and i already attached reports. the surgeon told it was perinial abcess luckily didnot grow much deeper.

Answered by Dr. Drkaushal85 (2 hours later)

Brief Answer:
I think you should consult pediatric surgeon.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
In my opinion, you should definitely consult pediatric surgeon and get done detailed clinical examination, ultrasound examination of local part, CT scan of pelvis (if needed).
Hope I have solved your. I will be happy to help you further. Wishing good health to your daughter. Thanks.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar