What Causes Nose And Lip Swelling With Pus Like Bumps Under Nostrils After Septoplasty And Rhinoplasty?

Posted on Fri, 20 Dec 2013

Question: My daughter had septoplasty and rhinoplasty 3 months ago and has had pusuals (pus like bumps) under the nostrils and her upper lip has puffed up significantly with white lip line and swelling on and off for the 3 months. Nothing has worked, antibiotics etc-seem 3 derm doctors, lab tests blood sugar test -nothing has helped. Last evening her lip started swelling again and nose became hot along with lip. What do you suggest.

Answered by Dr. David Okia (49 minutes later)

Brief Answer: I would suggest culture and sensitivity test Detailed Answer: Hi thanks for your question. Based on my experience i would suggest pus swab is taken ,culture and sensitivity done immediately so that we know which drugs the pus is sensitive to and which drugs she is resistant too. She must be evaluated for other causes of low immunity in addition to blood sugar that have already been done. MRI of the head should be done in addition. Meanwhile if pus is evident it should be drained, she can continue with ceftriaxone 2g once day combined with corticosteroid as we wait for culture and sensitivity results. Hope i answered your question, will be happy to help you if you have other queries.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. David Okia (57 minutes later)

We did culture in the beginning-2.5 months - her blood sugar was also done...then did another culture-did yeast culture, staph culture, have done corticosteroid 2 weeks ago, did cucumber in large amounts 2 weeks ago. I have taken her to Dr Ellithourpe in Tustin CA and she put her on a no sugar diet-aand no change. She is not only recovering from the sinus/rhinoplasy, she's now trying to handle the facial scars under nose from these pusules. He doctor is reknown, no names but has written books and teaches and said he's never come accross this and has dismissed his concerns and referred to derm doctor who is down the hall from him with no answers there. Last night with the swelling - pus- fever I was going to take her to the ER- but called Dr. D one last effort...he is out of town and spoke with on-call. He prescribed dicloxacillin without looking at her- she has taken 2 doses since 11pm last night. Hot compresses was recommended...I googled the drug and found "recurrent furunculosis" looks similar...any thoughts with this added information