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Felt mosquito bite between hips. Area gets swollen and inflamed. Not able to sit. Any thoughts?

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Hi, I was on a tour for the last 2 days. Somewhere during the tour, I felt like a mosquito has bit right in between the hips at the start of my anal/hip lining. Due to which that area has swollen up and inflamed. I am unable to sit because it pains. What should I do ?
Posted Thu, 23 Aug 2012 in Infections
 
 
Answered by Dr. Raju A.T 2 hours later
Hi,

Thanks for your query.

The mosquito bites usually induce an allergic reaction, which cause the swelling , redness and pain.

Best method to treat such an lesion is by a combination of anti inflammatory and a anti histaminic. Tab Sumocold taken twice in a day after food for three days will serve the purpose.

It may not take more than 2 days after you have started the medication.Do not apply any ointment over the lesion.

Hope I answered your query.

Wish you good health.
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Follow-up: Felt mosquito bite between hips. Area gets swollen and inflamed. Not able to sit. Any thoughts? 3 minutes later
Do you think I would need an antibiotic to supplement SUMOCOLD ?
Because its on the hip, I am unable t sit properly, so I was looking for a quick relief
Regards, XXXXX
 
 
Answered by Dr. Raju A.T 6 minutes later
Hi XXXXXX,

No , there would be no need for an antibiotic unless there is an open wound at the bite site.

If there is an open wound at the bite site then there may be need for an antibiotic specially in ointment form.One like BACTROBAN applied twice daily will reduce the infection.

Hope I cleared your doubts.

Wish you good health.
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Follow-up: Felt mosquito bite between hips. Area gets swollen and inflamed. Not able to sit. Any thoughts? 31 hours later
Dear Dr XXXXXXX

I have been taking SUMOCOLD. Today is the second day. But the pain has not subsided. It is paining too much, because it is on the hip lining and I am unable to sit properly the whole day.

Is there any thing more I can do to subside the pain ?
Should I do a hot compress, or a COLD compress ?
Regards, XXXXX
 
 
Answered by Dr. Raju A.T 14 hours later
Hi,

Thanks for writing back.

You can take Imol Plus tab instead of sumocold.Take twice a day for three times a day.

Hot compresses can provide you some relief.

If there is no recovery even after two days of Imol then you may have to visit your treating doctor. Examination would give him a better insight to formulate exact treatment.

Wish you good health.
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Follow-up: Felt mosquito bite between hips. Area gets swollen and inflamed. Not able to sit. Any thoughts? 24 hours later
Dear Dr XXXXXXX

Yesterday I switched to IMOL Plus and did a hot compress. I retracted the skin, and saw the open wound and then applied BACTROBAN ointment due to which it broke in the evening and the pus oozed out. When the pus oozed out, it gave me unbearable pain.

My question : Now that we know its kind of an abscess, what do you suggest.
I am not able to look at that area, because its between my hip lining. So I ask somebody to retract the skin. But when I press the area to extract the pus, the pain is huge.

Would there be something oral to dry the pus out ? Should I keep applying the Bactroban, for how long ?

Let me know.
Thank you

Regards, XXXXX
 
 
Answered by Dr. Raju A.T 1 hour later
Hi,

Thanks for writing back.

Now, the end to your problem has started.

The pus getting evacuated from the abscess is for its cure.

I would suggest you to take ones help and express all the pus out , even its painful.A course of oral antibiotics may help but the local application of Bactroban would be more fruitful than the oral antibiotics now.

You can apply few drops of Lignocaine jelly few minutes before expressing the pus out, this will decrease the pain while expressing.

Continue Imol for a day more. Do not close the wound until the pus had been completely expressed.

Wish you good health.

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Follow-up: Felt mosquito bite between hips. Area gets swollen and inflamed. Not able to sit. Any thoughts? 24 hours later
Dear Dr XXXXXXX

Sorry for bothering you. Here is the update from yesterday. The mouth of the wound has widened. It is now bigger than yesterday. I have been extracting pus 2-3 times a day. It is painful and though I am also applying Lidocaine, and pressing hard ignoring pain, but the pus coming out is not that much. I did a warm compress today.

I think the healing is slow, because of the area at which it is. As I have mentioned earlier, the area is the top of hip lining in between the hip fat, not around the anal area. Just where the hip lining ends (i.e. just below the pelvic girdle) The wound is hidden just a little inside the hip. So I have to retract the hips, and then ooze it out.

Mine is a computer-based job, and I am unable to sit for long hours. Taking Imol-Plus 3 times. Have not gone to office for 5-6 days. I have a workshop/seminar coming up on 2nd August which I really wish to attend, because my application has been selected amongst plenty of others.

So while I trust your opinion, and I am sure you will do whatever best can be done, I really wanted to ask you if it is possible to take an oral antibiotic which could fasten the process of healing.

I would welcome any other things that you want me to do .
My wife has clicked a photo of that area, and I hope you are able to make out.
I will try and upload the photo here...

Regards, XXXXXX
 
 
Answered by Dr. Raju A.T 1 hour later
Hi,

I had a look at the image.It appears red which is a sign of healing.It is the granulation tissue growing there, thats a good sign.

You are right in saying the the wound healing is delayed due its location.

I really consider that oral antibiotics would do no better than the ointment.The amount of antibiotic reaching the wound via ointment is much more when compared with oral drugs.

I assure you , the sufferings would not last long.It will heal soon, ointment is only the best remedy.After seeing the image I am enough convinced and suggest you to apply a bandage over it after applying the ointment .Do dress the wound twice daily.

Wish you good health.
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Follow-up: Felt mosquito bite between hips. Area gets swollen and inflamed. Not able to sit. Any thoughts? 18 minutes later
Dear Dr XXXXXXX

What kind of bandage should I apply ? Because it is inside, I don't know if the bandage can go inside and remain there, It will constrict my movement. Also should I apply T-Bact liberally, or just a small amount is enough.

How much time does the Lidocaine take to start acting, because when I apply Lidocaine about 1-2 minutes before I start pressing, the pain does not reduce that much. Is it OK if I apply Lidocaine also liberally ?

I will continue to apply T-bact (Same as Bactroban) as you say, and not take any oral antibiotics. Do you suggest a stronger painkiller than IMOL Plus ?

Regards, XXXXXX
 
 
Answered by Dr. Raju A.T 5 hours later
Hi,

Yes, liberal application of Bactroban is advised.Its always useful.

The same applies to the Lidocain gel apply liberally after cleaning the wound with Hydrogen peroxide (this removes dead tissue).It may take at-least 5 minutes for the lidocain to show action.

Do use a Gamgee pad for dressing, It is ok even if the dressing if not occluding the wound.Just apply it not for the dust or the sweat to enter the wound and prevent the spillage of ointment.

I would no load you with any more pain killers, as they are involved in serious gastric complications.Imol would suffice.

Wish you good health.



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Follow-up: Felt mosquito bite between hips. Area gets swollen and inflamed. Not able to sit. Any thoughts? 28 minutes later
Sorry to bother you, but do you think using a Medicated Dressing like a Sofra Tulle will help ? I am asking because it is thin, and a small piece of it might stick inside. Should I use micropore tape to stick it ? I am worried that it might not pluck the surrounding hair and cause more wounds....
 
 
Answered by Dr. Raju A.T 9 minutes later
Hi,

Sofra Tulle is good to use, Since it has Lint material on one side there would be no risk of cotton debris getting into the wound.

Yes, do use Micropore to stick.Cut the hairs or shave them clean to prevent them getting entangled in the tape adhesive.

I am here to help you .I shall be always ready to help you.Please feel free to ask any doubts.

I wish a sooner recovery.

Regards,

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Follow-up: Felt mosquito bite between hips. Area gets swollen and inflamed. Not able to sit. Any thoughts? 19 hours later
Dear Dr XXXXXXX
I have uploaded a new photo today clicked today.
While the swelling has subsided and my wife feels that the pus has drained out, whatever is left is still oozing out slowly by itself.

What I am concerned about is the wound has spread its mouth, and there is a large white patch showing with a lot of redness around it. Is this OK. Is this a sign of healing, or is this something to be concerned about. Has it turned septic ? How can we make the wound heal, and regenerate skin at that place ?

Should we continue applying TBact ?
Regards, XXXXX
 
 
Answered by Dr. Raju A.T 8 minutes later
Hi,

Do continue applying the ointment.

No , the wound do not seem worsening though there is peeling of the skin around.

The peeling of the surrounding dead tissue is a process of normal healing.

More red the wound is healthier it it.The red tissue is granulation tissue which lays the new layers of the skin.Mild tingling and itching around the wound is the sign of active healing, it takes few more days for you to feel such a sign.

Wish you a speedy recovery.
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Follow-up: Felt mosquito bite between hips. Area gets swollen and inflamed. Not able to sit. Any thoughts? 11 minutes later
Thank you.

I am getting tingle and itch today also 1-2 times every hour.
Do you think I still need to press and ooze out the pus, or should I just keep cleaning the wound and applying the ointment ?

So you mean the white patch is not a cause of concern.
Should I leave it open for it to dry itself ? Or should I put some sort of Neosporin Powder or ABSORB powder for it to suck out the excess moisture ?

Should I do the hot fomentation or stop it ?

Regards XXXXXX
 
 
Answered by Dr. Raju A.T 5 minutes later
Hi,

Stop the hot fomentation.

Do not press any more , let the wound heal.

Apply Neosporin after 2 days from now.

Continue bactroban and dressing for two more days later ointment and neosporin will do.

The whitening or glistening is a good sign of healing.

Regards,
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Follow-up: Felt mosquito bite between hips. Area gets swollen and inflamed. Not able to sit. Any thoughts? 19 hours later
Dear Dr XXXXXXX

Sorry to be bugging you. I presume you mean Neosporin powder, or is it Neosporin Ointment ?

For dressing, I am using 1 piece of Bactigras Tulle kept loosely on the wound. On top of that I cover with 1 piece of Paraffin Guaze outside the hip. Then I put a tampon on it (no tapes) to hold it secure, and then my underwear. This gives the wound enough space to breathe, and the exude does not spill over to the underwear. I hope it is OK.

I will continue T-bact and dressing for next 2 days, and then after 2 days will use NEOSPORIN (powder or ointment - which one?) and which other ointment have you suggested ?

I am not pressing any more. I am using IMOL till the pain subsides. Or should I switch to Combiflam (which is without caffeine) ?

Regards, XXXXXX
 
 
Answered by Dr. Raju A.T 24 hours later
Hi,

I am sorry I failed to mention, I was mentioning about Neosporin Powder.

The dressing you explained is adequate.

Do not apply any other ointment, T bact/bactroban is the best.

Yes, you can switch on to Combiflam.But do take an Antacid like Rantac along with Combiflam to reduce the gastric irritation caused by the Ibuprofen.

Hope I cleared your doubts.

Regards,
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Follow-up: Felt mosquito bite between hips. Area gets swollen and inflamed. Not able to sit. Any thoughts? 1 hour later
Dear Dr XXXXXXX
I have uploaded a new image.
Yesterday in the evening, no pus came out but the wound exuded a lot of blood.
Please see and let me know if we are doing OK. The itching and tingling has started for the past 2 days

Regards, XXXXXX
 
 
Answered by Dr. Raju A.T 24 hours later
Hi,

Granulation tissue is XXXXXXX in blood vessels and fibrous tissue.Bleeding is a good sign and indicator of granulation tissue.Just keep the wound clean now, this will lead into a healthy scar.

The itching and tingling are the signs of new skin formation.

Do continue the ointment.Postpone the neosporin powder for another 2 days.

Regards,


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Follow-up: Felt mosquito bite between hips. Area gets swollen and inflamed. Not able to sit. Any thoughts? 33 minutes later
This seemed like an Anal Fistula - isn't it doctor ? If its a Fistula, then I fear that the opening is not closing that easily.

I am just concerned that the white portion will never close, and become a scar.
Anyways I will continue with the treatment.

I also wanted to show it to a nearby doctor to see what he says after physical examination. What kind of doctor should I connect with - a general physician, or some other department ?

Let me know.
Regards, XXXXXX
 
 
Answered by Dr. Raju A.T 25 hours later
Hi,

I apologize for the delay.

The image attached above give me an idea of a Pilonidal sinus rather than a fistula.I do not completely rule it out.

A detailed hand on examination would be essential to arrive at the facts.

I recommend you to consult a General Surgeon who is specialized in such conditions.

Regrads,
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