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Have Recurrent Cysts And Diagnosed With Endometriosis. What Is The Cause For Swollen Lymph Nodes?

Posted on Sat, 30 Nov 2013

Question: I keep getting these recurrent cysts or mass. First one I had was on sept 16, 6 days after having a laparoscopy done and d&c diagnosing me with endometriosis. It was on my left labia minora in the fold. Caused pain, redness, swelling, fever. Whole left groin hurt and lymph glands were swollen and tender. I was admitted and started on IV antibiotics which they stopped Bc cultures were neg and mass didn't respond to meds. Eventually was dc home. It was solid not fluid according to sono. Next one I got was oct 11th, same thing, low fever, pain, swelling ect, but this one was up a little higher then last but in the Majora crease again. Current one I have appeared nov 11, but on the right minora close to clitoras. Tender and red again. All last week I was having bad pains in my knee and hips, stiffness, swelling in hands and feet in the am. Felt like I was in a car accident when I woke up, when I was able to sleep, saw my doc said it sounded like RA or arthritis. I was also having diahrrea all week too. Those both happen in different episodes or flare ups. Saw my OB, he did a punch biopsy and sent it off, has no idea what is is. They seem to occur the week before my cycle and the biopsy showed it being solid. I also have cysts or lypoma on my for arm about size of pea, thigh and also shoulder that one larger. Those never go away. I have keratosis on my arms and get bumps here and there on my thighs and forearms. Like pimples, but clear fluid comes out when popped, sometimes whitish. Have no idea why I keep getting these mass's and other symptoms. Please help.

Answered by Dr. Deepak Kishore Kaltari (2 hours later)

Brief Answer: Possibility of Scabies Detailed Answer: Hi, Thanks for your query. The pimple like masses you are getting, I would consider the possibility of Scabies. The distribution of site of lesion and description matches with Scabies. It is due to secondary infection of these lesion with bacteria which could account for your repeated episodes of swelling and redness. As the lesion are regression with antibiotics, I strongly believe it to be infective in origin and I don't consider the need for punch biopsy. These lesion may appear solid because of oedema and absence of pus/abscess on ultrasound. I would suggest you to discuss the possibility of Scabies and secondary bacterial infection with Staphyloccocal aureus as the cause of these lesion. I usually treat my patients with scabicidal ointment, antistaphyloccocal antibiotics like Augmentin and eradication of carrier state. I hope it helped Kindly get back to me if you have other query. Take care Regards Dr Deepak Kishore Consultant Surgeon

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Deepak Kishore Kaltari (9 minutes later)

Dont think so at all, if i had scabies i think they would of noticed already. Not related to labia mass. No itching. No response to antibiotics, a pimple here and there is now scabies. Biggest concern is the mass in my labia minora

Answered by Dr. Deepak Kishore Kaltari (14 minutes later)

Brief Answer: Bartholin gland infection other possibility Detailed Answer: Greetings Presence of persisting mass at same site is of clinical significance. On and off recurrent swelling are due to infective etiology. Would also consider possibility of Bartholin gland infection which could present as labia mass. Diagnosis can be easily made by good clinical examination. Also Scabies in many of the cases may be asymtomatic and usually detected on routine clinical examination by presence of characteristics lesion. I hope it helped. Take care Regards Dr Deepak Consultant Surgeon

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Deepak Kishore Kaltari (15 hours later)

It is not a bartholin cyst, they are not near the Bartholin gland. Maybe you mis understand, they appear then go away and appear again in a different place. Most current in on the minora near the clitoras. My OB did a punch biopsy yesterday to see what it may be, biopsy was solid not fluid.

Answered by Dr. Deepak Kishore Kaltari (57 minutes later)

Brief Answer: Detailed punch biopsy report and clinical picture Detailed Answer: Namaste Greetings of the day Biopsy is not done to know whether it is solid or cystic lesion, apart from that the origin and type of cell is usually mentioned. I had already pointed in my first mail that it appears to be recurrent infection likely to be Staphyloccocal. It would be extremely helpful if clinical picture of the lesion and detailed biopsy report is provided. Take care Regards Dr Deepak Kishore Consultant Surgeon

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Deepak Kishore Kaltari (1 hour later)

Biopsy was yesterday so I dont have a report yet, if it were infection, would my labs show that? Or the cultures ? I was on IV vanco& clyndo, po clyndo and keflex

Answered by Dr. Deepak Kishore Kaltari (13 minutes later)

Brief Answer: leucocytosis will be present in presence of infect Detailed Answer: Namaste Greetings Dear XXXX Presence of redness, regressing swelling and fever point towards infective etiology as the cause. If complete blood count is done it will definitely show elevated white blood count that is leucocytosis with elevated neutophils. In many cases blood culture may be negative. I would suggest you to wait for punch biopsy report and also clinical picture of the lesion. It would probably take another couple of days for histopathology report. Wishing you a healthy life Take care Regards Dr Deepak

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Deepak Kishore Kaltari (27 minutes later)

cbc has been done, no elevations,cultures neg as well.

Answered by Dr. Deepak Kishore Kaltari (58 minutes later)

Brief Answer: Wait for biopsy report Detailed Answer: Greetings Dear XXXX, I would once again like to stress Diagnosis of the lesion depends on a good clinical examination. Cbc may still be normal. Wait for the punch biopsy report. Take care Regards Dr Deepak

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