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What causes boils near the episiotomy site?

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Posted on Fri, 16 May 2014
Question: Dear Doctor, As always thanks for your earlier advice.As you might be aware I delivered baby normally on 13th April, however I have been not comfortable since then. Recently I contracted fever on 23rd(around 100 Deg F), could be also because of wether changes but I also suspected it to be related to post pregnancy therefore I visited a OBGYN since that and she advised following tablets and asked to sit in warm water tub 2 times a day.

Tablets are
Mahacef
Flexon
Zincovit

Later I visited today again as I had some boils near my lower parts adjacent to stitches I have also attached the photographs here. She also changed the antibiotic to Moxclav. I also have pain in my lower abdomen and burning sensation when I urinate.

Pl advice what are the causes and subsequent medication and is this normal. What are the additional signs to look out for post pregnancy that might require medications. In fact the real problem is to understand what is normal and what is not.

Thanks
XXXX
doctor
Answered by Dr. Aarti Abraham (1 hour later)
Brief Answer:
AS BELOW

Detailed Answer:
Hello XXXXXXX
Thank you for the compliment and as always, it is a pleasure to hear from you !
Am sad that the post partum period has been so uncomfortable for you.
I have seen the photograph.
It is indicative of an infection in the episiotomy site.
The episiotomy is the cut that they make on your perineum ( private parts ) to facilitate normal ( vaginal ) delivery of the baby.
It seems that these stitches have got infected.
Of course, I can see the boils ( infection part ) quite clearly, but I cannot see the location precisely.
Can you upload another picture taken from a slight distance that gives an idea of the exact location of the boils ?
Have the stitches healed ?
You should complete the course of antibiotics as prescribed.
It is vital to maintain meticulous hygiene locally there, since the area is very prone to infection.
After every bowel movement, clean thoroughly with warm water.
ALways clean from front to back, never back to front , as the anal area can badly infect the vaginal area.
What is your weight ? If you are overweight, get your blood sugars tested to rule out post partum diabetes as a cause of infection recurrently.
Also, after urinating, clean thoroughly with water.
Wash your hands with a good antibacterial soap / gel before touching the stitches again.
Apply local Mupirocin ointment on the boils and surrounding area atleast 5 - 6 times a day.
The infection should be alright within a week.
Since it is summer ( which city do you reside in ) , make sure that the ambient room temperature is comfortable.
The area is very prone to sweating and wetness.
Wear cool cotton undergarments and change frequently if you sweat.
Apply local Neosporin powder in the groin to prevent dampness.
Wear breathable cotton gowns or slips to be comfortable.
Please get back to me if the boils do not resolve within a week at the maximum.
Other conditions to watch out for ?
Are you breastfeeding your child - if yes, make sure you empty both breasts while nursing.
Milk retention can lead to similar infection / abscess in the breasts which can require extensive antibiotics or even surgical drainage.
Drink lots of water in this season to avoid dehydration and urinary tract infections.
Do not be sexually active for 2 months after childbirth.
Get a urine microscopy and culture testing also done.
Also, do not bend do much while bathing / massaging your child or changing diapers.
Take proper care of your back, since backache will be quite common.
Take regular iron, calcium and vitamin D supplements for atleast 3 more months.
Pay proper attention to your diet, having small frequent meals instead of 2 -3 big ones.
Include lots of fresh fruits and vegetables like cucumber in the diet during summer.
Has the swelling / tenderness in the armpit gone by now ?
The cause of such recurrent infections must be the hot weather, sweating and being unable to keep yourself scrupulously clean, looking after a small child all the time.
It is common to have some kind of spotting / altered discharge / bleeding for upto 3 weeks after delivery.
All the best
Please feel free to discuss further.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
Answered by
Dr.
Dr. Aarti Abraham

OBGYN

Practicing since :1998

Answered : 6009 Questions

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What causes boils near the episiotomy site?

Brief Answer: AS BELOW Detailed Answer: Hello XXXXXXX Thank you for the compliment and as always, it is a pleasure to hear from you ! Am sad that the post partum period has been so uncomfortable for you. I have seen the photograph. It is indicative of an infection in the episiotomy site. The episiotomy is the cut that they make on your perineum ( private parts ) to facilitate normal ( vaginal ) delivery of the baby. It seems that these stitches have got infected. Of course, I can see the boils ( infection part ) quite clearly, but I cannot see the location precisely. Can you upload another picture taken from a slight distance that gives an idea of the exact location of the boils ? Have the stitches healed ? You should complete the course of antibiotics as prescribed. It is vital to maintain meticulous hygiene locally there, since the area is very prone to infection. After every bowel movement, clean thoroughly with warm water. ALways clean from front to back, never back to front , as the anal area can badly infect the vaginal area. What is your weight ? If you are overweight, get your blood sugars tested to rule out post partum diabetes as a cause of infection recurrently. Also, after urinating, clean thoroughly with water. Wash your hands with a good antibacterial soap / gel before touching the stitches again. Apply local Mupirocin ointment on the boils and surrounding area atleast 5 - 6 times a day. The infection should be alright within a week. Since it is summer ( which city do you reside in ) , make sure that the ambient room temperature is comfortable. The area is very prone to sweating and wetness. Wear cool cotton undergarments and change frequently if you sweat. Apply local Neosporin powder in the groin to prevent dampness. Wear breathable cotton gowns or slips to be comfortable. Please get back to me if the boils do not resolve within a week at the maximum. Other conditions to watch out for ? Are you breastfeeding your child - if yes, make sure you empty both breasts while nursing. Milk retention can lead to similar infection / abscess in the breasts which can require extensive antibiotics or even surgical drainage. Drink lots of water in this season to avoid dehydration and urinary tract infections. Do not be sexually active for 2 months after childbirth. Get a urine microscopy and culture testing also done. Also, do not bend do much while bathing / massaging your child or changing diapers. Take proper care of your back, since backache will be quite common. Take regular iron, calcium and vitamin D supplements for atleast 3 more months. Pay proper attention to your diet, having small frequent meals instead of 2 -3 big ones. Include lots of fresh fruits and vegetables like cucumber in the diet during summer. Has the swelling / tenderness in the armpit gone by now ? The cause of such recurrent infections must be the hot weather, sweating and being unable to keep yourself scrupulously clean, looking after a small child all the time. It is common to have some kind of spotting / altered discharge / bleeding for upto 3 weeks after delivery. All the best Please feel free to discuss further.