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What do my lab test reports indicate?

Answered by
Dr.
Dr. Asmeet Kaur Sawhney

Dermatologist

Practicing since :2007

Answered : 4277 Questions

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Posted on Tue, 6 Sep 2016 in Skin Hair and Nails
Question: Hello Dr,
I have been suffering from folliculitus which has been re-occuring. I did visit a local doctor and have been on several medications since the onset.
Below is what was prescribed to me :
Week - 1 : Augpen-LB, T-bact cream, -(SOS) Allegra, Dolo
Week - 2 : The symptoms didn't subside too much and another antibiotic was added (LINOSPAN 600) in continuation of the previous ones.
With LINOSPAN , the painful bumps did subside and the area around armpits was around 90% recovered. During another visit to the dr. he did add RETAREL cream and stopped T-bact and Augpen LB tablets.
He also adviced me to undergo - Pus Culture and Senstivity - Aerobic lab test
The reports came normal with nothing significant. Attached is the report also.
Week - 3 : I did complete the course of LINOSPAN , however the pimples/follicultis did re-occur after couple of days and since then he has put me on additional antibiotics which included DOXOL-LB (100mg - 0-0-1) 10 days and Azee (500 mg - 1-0-0) along with Retarel cream for topical use.
Also did he suggest me to undergo another pus culture - Aerobic and Anaerobic (for which reports are still awaited)

I am attaching the previous report along with the current photographs of the armpits. Not sure if the diagnosis given is right as I am still having pain in the left armpit, also any suggestions you would recommend would be greatly helpful.

Thanks,
XXXX


I have been in terrible pain due to this and the has limited the arm movement. There is no fever at present but I am a little worried of the underlying cause. I do stay in XXXXXXX which is having ~85% humidity level.

Also I have attached the dr. prescriptions to this discussion thread. Let me know if anything else is needed.
doctor
Answered by Dr. Asmeet Kaur Sawhney 2 hours later
Brief Answer:
Recurrent folliculitis and its management

Detailed Answer:
Hi
Thanks for being at healthcaremagic
I am Dr Asmeet Kaur Sawhney, a dermatologist.
I have reviewed all the attached photographs as well gone through your complaints.
From the pictures you have uploaded it is looking like folliculitis.
For how long has it been recurring?
Is it recurring only under the arms or at some other body sites also?
The medicines prescribed to you are fine but in recurrent folliculitis I usually recommend my patients to take tablet rifampicin 600 mg once daily empty stomach along with tablet clindamycin 150 mg twice daily or capsule doxycycline 100mg once daily for 2 weeks.
Also I recommend them to apply the topical antibiotic like mupirocin cream or retarel cream on the affected areas along with the carriage sites of the bacteria like nostrils, external ears, finger and toe web spaces, umblicus and perianal area twice daily for atleast 6-8 weeks to avoid recurrences.
Besides this avoid using deodorant in the arm pits, wear loose cotton clothes maintain personal hygiene and stay in cool airy environment.
Regards
Dr Asmeet


Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Asmeet Kaur Sawhney 53 minutes later
Thanks for the reply.
Regarding the reoccurance, the first time it occured was on 24 july 16 and after continuous medication it was cured around second week of august.
However, within couple of days, it reoccured again the second, following to which the doctor prescribed medication as provided above under week 3.
It is only visible under both armpits.
Today, all of a sudden I experienced discomfort under the lower diaphragm and hence, have discontiniued all the medications prescribed.(Azee,DOXOL-LB). The pain is radiating from left to right portion of the stomach and suspect to be due to the heavy antibiotics I have had in the recent past.
Please suggest in case of any alternatives along with precautions and diet restrictions,if any.

Also, just forgot to mention doctor is observing the symptoms for Hidradenitis Suppurativa.
doctor
Answered by Dr. Asmeet Kaur Sawhney 47 minutes later
Brief Answer:
Hidradenitis suppurativa is differential diagnosis along with folliculitis

Detailed Answer:
Even I have a doubt of hidadrenitis suppurativa. That's why I asked you about the duration of the lesions.
As far as precautions are concerned no dietary restrictions are required if you have normal blood sugar levels.
Maintain proper hygiene, avoid tight occlusive clothes, go for weight reduction if you are overweight, avoid using deodorants, depilatory creams and razors over this area.
Go for clipping of hair if required.
You have to keep an eye on your symptoms.
If they are not responding to the usual antibiotics or are prolonged then hidradenitis suppurativa is definitely a differential diagnosis along with folliculitis.
As of now wait for the culture report and if you are not comfortable with oral medication continue using the topical antibiotics.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Asmeet Kaur Sawhney 13 hours later
Hello Dr.

I received the culture report and attached is for your reference. Kindly review and please let me know how to proceed.

Thanks,
XXXX
doctor
Answered by Dr. Asmeet Kaur Sawhney 1 hour later
Brief Answer:
Growth of pseudomonas, start with antibiotics

Detailed Answer:
Hi
I have seen your report and it shows growth of microorganism pseudomonas for which you need to take antibiotics.
Depending on the sensitivity report you can take either tablet ciprofloxacin 500 mg twice daily or tablet levofloxacin 750 mg once daily for 7 days.
This should help in resolving your infection.
Above answer was peer-reviewed by : Dr. Priyanka G Raj
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