Accesses surrounding the lower scalp - Diagnosis?

23 y/o male with multiple accesses surrounding the lower scalp. No past medical history and recently spent a lot of time in the woods. The rash started about 3 months ago and gradually progressed to abscesses; accompanied by a swollen lymph node on the back of the neck. What began as one abscess turned into several within the course of a week. First antibiotic treatment was Septra for 7 days. Following that, 3 incisions, drain, and packing was performed. The second antibiotic of amoxicillin was prescribed for 10 days. After day 7 of amoxicillin with more abscesses forming the fourth incision was performed to drain and pack. The patient was placed on clindamycin for a 14-day treatment. The patient has been taking clindamycin for 7 days now and more pockets are continuing to form in surrounding areas and the initial drainage site has begun to fill again. Any help with finding the diagnosis? and management options?

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IT'S A..CASE OF.. ? SCALP FOLLICULITIS.. LEADING TO ABSCESS FORMATION.. ? SCALP CELLULITIS.. NEED'S.. * BROAD SPECTRUM ANTIBIOTICS WITH NSAIDS AS PER REQUIREMENT.. * TOPICALLY..MUPIROCIN OINTMENT.. * VITAMIN C.. INVESTIGATIONS..SOS.. * BLOOD CBC.. * URINE ROUTINE.. * BSR .. * PUS C AND S EXAMINATION..

Tnx Dr Ramesh Kumar Singh
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Incision and drainage should be done full depth. All pockets should be broken , Cephlaxin 500mg bd,infection Gentamicin 2ccim bd , Vitamin C 500mg , to be given. Pus culture can be done. Dressing with magsulphglycerine

M.Boils ( turned to Abscess pockets due to bad weather conditions or sec Infection ) Needs further investigation and evaluation to conclude and treatment plan include I & D connecting all pockets and dressing with fucibact oint covered with sofra tullu gauge daily under LA. Inj ceftam 1gm iv bd Inj metrgyl 100ml iv TDS Soluzyme TDS before meal Diclo PCM TDS pc. Multivitamin and antioxidant orally. Keep the area clean and covered with sterile gauge. Improve General health and personal hygiene. Till reports of pus c/s and other complied.

Thanks Dr Sandeep S
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SCALP Folliculitis with abscess treatment Incision and drainage and dressings with Megaheal ointment Tab Clavum 625 one bd , Tab Algesia sp one bd

Multiple abscesses scalp Probably MRSA Send pus for c&s Attempt incision of sufficient size and depth so as no pockets are left

Thanx dr Ashok Leel
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Perifolliculitis capitis.clindamycin in combination with metronidazole may be tried in addition to the local treatment.

Rule out diabetes or any sourse of immunosuppression ...give coamoxyclav along with linezolid ...for 10days min.give 3days IV at least..send C/S ..and routine blood inv.not to be worried may be SOM uncommon bacteria..only fluctuant area to be drained not all..it may cause lodging superadded infection..keep head end elevated ..please give feed back.thank you

According to the history and treatment course. Most probably it is scalp folliculitis . Treatment Shaved hairs around the abscess and wide incision and break all the pocket and drain slug and pack . Send Investigation CBC Pus culture and senstivity RBS And start broad spectrum antibiotics or acc to pus culture sensitive. Daily dressing .

Repeated abscess means there was incomplete drainage of pus, . Now the pt had four incision so dressing should be done with inter communicating with each other after complete drainage of pus Blood sugar to see wheather pt is diabetic or not and to take measue accordingly. Pus for culture and sensitivity for proper antibiotic.

Abscess. Large incision ,break all the pockets and drainage. Daily dressing with T Bact ointment BD. Inj Lizolid(600)- TDPC 15 days. Cap Chymoral Forte-1 cap TDAC 10 days. Cap Rabium DSR-1 cap ODAC 15 days. Tab Limcee 500- ODPC 1 month. Proper hydration. Investigation: Blood for CBC ESR FBG. PUC for CS.

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