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Skin Care and Diseases

Recurring boils/abscesses?

07/27/2006

Question:

About 6 months ago I noticed a small pimple-like mark on my elbow, which eventually turned into a large, swollen, painful, abscess which discharged pus. I went to the local clinic and was given a shot of antibiotics and the abscess healed in about 2 weeks. About a month or two after that, I developed another one of these abscess just below the beltline in my lower abdominal area. Again, it started out looking like a small pimple and eventually formed into an abscess. After a few weeks of drainage, it healed and went away. Now (about six months after the first abscess appeared) I have been getting more and more of these abscess. They all seem to start out the same exact way (as a small pimple) and have been developing on my buttocks and thighs. The abscesses on my thighs (which are fairly muscular) seem to heal quickly and don`t get nearly as large as the ones on my buttocks. Why is this happening and how can I prevent it? I feel fine other than the abscesses being mildly painful at times. I am a 23 year old male in excellent health and exercise on a regular basis - I havent been sick in over 6 years and have never had similar symptoms. I take a daily multivitamin, avoid sweets, and shower daily. Any help or advice is appreciated!

Answer:

The history and physical findings that you enumerated strongly suggests that you have been colonized with a pathogenic Staphylococcus aureus.  You need the guidance and wisdom of an infectious disease expert.  That individual can work with you about eliminating the organism from not only your skin but also your nasopharynx which is the likely source of reinfection. 

Bare in mind that some individuals are reinfected from their pets which can be carriers of Staph aureus in their nose and respiratory tract.  Other members of your family may be carriers as well.  It is important to have a knowledgeable internist/infectious disease person to review your environment as well as your own body as you prepare to try to resolve the issues.

Even though you feel fine, there may be other processes going on such as type II diabetes in its early stages or other immune abnormalities that might predispose you to infection.

Please see your internist/infectious disease expert promptly.

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Response by:

Charles L Heaton, MD
Professor
College of Medicine
University of Cincinnati