I am a 41 year old female with Crohn's disease. I seem to have an infected lipoma or erythema nodosum in my upper left thigh, and my physician wants to prescribe antibiotics and subsequent drainage by a surgeon to treat it. The small lump, the size of a marble, occured six years ago and has been dormant in my thigh since then, until 4 days ago when it became inflamed. (When it first occured 6 years ago, my GI did an upper GI series and found nothing, but I did not have the colonscopy he recommended. I am now scheduled for a colonoscopy next week.) He doesn't feel this lump is connected to a fistula, so it may be a secondary symptom of Crohn's. Due to my Crohn's I don't agree with all antibiotics as they may adversely affect my colon. In addition, I think the liberal use of broad spectrum antibiotics may be unsafe in the long run. My questions are, 1) How can a lipoma become infected if it's subcutaneous with no visible skin cuts? 2) Is it wise to have a doctor take a culture of the pus so he can decide exactly which antibiotic I need, instead of prescribing a broad one? Would the amount of time the culture would take to grow increase the risk of the infection spreading? Would taking a culture risk spreading the infection? Thanks, LL
To answer your questions:
1) There may be some breakdown in the skin that cannot be visible to the naked eye. This can cause an entryway for bacteria to enter, and possibly infect the lipoma.
2) That is a possibiliy. Skin infections (i.e. cellulitis), or infection of the lipoma, do not necessarily need extremely broad-spectrum antibiotics. Narrower-spectrum antibiotics, such as dicloxacillin or Keflex may suffice. However, without reviewing your case, it is impossible to say for sure. You should discuss this with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
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