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Deep Lump w/ pain to pereneum

Hi all,

So to preface this post; I am an EMT so I'm kinda looking for a differential diagnosis from this.

24 y/o Caucasian Male, 6 foot 180lbs.
Pertinent PMH: Hx of infrequent Hemmorhoids. +steatocystoma multiplex.  Body hair depilation has given ingrown hairs & folliculitis. STD panel negative (G/C, Hep series, HIV/AIDS, HPV, Herpes Simplex) sexually active with only one person.

Allergies: trazodone

Medications: just finished a Z pack for cold/resp infection

Presented this AM with "prostate pain" to the pereneum. After 8 hours, pain progresses to a throbbing pain. Upon palpation to pereneum, a subdermal mass (slightly spongy like that of a lymph node when inflamed). There is referred pain to the prostate when palpated with no rebound tenderness. The site has no redness, drainage/discharge, crustation. Of DCAPBTLS pneumonic, only tenderness and (almost negligible) swelling.

Based upon these findings, I have it ruled down to folliculitis vs. a cyst. The pain mimics that of past underarm folliculitis, however due to the location of the inflammation, drainage or lancing isn't possible for a solo act.

I have doxycycline available, and was going to restart it to see if this lump disappears (along with witch hazel for anal-rectal cleaning). Any help would be appreciated!

2 Responses
1340994 tn?1374197577
While I know it's embarrassing, and I commend your self-sufficient attitude, this could be an abscess and it needs to be checked out and treated medically.  Okay?  Seriously.  I remember when I worked in the OR my nurse supervisor, a very dignified and capable  woman, admitted having to go see the surgeon to have something drained in this area emergently.  She was embarrassed yet matter of fact about it.  This impressed me.  I do my own little procedures sometimes, but this area needs medical attention.  Remember it's very common and having it treated correctly and thoroughly will give the best result.  
Avatar universal
Follow up info from today. Went to PA at local Doc in the Box and was issued levaquin 750mg and bactrim DS for round 2 for cold and for possible cellulitis. A return trip to be made if signs/symptoms persist/worsen.
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