Do I need Dr. House or some perspective?
January 2, 2018 6:32 AM   Subscribe

I don't know if I have a medical mystery that's worth pursuing or if all these things are unrelated and insignificant. Can you help me figure out how to proceed? If you like medical mysteries, please read!

OK. So. Back in October I noticed a large lump that appeared rather suddenly on my left inner thigh, near the bikini area. It didn't go away on its own so I went to the doctor on Nov. 9th to get it looked at. She diagnosed folliculitis (I shave the bikini area and she said that's what caused it), took a culture swab (it was oozing a little) and gave me a course of antibiotics. I took the antibiotics and never heard back about the culture.

After the antibiotics were done, the lump was still there but I figured it was probably just the remnants of whatever it was, wasn't dangerous because I had taken the antibiotics, and would go away on its own eventually. So this was around Thanksgiving time. It didn't really go away, and in early December I started noticing that whenever I got up from my chair during the workday (my job involves sitting in a chair for a large part of the day) there was a bit of soreness where my left leg and hip connect. It was momentary but it was definitely noticeable. I can't say how long this went on, but probably the first half of December.

Meanwhile I still had the lump, and one morning when I got up I noticed some soreness on the surface of it and decided maybe I should treat it topically, so I put some neosporin and a bandaid on it for a couple days. The lump went down SIGNIFICANTLY, to the point where it's still visible (it's kind of bruise-colored) but not raised anymore.

So now we're into the Christmas holiday season. I'm off work, so I'm not sitting in a chair several hours a day and I don't have the ache where my leg and hip connect... BUT shortly after Christmas I notice that my waist is achy right above my left hip. It was like the skin achiness you get with a fever but ONLY in that area -- it kind of hurt to run my fingers across the skin in that area.

It was like that for a few days when I noticed that there was some kind of bright pink rash on my left hip -- it looked like some kind of large bug bite, though unlike bug bites which feel somewhat smooth to the touch, this is quite bumpy and rough. I am also now noticing that my hip aches a bit in general now, not just on the surface. The area might also be slightly swollen now though if it is it's so slight that I can't say that it's for sure swollen.

Sooo... all of these things, separately, I would just ignore because they're not really affecting my quality of life (pain scale is like a 1), but could they be connected? Is this something that might require medical intervention or maybe will it pass? I'm 43, and I have definitely noticed more body weirdness since I entered my 40's (last July, I had some low back pain for a couple weeks which I would have just ignored except I also got a headache that would just not go away for days and days about a week into it so I went to the Urgent Care and they didn't seem concerned and it did indeed go away on its own a few days after that) so I feel like it's harder to tell now what is significant and what is just stupid getting-old stuff.

Basically, should I make an appointment? And if I do, should I inquire about the folliculitis culture and ask if that's related or should I just ask about the soreness? Honestly if they're not connected I don't feel like it's severe enough to see a doctor.... and it's the beginning of the year so this visit wouldn't just be a copay, it would be part of my deductible.

I guess I'm looking for worst-case scenarios if I don't make an appointment. My question boils down to, is there anything serious this could be? Or should I just ignore this? Could it all be connected? Or is this just random body stuff? Yes, I know you are not my doctor. But what would you do if you were me?
posted by rabbitrabbit to Health & Fitness (15 answers total)
I'd see a doctor - sounds like a topical infection that isn't going away. Yes, I'd inquire about the folliculitis culture, as it sounds like the start of your troubles.
posted by randomkeystrike at 6:39 AM on January 2, 2018 [6 favorites]

I, uhm, should probably do this too since it happens to me with some regularity. The pain only usually lasts for a couple days but the lump/bruising lasts longer, though it does go away eventually.

At the very least I would call back about the culture and ask the nurse if they think it's something they need to look at again or just the normal course for a small infection like that.
posted by lydhre at 6:59 AM on January 2, 2018

I err on the side of not going to the doctor and from what you describe I probably wouldn't but that doesn't mean you shouldn't.

If you're concerned, It's best to go. It can't hurt. My inexpert opinion is that your hip pain is not related to the rashes and folliculitis.
posted by loveandhappiness at 7:01 AM on January 2, 2018

Do you have swollen glands, including in the groin? Any fever? I would call the doctor's office, talk to a nurse or PA and ask if you should go in. It's possible to have an infection that goes below the skin and hangs around - cellulitis.
posted by theora55 at 8:35 AM on January 2, 2018 [2 favorites]

It sounds like your first antibiotic didn't work and you still have an infection. I'm a pharmacist and I think most people would be surprised how often this happens. If the first antibiotic doesn't work, the doctor EXPECTS you to come back and try something else. But most people figure, "well, I tried an antibiotic and it didn't work." But there are probably other drugs that would work for that particular bug. It sounds like the culture result wasn't back yet when doctor prescribed your first antibiotic, so it seems quite likely that you didn't get one that worked. Two months is a long time to have an infection. You should go back.
posted by selfmedicating at 9:00 AM on January 2, 2018 [5 favorites]

( hip ache/rash also consistent with shingles, so ask about that. but that's usually recognized right away.)
posted by acm at 10:13 AM on January 2, 2018

Maybe you got a tick bite, if you do stuff that puts you in that arena. But get this, you are a woman, therefore all your concerns about that area are unfounded. So get after your medical professionals to relate to this. Make sure you follow up. You should have heard what the cultures revealed.
posted by Oyéah at 10:44 AM on January 2, 2018 [1 favorite]

I tend to err on the side of avoiding the doctor for small things so my opinion is biased, but it seems surprising to me that the doc gave you antibiotics for a non-urgent problem before the culture swab came back.

I mean it definitely sounds (to me, a non doc) like you had a bacterial infection in a hair follicle (or a little cyst, which is kinda the same thing on a longer timescale) but like... doesn't the kind of bacteria influence the kind of antibiotic? Why prescribe what might be (and seems to have been) the wrong drug for an infection that's only causing minor discomfort? Why disrupt an otherwise-healthy person's gut flora and boost their drug resistance for a small uncomfortable bump when you could wait a few days and get the right antibiotic? Also why use a systemic drug when you could probably use a topical drug which means less active ingredients and fewer side effects? Again, I'm not a doctor, but that'd be my leaning for my own body.

Anyway if that bump were just the same as it originally was, and it were on my body, I'd take the risk of treating it myself, by using a hot-compress to raise the pus, appling iodine to clean it, lancing the top with a sterilized needle, squeezing out the stuff inside with very clean fingers, and covering it with more iodine and topical antibiotic ointment til it was totally healed.

However.... now that you have a larger problem in that area, I'd definitely go to the doc. Get another swab, wait til that swab comes back, take the right antibiotic to address the infection. Now that the joint pain is in the picture, you probably do want a pill rather than a cream.
posted by pseudostrabismus at 10:47 AM on January 2, 2018 [1 favorite]

Nthing chasing down the doc, and while oyeah mentioned tick, checking for Lyme is a simple-enough process if there is a tick bite possibility.
posted by childofTethys at 12:53 PM on January 2, 2018

MRSA Can be mistaken for a spider bite
posted by KateViolet at 1:53 PM on January 2, 2018

Doctor here, not your doctor, definitely not a dermatologist or a primary care doc. It's been years since I (willingly) saw a rash.

So disclaimer aside, definitely call your PCP and ask them what the results of that culture were, and if it was sensitive to the antibiotic. Also mention the joint aches and the new rash. If there's a patient portal type thing, you might be able to upload a photo of it -- if you do this, please make sure it's well-lit and has decent contrast and is not super blurry. Oh, and make sure you can tell which way is up.

In terms of what this could be: shingles is a decent possibility, though you are relatively young, and from what I hear, shingles pain is a pain like no other. Community-acquired MRSA is definitely a thing, but barring known contact or immunosuppression, the risk is low. Lyme is endemic in the Northeast, but doesn't cause a pustular lesion. I mean, the differential of joint ache and rash is broad, and whatever is going on has been a problem for two months. Go see your doctor.
posted by basalganglia at 3:11 PM on January 2, 2018 [1 favorite]

It sounds like your first antibiotic didn't work and you still have an infection.

Hey, so I get these cyst-y things in uncomfortable places (often between my legs, around the bikini area, etc). Some of them form out of folliculitus and sometimes they get, like, pretty big and I have had pain radiate out before. The last big one I had was a couple of years ago and it took two rounds of antibiotics for the thing to go away.
posted by thivaia at 6:42 PM on January 2, 2018

So the cellulitis thing is maybe what it is and looks kind of scary, so I called my doctor's office yesterday and they finally got back to me last night.. the culture was positive for staph, and they said if I'm still having problems to come back in, so I'm going in tomorrow at 1:40pm which is the first appointment they had.

Good thing too, because today I've got more of those rashy things and the pain is radiating up into my ribcage area (!) hopefully tomorrow is soon enough. They had given me amoxicillin, which is supposed to work for staph, so I guess they figured if they didn't hear from me they didn't need to call to tell me about the culture...?
posted by rabbitrabbit at 9:43 AM on January 3, 2018

Do make sure they have a look at the rash and report the skin tenderness and pain - as others have suggested, you could have shingles as well. I had it last year - the progression was - lower back pain, skin that hurt to a soft touch, tingly itchiness and then itchy rash that was sore when scratched. Shingles is opportunistic; so if your immune system crashed with the staph infection it could have come on. Shingles can be mild and it can happen to younger people.
posted by kitcat at 10:20 AM on January 3, 2018

Diagnosis: shingles.
posted by rabbitrabbit at 12:42 PM on January 4, 2018 [1 favorite]

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