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Dr. Frank
Dr. Frank, Board Certified Physician
Category: Medical
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Experience:  Neurologist/Internist with academic and clinical experience.
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Hello Dr., I was diagnosed with a burst anal abscess twelve

Resolved Question:

Hello Dr.,
I was diagnosed with a burst anal abscess twelve days ago. I was put on a 10 day treatment of keflex (the bacteria was staph and susceptible to the keflex). After three days there was no more drainage and no recurrence of the abscess, and I finished the 10 day course of antibiotics on Wednesday morning. Starting today it started draining a lot of pus again but doesn't really hurt.

Unfortunately I just moved to a new location and don't have a PCP yet (who then would need to refer me to a colon doctor). I need to know if (a) I should go back on antibiotics and (b) if this situation can just wait (i.e. drainage but no fever/pain) until I can get in to see someone, probably 7-10 days.
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. Frank replied 1 year ago.

neuromd2012 :

Welcome, as an Internist I will try to answer your Medical Question, for informational purposes only, please see your doctor as needed.

neuromd2012 :

Hello. It sounds like your abscess is still draining, and as long as it remains clear and non-painful, and you don't have a fever

Customer:

Even though it stopped draining for a week? And what do you mean by clear? The pus is greenish and sometimes bloody

neuromd2012 :

it is not a problem, it should continue to drain. One issue that the colon doctor may have to address is formation of an anal fistula, a persistent track

neuromd2012 :

hi

neuromd2012 :

if it is greenish, you still need antibiotics

Customer:

Ok, so I have to go back to urgent care to get more? the same one, or a different?

neuromd2012 :

you have to continue antibiotics until it becomes non-purulent

neuromd2012 :

how big was the abscess?

neuromd2012 :

do you know?

Customer:

well the part I could feel was like the size of a nickle, but they said there might be more deep inside

neuromd2012 :

you would continue the same antibiotics if you were cultured

neuromd2012 :

as that remains the dominant organism in the flora

Customer:

Is it ok that I wasn't on the antibiotics for a few days though?

neuromd2012 :

you just need more keflex, until you see the colon doc

neuromd2012 :

yes

neuromd2012 :

it will still be the same organism

Customer:

What is purulent?

neuromd2012 :

pus like

neuromd2012 :

if it is green that means you are making white cells against it

neuromd2012 :

that it is still active bacteria

Customer:

oh ok.

Customer:

Is there anything I can do to prevent a fistula?

neuromd2012 :

you have to wait until the drainage stops

neuromd2012 :

then after it stops you can do a few things to prevent it from forming a fistula

Customer:

So can you prescibe me antiobiotics?

neuromd2012 :

there are a variety of methods

neuromd2012 :

sorry, cannot prescribe anything online, it is against the law in the US

Customer:

Bummer

neuromd2012 :

but you can call the pharmacy

neuromd2012 :

if you filled with them, they may have a refill for you

Customer:

how long can abscesses take to stop draining?

neuromd2012 :

they can drain for weeks,, if your abscess was very large, you may have to pack it

neuromd2012 :

did the doc discuss packing with you?

Customer:

no.. it just broke on its own in a tiny pin point

neuromd2012 :

I see

neuromd2012 :

and it opened it up for you?

Customer:

enough to drain, but they didn't open it larger

neuromd2012 :

well sometimes if it is large, they have to open it up completely to prevent a fistula

neuromd2012 :

but I would see a colo-rectal surgeon

Customer:

how can they tell how big it is?

Customer:

oh ok

neuromd2012 :

and start the antibiotics now

neuromd2012 :

they can MRI the area

neuromd2012 :

and tell you

Customer:

ok

neuromd2012 :

usually it is contained by the glandular tissue

neuromd2012 :

so it will not get too large

neuromd2012 :

but my concern is that the opening wasn't big enough

Customer:

so it's not likely to be like filling my entire lower body?

neuromd2012 :

so it closed without completely draining

neuromd2012 :

no

neuromd2012 :

no way

neuromd2012 :

you don't even have a fever

neuromd2012 :

so it is walled off

neuromd2012 :

and you just need to keep the orafice open so it drains

neuromd2012 :

ok?

Customer:

ok, thanks!

neuromd2012 :

get back on the antibiotics if it is green

neuromd2012 :

you are welcome

neuromd2012 :

Dr Frank T

Customer:

ok thanks

Dr. Frank, Board Certified Physician
Category: Medical
Satisfied Customers: 7201
Experience: Neurologist/Internist with academic and clinical experience.
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