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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 17556
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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Is this real, I had foliculitis that was diagnosed as

Customer Question

Is this real
JA: I'm the doctor's Assistant. I work with them to help customers like you.
Customer: I had foliculitis that was diagnosed as infected. Took doxycycline for ten days. Infetction has returned worse and three of my lymph nodes on the right side of my neck and behind my ear have become very swollen and hard in the last two hours.
JA: How long have you been dealing with this issue? Are you experiencing any numbness or tingling?
Customer: A month. I waited two weeks before seeking treatment trying to resolve on my own. My scalp burns itches and becomes sore and now my neck is super stiff and sore.
JA: Anything else in your medical history you think the doctor should know?
Customer: No. I have no serious or chronic illnesses.
Submitted: 29 days ago.
Category: Medical
Expert:  Dr. D. Love replied 29 days ago.

Hello from JustAnswer. Thid id Dr. Love and I will be assisting you today.

However, you did not ask a question about the folliculitis.

Are you asking how about the usual next step in treating the folliculitis?

Where is the folliculitis located?

Can you attach a picture of the folliculitis?

Customer: replied 29 days ago.
Foliculitis is on my scalp. Here is a picture from last night.
Customer: replied 29 days ago.
The doctor called in a new antibiotic but there growing lyphmnodes so quickly concerned me. Should I go to a quick care center to get reevaluated? My doctor left at noon today.
Expert:  Dr. D. Love replied 29 days ago.

The usual treatment for recurrent folliculitis after an initial course of doxycycline would be the use of an antibiotic in a different class. There are several to choose from, but I would usually chose an antibiotic that is better against Staph, such as cephalexin/Keflex or Augmentin. If there is purulent drainage, then a culture may be obtained, but it is also common that folliculitis may not have pus or fluid that can be readily cultured, so treatment is oriented towards what is commonly seen. In looking at the pictures, I do not see any pus or fluid that would generate an accurate culture.

The swelling of the lymph nodes, by itself, would not alter the treatment, nor the rapidity of the swelling. It is normal for lymph nodes to swell in response to infection, and they can swell very quickly. The concern would be if the infection settles into a lymph node and is causing a focused infection in the lymph node with a collection of pus in the lymph node. If pus is collecting in a lymph node, it may need to be drained in addition to the antibiotics. This would be unlikely in your cases for a couple reasons. First, it usually takes longer for the infection to settle in the lymph nodes and generate any significant amount of pus. Second, it would be very unlikely that three different lymph nodes were similarly affected at the same time. Since you have had three lymph nodes swell quickly, it is far more likely that this is reactive swelling of the lymph node.

So, in this situation, it would be appropriate to get the prescription for antibiotics that was called to the pharmacy. There is no need to be seen again in an Urgent Care Center.

If I can provide any additional information, please let me know.

Customer: replied 29 days ago.
Thank you so much
Expert:  Dr. D. Love replied 29 days ago.

You are most welcome.

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