What is the reason for the frequent abscesses in my jaw, sides of the face, chin and neck?

Question

Hi doctor,

I am 31 years old otherwise healthy male. I think I have a pretty unique infectious issue happening. I formerly had a wrap-around jaw implant (silicon prosthetics) which was in place for about three years. There developed a draining abscess in the chin area. Bactrim worked initially to clear it up. But then, it came back. Eventually, streaks of cellulitis would form on the skin around my chin on both the jaw angles, sides of the face, or even down the neck. The implant was infected with biofilm, so we had to take it out. I thought that removing it would resolve the infection.

However, three months after removal, similar cellulitis patches have cropped up at chin and jaw angles or the top of the neck. It is surprising and frustrating. May I have periostitis or osteomyelitis of the jaw bone? I have Clindamycin, Bactrim, and Doxycycline antibiotics, and I am thinking of just taking them all for a while to try to clear this out. However, I think it is better to speak with an expert.

My plastic surgeon has not been particularly helpful. He did not wound culture the infected implant, which I wish he had. Anyways please reach out to me to establish care. Thanks a lot.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your query. Rather than going for empiric antibiotic therapy like Doxycycline and Clindamycin, we can go for a culture and sensitivity test of the pus specimen obtained from the infection site, followed by antimicrobial selection. Frequent usage of antibiotics can end in the development of antimicrobial resistance. Certain antibiotics may have to be given for a longer duration depending on the culture and sensitivity study.

When you get the lesion again, we need to collect a specimen from the site using aseptic methods and send it for bacteriological culture study. It is called a culture and sensitivity study. We need to find out which organism is causing it. We have a variety of organisms like gram-positive bacteria (Staphylococcus aureus and many more) and gram-negative bacteria (Klebsiella and many more). After finding out the organism, they study the sensitivity and resistance pattern of the particular bacteria towards various anti bacterial in the laboratory. Depending on the culture and sensitivity pattern, we can choose the sensitive antibiotics for the appropriate duration. There are also a few chances of the pathogen living in your skin as a colonizer and causing recurrent infection flare-ups.

The test name is culture and sensitivity study (you will get the report in three to four days, containing the organism name and its sensitivity pattern).

You can use 0.2% Silver Nitrate ointment (use it four times a day - external application over the affected site). You can use over-the-counter available antiseptic soap containing Triclocarban (make sure it has Triclocarban, which is an excellent antibacterial) to wash the affected area thrice a day.

Most of the infections will be taken care of by your body's immune system. I suggest you take fruits rich in vitamin C, food rich in vitamin D3, food rich in zinc, iron, and folic acid. You can include flavonoids containing substances like green tea two to three cups a day. All these are proven to improve immune function against bacterial pathogens.

Also, make sure that you are not suffering from any other conditions like diabetes mellitus, where there can be recurrent bacterial infections due to high blood sugar. You will be fine.

Regards.

What is the reason for the frequent abscesses in my jaw, sides of the face, chin and neck?

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