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Q. Why is there a recurring infected sore with pus on my skin?

Answered by
Dr. Mashfika N Alam
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Aug 02, 2018

Hello doctor,

I keep getting quite bad infected sore on my skin like a small pimple with a little pus initially which then gets infected. About 14 months ago, I got one of these on one side of my leg and middle of the upper thigh.

It got worse over a few days and then blew up very infected, and I went to the hospital and had to have four IV antibiotic drips. I was there about 36 hours at the hospital. The entire upper leg was swollen down to my knee. The diagnosis was cellulitis.

Through last year I had several more of there sores, always on the left side of my body only which I thought was strange and interesting as to the cause? Several on the left side of the torso from a few on the side of belly and about ten at different times upside of my chest or near left armpit. I have had several lumps under my left armpit (about eight or so, some two or three at once) which can get quite painful.

These have all cleared up by themselves over about two to three weeks but were red and some with red radiating outward on my skin, but I was able to fight off the infection.

I have also had a rash under my left armpit several times. I had a more severe one near my left elbow about three months ago that the infection was spreading up my arm. So, I got oral antibiotics from the doctor and it cleared in about four days.

I have just now in the last few weeks had another near my left elbow (still there and very sore) and a second one appeared nearby about five days ago.

Initially, the first one looked like red was spreading but I put some antibiotic eye cream on the area each day for past week and it has gone down a little but both are still very sore.

Overall, I am really wanting to find the cause and fix this. I had not taken antibiotics for about 15 years before the first leg episode about 14 months ago. I have changed my diet a lot to be eating very healthy past 12 months.

So, I am surprised with this unless its something relating to gradual detox. I am not eating many complex carbohydrates (rice, bread, pasta) and stick mainly to lots of green vegetables and good protein like grass fed meat, free range chicken, salmon, and free-range eggs.

I guess sometimes I may go in and out of ketosis a bit. When I drink, I drink a fair bit (15 standard drinks) but only do this once a week. Unsure if this is related. Hoping to get to the bottom of this. Thanks.

#

Hi,

Welcome to icliniq.com.

It seems like a frequent case of bacterial infection of your skin. Why are you frequently getting bacterial furunculosis is what we need to look at. This usually indicates an immunocompromised state or underlying uncontrolled diabetes mellitus or a complement deficiency disorder.

What I can gather from your symptoms is that you get bad cases of furunculosis, some with infected axillary lymphadenopathy (the tender lumps in axilla).

The axillary rash is something else which also occurs in diabetics or immunocompromised individuals. It is called erythrasma. It also occurs with obesity as in your case.

It would be helpful to know a bit more about your condition like,

  • Has this ever happened when you were a child?
  • Did you get frequent infections as a child or is it something that happened only recently?
  • Do you have diabetes mellitus or a family history of diabetes?

Given your BMI, you are very prone to insulin resistance.

Hence we need to take a look at your blood glucose levels. I am very hopeful we can get to the bottom of this.

We need to look at it in a stepwise manner, ruling out possibilities and establishing a diagnosis.

Please give me the details I asked for and get the following investigations done.

Investigation to be done:

  • Oral glucose tolerance test.
  • HbA1c.
  • Full blood count.

If these turn out to be normal, then we have to check your complete immunoglobulin levels.

Hope this helps.

For more information consult a dermatologist online --> https://www.icliniq.com/ask-a-doctor-online/dermatologist


Thank you doctor,

I have attached my latest blood test results. As you can see, I did have some strange things with my white blood cells starting from a similar time to my first leg infection.

I do not know whether I had that before or after the leg infection. In any case, I changed my diet as in my original email about 12 months, and I think that helped me get better. I have got regular blood tests since monitoring everything.

Everything has been getting better and better which I am working towards which is why this skin condition is a bit frustrating and want to work it out. I have lost 15 kg in past 12 months.

My stats this morning were 108 kg with body fat percentage being 29.9 %. I saw a doctor today and they said it could be a resilient staphylococci infection and gave me some strong antibiotics.

#

Hello,

Welcome back to icliniq.com.

I am always glad to be of help. Now I have taken a good look at the reports (attachment removed to protect patient identity).

Your WBC has always been within the range. So, it is normal. In fact other than the lipid profile, the rest are fine. If it is a Methicillin-resistant staphylococci aureus, I understand he must have put you on Vancomycin.

However, we need to figure out why this is happening. Since your blood glucose is normal, we need to see if the complement levels are normal.

But it would be helpful to know if you have always suffered from frequent infections as a child or only for the last 14 months.

If always, then we need to get you complement levels checked. If not, then it is probably a bad case of Methicillin-resistant staphylococci infection.

For more information consult a dermatologist online --> https://www.icliniq.com/ask-a-doctor-online/dermatologist

Thank you doctor,

I have never had these skin infections before, only over the last 14 months. Also to note, I have not been sick at all last year (no flu, colds, etc.). If you can give me the exact name of the blood test I need, I will check with my doctor in person next week. I am due for another blood test soon anyway. So, I might as well get that checked also.

#

Hello,

Welcome back to icliniq.com.

Those are IgG, IgA, and IgM and complement component levels. But, if you have never had recurrent infections since childhood, then the possibility of an underlying congenital deficiency is less. However, it could be acquired. Hence, it is better to get them checked as such deficiency disorders are frequently associated with bacterial infections.

Hope this helps. Do let me know if you need anything.

For more information consult a dermatologist online --> https://www.icliniq.com/ask-a-doctor-online/dermatologist


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