Abscess: How long?

[Mehita]

So, three weeks ago DS had a prune sized perianal abscess on the inside with a fistula connecting to his rectum. Drainage was coming out his rectum so no surgery was necessary. He's since had two weeks of IV Zosyn and IV Clindamycin administered at the same time, then stopped that and was switched to oral Augmentin. He's also had two doses of Remicade now as well.

Good news is there has not been any drainage in two weeks and the abscess has shrunk to pebble sized. He has a hard time finding it now, but the problem is that it is still there. He can still feel it and it is painful to the touch. His GI said he needs to stay on the antibiotics until it's completely gone.

My questions are... will it ever go away completely? And once you have an abscess/fistula in a certain spot, does it keep coming back in that same spot? Am I being impatient or does it usually take longer than four weeks for abscesses to clear up?

 

[nogutsnoglory]

I hope this is not the case for him but they can be very aggressive. I had a tiny abscess that became a major problem involving multiple antibiotics and surgeries. It resulted in multiple fistulas and ultimately an ileostomy.

Now that the flow of stool had stopped, the abscess had cleared. I do have a light fever today and pray it's not starting up again.

I don't mean to scare you but please keep a close eye because the little buggers can turn into a nightmare. I wish I had surgery at the start instead of wasting time with useless antibiotics. Mine was a little deeper though and surface abscess responded better to antibiotics.

 

[Essieluv]

It is possible to have an abscess, go on antibiotics, and be fine for years after. However, it is also really common to have recurring abscesses. It's just that, once those suckers show up, they like to have long parties and invite lots of friends. I would just have him do a lot of sitz baths, and if it feels at all like it is getting worse, go to the doc. Having an abscess surgically drained is not a big deal (but make sure you request to be put out, because local anesthesia is not enough) and helps tremendously. It's best to just keep an eye on it, but hope for the best. My fingers are crossed for you both.

 

[Ams-Qld]

Hey Mehita, sorry you guys are going through this, we have been there too and it is not nice! Our sons abscess took about 4 months or more to stop draining. They apparently have a 50% chance of developing into a fistula, and this is what happened to us the drainage then moved to faecal matter the good news is it appears (15 months later) that the fistula tracts have healed (yay) but he is still facing other perianal complications. Here's hoping and praying that your DS drains quickly, heals quickly, and doesn't develop a fistula!!! :hug:

 

[Sascot]

From our experience antibiotics never made the abscess go away, only toned down the infection. My son was on antibiotics for about 3 months before they gave in and operated, by then it had formed a fistula. It does sound promising that it has shrunk to the size of a pebble now, so he might be lucky.

 

[Mehita]

Hmmm, ok. He does have a fistula already, though it was very small on the ultrasound.

I guess what I don't understand is what the point of the antibiotics is if the abscess is no longer draining and is so small. Does it just continue to shrivel up?

 

[nogutsnoglory]

Well the antibiotics continue to target that small abscess because if you stop before the infection is fully healed it can grow again and create additional complications. Since he is responding so well to the antibiotics, it seems to make sense to continue it but if it doesn't fully eliminate the abscess I would consider incision and drainage.

 

[Mom2oneboy]

So sorry your guy is having to deal with this. Perianal abscesses are not fun!! My DS had to have his drained a couple of years ago. A few months later it came back but because the skin was still very thin in that area it started to drain on its own. It would come and go for the next few months until he got started on Remicade. Once we got the disease itself under control, the abscess quieted down. It hasn't reared its ugly head in over a year now. I still check my son's bottom on a regular basis to make sure nothing is brewing.

Hopefully, as you continue with the antibiotics and Remicade, you will see that area calm down and eventually go away. Sounds like he is heading in the right direction!

 

[VeganOstomy]

I hope this is not the case for him but they can be very aggressive. I had a tiny abscess that became a major problem involving multiple antibiotics and surgeries. It resulted in multiple fistulas and ultimately an ileostomy.

Like Nogutsnoglory, my abscesses and fistulas ultimately led to my ileostomy too. They caused my anus so much pain and damage that my bum was unrecognizable. Hopefully, once it heals (now that my anus has been removed), I won't have any more problems there.

The first symptom of my Crohn's disease was a small abscess. It got considerably worse from there, but I wasn't responding well to any medical treatment including antibiotics, anti inflammatory drugs, biologics and both steroid enema or oral prednisone.

 

[Mehita]

We saw DS's GI today and even though my son thinks it's still there, but tiny, the GI couldn't find it and was quite happy. He needs to finish up his last week of Augmentin and then he's done. Woohoo!

 

[Tesscorm]

GREAT news!!!