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Tenderness behind ear after antibiotics for CELLULITIS.

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Hi. I have been advised by Dr. Deepu Sebun Sebastian and would like to continue follow up with him. Consult ID 195967.
Regarding my previous suspected diagnostic; cellulitis on the face, I just got my blood culture results and it's negative. And as I mentioned before, WBC count was normal. I am on a very strong dose of antibiotics for 10 days (today is day seven on those) and thinking I should perhaps drop the strongest one. I would appreciate some insight, wonder if I had an allergic reaction to Voluma...
Regarding my condition: The face swelling and lymph nodes have almost completely gone down and no tenderness, however, on the right side just behind the ear i have started feeling tenderness since yesterday and it feels a little lumpy.

Category: Family Physician-GP

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Category: HIV- AIDS Specialist
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Hello. Thank you for posting your query at DoctorSpring.com
Yes i remember your case. I am glad that most of your symptoms are now gone. It is possible that you got the infection, but blood culture can be negative, since we started the antibiotics right away and following that the blood was given. Do you remember if you gave the blood for culture, after taking any antibiotic dose? Because even one dose, can indicate that there is no active virus.
What i personally feel, is that a lot of times lymph nodes, get enlarged sue to some minor injury, or even allergy. Yes allergy can be one of the causes. There are some lymph nodes behind the ear too, the post-auricular lymph nodes, and it is possible that they are enlarging. Since its a recent development, it points more towards allergy, because infection won't manifest so late.
Since its been around 7 days already, you can stop the antibiotics. If there is a lot of pain, then you can take OTC tylenol, and i will recommend using Tab. Claritin 10 mg one tablet at bed time for 3 days. If there is any ongoing allergy, it will be relieved.
Feel free to discuss further,
Regards


Patient replied :

Thank you for your prompt response, Dr. The blood culture was done BEFORE I had any antibiotics! So yeah, a little confusing. I will take Claritin tonight to see if helps with behind ear lump and tenderness. Would Benadryl be ok? I already have that one. And again, should I stop both antibiotics? I will see my dr tomorrow. He had already advised me to stop Septra, and that was without knowing blood culture result. Would Advil be ok instead of Tylenol?


Hello. Thank you for writing to us again.
Benadryl is a cough syrup and even though it has Chlorpheniramine maleate, the active anti-histaminic, i will still recommend Claritin. Since you're meeting the doctor tomorrow, it is better to continue the antibiotic for one day, and discuss it with him before stopping. If there is a lot of pain, then Advil is fine, make sure you have it after food, to prevent gastric side effects.
The good thing is that you're recovering, and since the blood culture is negative, then a possibility of anything serious has been ruled out. Lymph nodes can even swell up due to minor injury as i said, so it is possible in your case too.
Let me know what the doctor says tomorrow,
Regards


Patient replied :

Hi DR- I took one 10mg Claritin last night and I woke up this morning with a skin rash, mainly on chest, abdomen, back and face. I wouldn't say is severe, not really itchy. I'm not swollen , lymph node below ear still feels a little sensitive like yesterday. Could I be having an allergic reaction to the Claritin? Is the only thing I did different. I don't think I had ever taken it before. I am supposed to see my Dr this afternoon. However, I don't know if should go to the ER now since its early and can't call my DR yet. Im sending you pictures. Please advise soon.


Hello. Thank you for writing to us again.
No claritin is rather given to prevent allergy. It is loratadine, a pure anti-histaminic.
I am really surprised that you developed this kind of a rash. But yeah it does seem to be allergy.
You can wait till you see the doctor. Try to apply Histocalamine lotion/ Lactocalamine lotion on the rash affected areas. Is it possible you developed some kind of food allergy? Also you can stop calritine, and if the rash is not subsiding after applying thr lotion, then it is better to take Tab. Levocetrizine, it is the safest anti-allergy medication and also doesn't cause that much drowsiness.
I feel it is better to get examined by a doctor, because if it is an enlarged lymph node, due to an infection, it should have settled by now. Since i can't examine it myself i can't commit what it exactly is. Since you took antibiotics we can rule out infection, so the only other cause can be injury to the lymph nodes, or an allergic reaction. However it is better to be examined by a physician for the same. Please apply histocalamine,and your rash should subside. If it's not itchy, you can wait, it will settle by itself.
Regards


Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
Experience: 
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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