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Infected cyst in the buttock on Clindamycin.

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Good Morning,

I am asking a question to make sure I made the right choice for my health care.
Two weeks and three days ago (a Monday) I went to the doctor to have a cyst removed from my buttocks. I had it for two years or more, but it had finally started to bother me (it had grown to nearly golf ball size). They lanced it and sent me on my way. Two days later (Wednesday) it was swollen larger than before, it was red, and the surrounding area hurt. I went back to the same doctor the next day (Thursday) and he lanced it again, packed it, and prescribed Bactrim. I then went back to him for the next 7 days (minus one day when they were closed and sent me to an urgent care center), and every day they would squeeze more drainage out, probe it, pack it, and send me on my way. The next Thursday my antibiotics ran out, and they said the treatment plan was for me to continue to come back and do the same routine until there was no more drainage. Then they were closed that Saturday and sent me to the same urgent care center for the day. The doctor there told me there was no need to pack it again, that he wanted to let it heal, and he prescribed Clindamycin and put a band-aid over it. I was ecstatic because that meant I didn't have to go to the doctor every morning and get probed, so I didn't even question it.
Today is 4 days since I started taking Clindamycin, and I'm starting to get worried. The place where the incision was made is still open, and every time I change the band-aid there is a small amount of drainage on it. I squeeze it myself and get a bit more out (no blood, just drainage). I just want to make sure the second doctor made the right call, or if I should start going back for the daily probing again. There is no pain in the surrounding area, I'm just worried that the second doctor didn't fully understand the situation since he wasn't there from the beginning.
Thanks in advance!

Category: Family Physician-GP

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Category: HIV- AIDS Specialist
 19 Doctors Online


Thank you for choosing DoctorSpring.

The treatment plan by both the Doctors are acceptable. They are two different approaches, and both are acceptable. Since you second Doctor left it rather open he/she expected self drainage of the cyst followed by healing.

As of now you have some discharge and when you press there is more. In that scenario a minimal exploration is warranted. You can go to your current (second ) Doctor. He will look whether there is any pus to be drained.

Pus if any has to be drained regardless of the approach. In the first scenario your Doctor was draining it and keep the wound closed. Your second Doctor was letting it for open drainage. Now since there is some pus drainage when pressure is applied you need to make sure there is no organised pus.

Continue the antibiotics. If the pus drainage persists you should consider a pus culture and sensitivity test for antibiotics. I understand that this can be really frustrating, but thankfully most of these kind of lesions will heal in few weeks.

PS : If you have not tested you Diabetic status, you need to do a screening by doing a fasting blood sugar.

Hope this clarifies.
Feel free to ask followups/ clarifications

Thank you

Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
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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