Levaquin and Saddle Sore -- Calling all Doctors

[Rick_Gamble]

My physician prescribed a 14 day course of 500 mg Levaquin, a heavy duty antibiotic. At the same time a referral was provided to my urologist who surgically excised a much worse sore in a different area three years ago. In other words the two events are unrelated.

Today marks the seventh day of the course of the Levaquin. At this point the sore is reduced to 1/2 cm in diameter and hardly noticeable.

My urologist wants to surgically remove it four days after the 14 day course of Levaquin has been completed. His logic holds that any infected tissue remaining at the end of the 14 day antibiotic course will reignite the condition.

My question is this: In another seven days when the Levaquin course is completed if the sore is not detectible by probing should I forgo the surgical procedure?

Thanks in advance for any insight into this.

 

[Dr. Wattini]

Hey,
Are you sure you have saddle sore? It sounds more like a venereal disease in your rearend!
In all seriousness, what did you do to yourself to develop a saddle sore that is so bad? Did you ride with a not so clean pair of shorts? Just asking so I do not do what you did.

 

[elapid]

You have two options: close the wound primarily or allow it to heal as per any wound (called second intention healing). If the wound is infected, then antibiotics, local wound cleaning and allowing the wound to heal by second intention is preferable because otherwise surgery has the potential to trap bacteria and result in the development of an abscess. If the wound is not infected, then either route is acceptable. If surgery is elected, then ideally you want all sutures (stitches) below the skin. However, a 0.5 cm diameter wound will also heal quite quickly by second intention and no surgery. Just the same as a wound anywhere else on the body. For both surgery and second intention, you will have to avoid any activity which may exacerbate the condition (ie, riding) until the wound has fully healed. Obviously, look at different saddle and bib options as well to minimize the risk of developing saddle sores in the future.

 

[Rick_Gamble]

Dr. Wattini Reply

The sore is the furnicle variety the result of a common staph (areouls?) bacteria.

Hard to say what directly lead to the event. It may have started as a result of wearing the same tights twice in cold weather and perhaps without cream (?) thinking given the conditions it wasn't a big deal.

 

[tifosa]

A urologist for a saddle sore?
In my experience with doctors, they are (mostly) certain of diagnoses in their particular area of expertise - and quite uncertain when it comes to other areas of medicine.
I'd get a second opinion by a dermatologist who is quite adept in skin conditions.
You didn't say where sore is located, but it's possible that a pilonidal cyst may have been overlooked as the source of your problem.

 

[Rick_Gamble]

Re: A urologist for a saddle sore?

That is my take as well and the reason for posting this thread.

His admonition is that when the Levaquin course is completed any remaining infected tissue in the area will restart the condition. The only way to be sure is to surgically remove the tissue. This professional also does his own surgery in his own facility and I'm somewhat concerned that I'm viewed as a revenue source.

My thought is that when the Levaquin course is completed the subcutaneous infection with have deteriorated to the extent to be undetectable by digital manipulation although that doesn't necessarily mean there isn't and remaining infected tissue. An indeterminate condition hence the indecision on my part.

This is why I'm seeking the insights of others who have knowledge regarding situations of this nature.

 

[fatandfast]

you may need a little different approach to your condition. Buy a couple more pairs of shorts. wash all your cycling clothes at the same time taking a great deal of care to ensure that all your shorts are inside out at the start, and spray a soap mixture directly on the chamoix. If you have some cystic condition, like ingrown hairs or alaike you need to condition yourself before and after the ride. Surgery can be super tricky,but it has worked for people I know that had a boil that soilidified and left a lump that would expand often. Antiboitics are a last resort..they mean that the boil got way to big. Bagbalm and Boilease all will make the condition lessen a little. It is most common that it is bacteria.Your shorts may be an incubator for the condition. Not a good pad,an incomplete washing, in too low a temp are the best place to start before you put a scar in an area that is a high stress point is where I would start. All your shorts should be marked w a sharpie to ensure that you are wearing pair number 5 rather than the same shorts over and over. Alcohol wipes before and after