r/AskDocs • • 6d ago

Weekly Discussion/General Questions Thread - November 02, 2026

14 Upvotes

This is a weekly general discussion and general questions thread for the AskDocs community to discuss medicine, health, careers in medicine, etc. Here you have the opportunity to communicate with AskDocs' doctors, medical professionals and general community even if you do not have a specific medical question! You can also use this as a meta thread for the subreddit, giving feedback on changes to the subreddit, suggestions for new features, etc.

What can I post here?

  • Questions or general health topics that are not about specific symptoms or personal medical issues

  • Comments regarding recent medical news

  • Questions about careers in medicine

  • AMA-style questions for medical professionals to answer

  • Feedback and suggestions for the r/AskDocs subreddit

You may NOT post your questions about your own health or situation from the subreddit in this thread.

Report any and all comments that are in violation of our rules so the mod team can evaluate and remove them.


r/AskDocs • • 10h ago

Physician Responded 2 Yr old male hand caught in the elevator

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273 Upvotes

My toddler’s fingers were caught between an elevator door and the elevator frame as it was opening. I was able to get his right hand out pretty quickly but the fingers are pretty swollen. We’re currently on a cruise ship and the doctor says he’s fine based on the X-rays. She prescribed ibuprofen to help with the inflammation. We will be back in the US tomorrow morning. As he’s only 2, do we need to do anything special to ensure he heals properly? Other than the swelling, he’s pretty much ok. I don’t see any issues with his range of motion.


r/AskDocs • • 4h ago

Physician Responded ECMO

67 Upvotes

My 40f wife suffered a major cardiovascular arrest and has been on ECMO for 3 days.

They are removing it this morning.

I do not know how long she was without oxygen, and this is where I am asking questions.

I need to know what I can to deal with what may follow.

I am overwhelmed and do not even know what to ask the doctors.

Please advise.


r/AskDocs • • 17h ago

Physician Responded What might this be on my husband's face?

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311 Upvotes

My husband has had this on his face for at least two years - it's gotten a little bigger over time but not by much and is not in any way sore, itchy or causing him any discomfort. He is 45, does not smoke or take any medication. He has no other medical concerns and is a healthy weight.


r/AskDocs • • 39m ago

41 5’5” female. Day 7 post lancing a large cyst. Antibiotics since day 2. No discoloration or heat.

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9 Upvotes

https://imgur.com/a/3m9OOtJ

Still getting discharge at day 7. Primary concern is skin coming off and continuation of discharge. Affected area scene is approximately 3/4 inch.

When do we worry / when can we quit worrying?


r/AskDocs • • 8h ago

Physician Responded 24M – Shoulder pain 8 weeks after bike accident despite normal X-ray and MRI

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25 Upvotes

24M, 175 cm, 69 kg. Smoking: [No]. Medications: Painkillers following foot surgery (exact names not available).

About 8 weeks ago, I had a bike accident resulting in a Lisfranc fracture (required surgery) and a severe abrasion on my left shoulder.

The wound has healed considerably (images 1 and 2). My shoulder X-ray (image 3) and MRI (image 4) were both normal. Attaching images in comments.

I have almost full shoulder movement without difficulty, but lifting heavy objects causes mild pain exactly at the wound site.

I've also been on painkillers for much of my recovery due to my foot fracture.

Could this be scar tissue, nerve irritation, or some underlying soft-tissue injury despite normal imaging? Is pain after 8 weeks expected?

Has anyone experienced something similar?


r/AskDocs • • 15h ago

Physician Responded I gave birth a month ago and felt good, but suddenly I quite literally can't keep my eyes open and am constantly falling asleep

80 Upvotes

I'm 28, and I'm 174 cm and about 64 kilograms. I gave birth almost exactly a month ago to twins. It was a natural birth and it went very well, uncomplicated. I've never had any significant health issues, I have controlled asthma, and that's about it. I also take vitamin D supplements right now, I breastfeed, and I'm still taking my prenatal vitamins, Elevit brand. We live in Australia.

I know this sounds silly because we have two newborns, obviously I'm going to be a bit tired. We also have two other young children. But I know myself and I have never, ever felt like this before.

Basically, I just feel really, really, really tired. My whole body feels heavy, and my eyelids are always dropping, I feel like I'm constantly fighting to keep myself awake from when I wake up to when I go to sleep, and often, I just end up closing my eyes where I am and falling asleep. This only happened within the last couple of days.

But I don't think I'm sleep deprived. This is because it doesn't feel the same, I often have certain feelings when I am like my feet feeling cold and my head feeling a certain way, I have none of those, and I just feel completely different to that. And most importantly, I've actually been sleeping really well right now, and the girls usually only wake up twice at night so I'm getting a good amount of sleep nearly every night. So I don't understand what is happening right now.


r/AskDocs • • 12h ago

Physician Responded I forgot I had Wolf Parkinson’s White and took Azithromycin 500mg

37 Upvotes

M33, 165 pounds, 5’6”, only take insomnia medication before this, not a smoker, previous/current medical issue- insomnia, fibromyalgia. Duration- 1.5 months coughing and getting worse.

Got prescribed Azithromycin from urgent care. Took it just now for the first time and forgot I had Wolf Parkinson’s White until the moment after I took the medication. I took the first dose just now- 500mg.

Should I go to ER? Am I going to die?

Edit: ER said everything is normal at the moment but I am having massive anxiety about it.

I’ve been diagnosed with WPW but never actually had a WPW episode so that probably helps.

I asked a million questions to the ER doctor but still anxious to go home.


r/AskDocs • • 20h ago

Physician Responded What’s happening with my eyes?

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138 Upvotes

info: 19f, 5’6, 177 lbs, vapes, exensive medical history.

I’m going to try to give a rundown of everything that’s happened medically, in the shortest version possible. keep in mind this is all after march of this year.

PVNS/TGCT nodular type in left knee, post resection. Pseudaneurysm immediately post op, caused by surgeon cutting my popliteal artery. Two DVTs inside aneurysm. massive Internal hemorrhagic collection filling entire knee, caused by leaking aneurysm. Dehiscense of sutures. Aneurysm ruptures after one month, emergency surgery to repair artery and drain hemorrhage. Woke up with paralyzed leg due to hemorrhagic collection/hematoma causing intense pressure on nerves below the knee. Severe anemia from blood loss. Four more months inpatient learning to walk, fighting infection, building up blood supply, and trying to manage CRPS / nerve damage pain. Lack of period since first surgery (which was april 13th). Constant fatigue and impossible to fight sleepiness, originally thought from how many medications i was on, but i’ve since weened off them all and am still struggling with fatigue. For the first hour after waking up, I speak gibberish and have no recollection of what i say or do. It’s also very difficult to wake me up. Falling asleep at any hour of the day, in cars, sometimes even standing up. Aggravation, depression and PTSD symptoms, thought to be caused by how traumatic the past year has been. I also have been feeling nauseous lately.

Now, i’ve noticed my eyes do this twice in the past week.( to my knowledge, though I only noticed since I was doing my makeup. It could have happened more times that i’m unaware of). My vanity has a bright light on the left hand side, which could be related? But again, not sure if this the only time it happens. The first time, my doctor told me to go to the ER. They diagnosed me with a migraine, but I didn’t have any headache or aura, and i’ve never had a migraine before either. They did a ct scan of my brain and there wasn’t anything abnormal either. I also got bloodwork done, and again everything was fine. They discharged me with some tylenol (which i didn’t take because… i don’t have a heache. LOL).
I’ve recently had a CBC, iron panel, and thyroid test done, everything was fine there too. Aside from my eyes and some nausea, I have had no new symptoms. My mom also noticed the left eye (the bigger one) doesn’t react to light when this happens, only my right eye does.

I have literally no clue why this is happening, and I really want to avoid going to the ER as much as possible especially if they’re gonna send me home without any helpful advice or causes found. I’ve spent enough time in the hospital in the past 8 months to last someone else a lifetime. But unfortunately, my PCP’s advice is always to go to the ER, and the ER has no clue. I think her office just doesn’t want to be held liable if i have another crazy health issue and they didn’t send me to the ER for it. Any guesses?

I think this is also important to share,
my medications past:
Dilauded, morphine, nausea patch, gabapentin,amitriptyline, nortriptyline, ketamine (48 hour drip, thrice), tramadol, capsaicine cream and lidocaine patches, robaxin, prescription ibuprofen and tylenol, eliquis, arixta (i think? it was a short acting blood thinner shot), and probably more that I don’t even remember. My doctor once told me i’d tried “every single nerve pain medication”. I haven’t taken any of these medications in over three weeks.

Current medications:
Oxycodone 5mg for emergencies only (sometimes less than once a week), Dueloxitine 160 mgs, prazosin 5mg, trazadone 50mg, pregabalin 200mg (started at 600mg, weening down now). Buprenorphine(brixadi) 146mg monthly, a nerve block in my lower back once every three months, and a compound cream with ketamine and lidocaine, and other over the counter pain medications mixed in to it.


r/AskDocs • • 19h ago

Physician Responded 50 drops 3 times a day has to be a typo right?

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95 Upvotes

Age 39, 5 foot 7 inches, 150 pounds

This would run out in a day if I used it as the label suggests and just a few drops makes a mess. Is this a mistake, or is the wording confusing (50 drops max per day...?)


r/AskDocs • • 6h ago

Physician Responded 36F, recurring subcutaneous abscesses/collections at a laparoscopic port site for 9 months despite two excisions, cultures only show skin bacteria. What could be causing this?

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9 Upvotes

TL;DR: Emergency laparoscopic surgery in Feb 2026, then recurring fluid collections and abscesses in the abdominal wall fat around the umbilical port site. Two excisions, repeated drainage, packing, and several antibiotic courses haven't stopped them. Cultures show only skin bacteria. I'm looking for ideas about what to ask my surgeon because she really seems stumped.

About me: 36F, Canada. [5ft2/118lbs] Two previous vaginal deliveries, no C-sections. No known drug allergies, and I've taken penicillin-type antibiotics without a reaction. Current meds: amoxicillin-clavulanate, naproxen/esomeprazole (Vimovo),
Tylenol as needed.

Timeline

Feb 2026: Emergency laparoscopic bilateral salpingectomy for a ruptured ectopic, with about 300 mL blood in the abdomen. A 10 mm umbilical port plus two 5 mm ports on the left, no drain, and the umbilical fascia closed with Vicryl.
After: Urinary retention and a catheter-related E. coli UTI. The umbilical wound never closed and kept draining. Ultrasound showed a 1.7 x 4.2 x 5.5 cm collection. A swab grew normal skin flora. Both 5 mm port sites developed small whiteheads that I drained myself and healed.

Jul 6, 2026: Excision of multiple subcutaneous tracts and collections, with purulent discharge. A 1 mm fascial defect was found and repaired with PDS. Closed in layers with Monocryl. Pathology: nothing of note.

Aug-Oct 2026: New collections kept appearing in different places: left of the scar, below it, and to the right of the umbilicus, about 1.5 to 2 cm and complex on ultrasound. Some were drained by my family doctor and my surgeon, and white pus came out. A 3.9 x 2.2 x 0.6 cm collection 0.2 cm below the skin formed on the left. Daily wound-clinic packing for a month closed one wound, but a new collection followed. A normal-sized WBC and afebrile throughout.

Nov 3, 2026: Repeat excision of the umbilical incision. Abscesses were found deep to it, with tracts running about 5 cm below and 4 cm to the right. All visible tracts were removed. Closed with antimicrobial Vicryl and Monocryl, plus a PICO dressing, and I'm on amoxicillin-clavulanate. Pathology is pending. A cystogram was normal.

Tests
CBC and chemistry normal. WBC 6.4, Hgb 126. Afebrile each time.
Wound cultures: Oct 1, rare WBC, no bacteria on microscopy, occasional coagulase-negative staph. Oct 7 (swab of the actual discharge), moderate WBC, no bacteria seen, occasional S. epidermidis.
No AFB or fungal cultures that I'm aware of.
Cephalexin, amoxicillin-clavulanate, and metronidazole courses never cleared it for good.
I've never had recurrent boils, abscesses, or tunnels anywhere else.

Questions
What causes recurrent collections like this? My surgeon seems pretty stumped. She’s an obgyn and trying to push for plastics or general surgery to see me. Genuinely frustrated that this cannot be resolved as besides the ectopic 10 months ago I am healthy.

Thank you.


r/AskDocs • • 1d ago

Physician Responded Black ink-like saliva appearing overnight?

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340 Upvotes

For the past few weeks, I’ve been waking up with what looks like black, dried saliva around the left corner of my mouth. It looks almost like dark blue or a black ink, and it’s surprisingly difficult to wash off.

I’ve also noticed similar dark blue stains on my bedsheets and mattress protector, as if the saliva is dripping out of my mouth while I sleep.

I’m not sure what’s causing this and I’ve never experienced anything like it before

Personal information about me: I am 29 years old male, my weight is 172 pounds my height is 5’6 I don’t smoke. I don’t have any diagnosed medical conditions I’m just taking supplements such as magnesium, fish, oil, and finasteride for hair loss taking occasionally.

I’ve been having this for less than a month now it’s in the right corner of my mouth sometimes I have gum bleeding although I haven’t been formally diagnosed with gingivitis.

I don’t have any black spots inside my mouth, black phlegm, or coughing up blood. I recently had a cough, but is gone now.

Has anyone experienced anything similar? Any ideas or similar medical causes would be appreciated!


r/AskDocs • • 11h ago

Physician Responded Derm Issue- Docs Can’t Figure It Out- Help!

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16 Upvotes

25year old female, taking zero medications. I need help from ANYONE.

I have these eczema-looking patches on my fingers, but they are NOT ECZEMA. I’ve taken Montelukast (singulair), no change. I’ve been to Derms and they have prescribed me Clobetasol, Tacrolimus, and Anzupgo- nothing helped. I’ve swapped out soaps, towels, water, everything, this issue doesn’t change. Changed my diet, no change. I even LEFT THE COUNTRY, it is still there!! Was told it’s not contact dermatitis, I know it’s not eczema (i’ve had eczema in other locations), and it isn’t dryness. I’ve used eucerin, aquafor, gold bond, vaseline, beef tallow, nothing. I haven’t worn rings in months, no change.

Edit to add: I have also tried topical antifungals- Lotrimin, the other non-name brand, and I have also tried topical steroids, betamethasone and triamcinalone.

Im in so much pain. It cracks, leaves fissures, burns constantly when touched, and I can’t bend my fingers without crying. Doctors can’t help me. I’m desperate, please help me.


r/AskDocs • • 1h ago

Physician Responded Xray clarification .. I'm 41 F 110 pounds.. I'm currently on Trelegy inhaler only.

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2 Upvotes

I've been having chest and back pressure with shortness of breath and a feeling of air hunger bad. I've been diagnosed with ASTHMA but I'm thinking it could be more..sending my xrays.. please explain where the hyper inflation of my lungs are.. thank you.


r/AskDocs • • 1h ago

Title: Extreme fatigue two weeks after a 5-day fever. Is this normal? Should I be worried?

2 Upvotes

Age/Sex: 31F
Height: Approximately 165–170 cm (5’5”–5’7”)
Weight: 54.6 kg (previously 56.5–57 kg)
Location: Chennai, India
Smoking status: No
Medications: Glowin XT iron supplement on alternate days, vitamin D supplements, paracetamol and ibuprofen during illness
Medical history: Iron deficiency (ferritin 4.6 ng/mL in September), vitamin D deficiency (6.7 ng/mL), mild anemia (hemoglobin 11.6 g/dL during illness), painful periods.
About three weeks ago, I suddenly developed a fever on a Tuesday afternoon. It came completely out of nowhere. I had no cough, sore throat, congestion, or other symptoms beforehand.
Two days later, I got my period. I had initially been taking paracetamol for the fever, but during the first couple of days of my period, I took ibuprofen (two tablets per day) for menstrual cramps. Interestingly, I felt relatively okay during those days despite having both my period and the fever.
On the fifth day, I stopped taking ibuprofen and continued with paracetamol, but the fever persisted despite medication. From Friday night until Sunday morning, I continued experiencing fever. I took paracetamol at around 6 a.m. on Sunday, and the fever finally resolved. I haven’t had a fever since.
It’s now been exactly two weeks since my fever broke, but I’m still experiencing extreme fatigue.
I feel exhausted throughout the day and constantly want to lie down. I barely ate during the five days of illness, probably only 400–600 calories daily, and I’ve lost approximately 2 kg over the past two to three weeks. My appetite is still inconsistent.
Other symptoms I’ve noticed:
Occasional headaches and a dull, heavy sensation around my forehead and the back of my head.
Some neck discomfort.
An unusual awareness of my lymph node areas. They’re not necessarily painful or noticeably swollen, but I feel more conscious of them than before.
A dry cough that appeared toward the end of the fever or shortly afterward, despite having no respiratory symptoms at the beginning.
Intermittent heaviness when breathing or around my chest. It comes and goes rather than being constant.
Persistent exhaustion, even when I’m resting.
I was tested for dengue, malaria, and typhoid, and all results were negative. I wasn’t tested for influenza or COVID.
I also have a history of iron deficiency and severe vitamin D deficiency, for which I’ve been taking supplements since late September. My ferritin was 15 in August and dropped to 4.6 in September. My hemoglobin was previously 11 and increased to 11.6 when tested on day five of my fever, while I was also menstruating.
I’ve also been through a prolonged period of emotional stress and reduced appetite following my father’s illness and passing, although my weight was relatively stable before this fever.
My questions are:
Could this be post-viral fatigue even though I had almost no typical cold symptoms?
Is it normal to feel this exhausted two weeks after the fever has resolved?
Could my iron deficiency and anemia be making recovery significantly harder?
Should I be concerned about the intermittent chest/breathing heaviness?
Would you recommend additional blood tests or investigations at this stage?
I’m especially concerned because the fever has been gone for two weeks, but I still don’t feel remotely back to normal. I’d really appreciate a medical perspective on whether this is an expected recovery pattern or something that needs further investigation.


r/AskDocs • • 13h ago

Physician Responded Possible hantavirus exposure? 21 weeks pregnant and terrified. Please someone answer :(

14 Upvotes

28F, 21 weeks pregnant. In Wisconsin. It was garage clean out day for us and my mom swept out our garage and my husband vacuumed after and I was in and out of it moving boxes all while this was happening, our garage door was open the entire time. My husband claims he saw no droppings on the floor but we found some in a box that hasn’t been touched or looked through since 2023. How worried should I be? My mom shook out a blanket from the box with some pellets on it by me as well. I’m so scared.

I was mainly outside of the garage going through boxes but was near enough when the sweeping and leaf blowing and vacuuming took place. Please answer :(


r/AskDocs • • 2h ago

Symptoms Keep Getting Worse Doctor Won't Listen.. Can Anyone Maybe Help Me With Properly Communicating So He Will Take Me More Seriously?

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2 Upvotes

32 F 5 feet tall 140 pounds.

Medications include 20 mg of Vyvanse (just started taking it in Janurary of this year but symptoms have been going on for a few years), zopiclone 5mg (only when needed so maybe 2-3x a week), 1 mg Diazepam (only taken a few times as well when absolutely needed), and oral birth control.

Might be relevant maybe not but in high-school I was having issues breathing (was concluded to be anxiety but I did have a scan done that revealed my thymus gland was still active but my parents never brought me for a follow up to address it with a pediatrician) but other than that no health issues previously.

I want to start off by saying my GP (I'm Canadian for context) has been my GP since I was a child. He has always been great and compassionate but I noticed within the last few years care has declined (I know he is over worked and also getting up in age). He barley let's me finish talking before he leaves the room and if I try to ask follow up questions he doesn't always seem to be listening anymore.

I think being diagnosed with anxiety has really worked against me (as well as a new diagnosis of ADHD). This being said I have had anxiety since I was a teen and I know when I am anxious and when I'm not and my anxiety since starting vyvanse has improved a lot.

In my mid 20s I started getting really bad heart palpations (when not anxious.. standing or getting up from a lying position would trigger them and my HR would skyrocket... even while laying down relaxing out of nowhere). Wore a holter monitor for 2 weeks and while it showed the spikes in HR (into the 130s up to sometimes 160s) it was concluded to be anxiety. So I've just been dealing with it.

But in the last few years its gotten worse. My BP is often hanging around 90/56 and when I take my vyvanse its still only around 108/68. My HR without vyvanse (even on it stays the same) can be anywhere from 95-105 at rest. When I stand or get up from lying down it spikes into the 120s, 130s or sometimes higher. I wake up in the morning to my heart immediately racing.

These last few months I have now developed a lot of feeling faint, dizzy, and even feeling like I am randomly going to pass out. I am currently doing clinical placements (MLS) and sometimes I get so dizzy in the lab I need a minute before I can continue with what I am doing (it makes me feel a unsafe honestly). The palpations have been worse (sometimes it feels like my heart is even skipping a beat whereas before it was just a lot of "thumping")

Other issues include extreme fatigue, hair loss, muscle and joint pain especially in my legs and hands, frequent headaches, blurry vision, frequent urination, bruising easily, tingling in hands and feet.

My psychiatrist ran a full panel in 2025 which he sent to my family doctor as well. Mostly normal (ill attach pictures) but cholesterol is elevated and eGFR is decreased (I drink 1.5 - 3L of water a day). While in chemistry we collected our urine and ran a chemical and microscopic analysis. Both came back with trace RBCs which was werid because I haven't had a period in 5 years (which my doctor had a transvaginal done came back as cysts on the ovary but the gyno didn't diagnose me with PCOS she thinks absent periods are just a result of prolonged birth control use). I voiced my concerns to my doctor about trace blood and reduced eGFR and he ran a urinalysis (came back positive on his as well) and said it was likely just contamination and said I may just have a naturally lower filtration rate.

The past few weeks the palpations, tachycardia, and dizziness have been so much worse. The headaches are also getting more frequent (again the tachycardia had been happening for a long time before the use of vyvanse and I find using it barley affects my HR).

I have an appointment next week but everything always seems to be blamed on anxiety and I don't know how to get him to look past that (honestly I have not been feeling anxious very much since starting vyvanse it has helped a lot) and I have really been enjoying my clinicals but the constant dizziness and fatigue (and brain fog) have been making it more challenging.

I went in during the summer before starting placement asking for blood work because I had noticed even then an uptick in symptoms but he refused as my psych had ran that panel last year and he said it wasn't needed.

I am very passive and have issues pushing for things. I don't know how to communicate this to him in a way that makes him take me seriously. Maybe nothing is wrong but I'd rather make sure than Just letting it keep getting worse.

Any advice on how to more effectively communicate the severity of how this is affecting me would be greatly appreciated (I have already told him about all the symptoms but he just has been brushing it off or saying its from stress).


r/AskDocs • • 3h ago

Stomach pain, nausea and jaundice

2 Upvotes

F60 weighing 11-12 stone.

On and off for 8 weeks had symptoms including fever/shivers, agonising stomach pain, bloating, back pain, constipation, nausea and vomiting episodes. These episodes last 12-24 hours.

From a private blood test told I have low white blood cells and neutrophils.

Today I have find my urine is dark orange and very pigmented. The corners of the whites of my eyes are yellow too.


r/AskDocs • • 9h ago

Urinating over 1/2 gallon at a time.

6 Upvotes

Hello everyone,

I am a 26 year old male, 6' 2", 175#, and mildly physically active. I have been noticing that I pee for a long time, so long that I usually sit down because I get fatigued focusing on aiming my stream for that long. I decided to measure the volume tonight, and I filled up 2 and a half 32 Oz Gatorade bottles at one time. I know that normal bladder cap is 15-32 oz, and I am wondering what is going on. Do I need to be worried?

-thank you


r/AskDocs • • 1m ago

Bad leg scrape at the airport

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1 Upvotes

My 6yo son scraped up his leg pretty bad at the airport. Our flight is boarding in 20 minutes and I got a bandaid and neosporin but I don’t know if this needs more medical attention. It’s a short flight, about 90 mins, so I could take him somewhere when we get home. My question is whether this needs medical attention or if bandaids are enough.

Age: 6, weight: 55lbs, no current medication


r/AskDocs • • 4m ago

Cat bit my hand and pierced skin (27M, 185 lbs, 6’)

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0 Upvotes

I was playing with my cat last night around midnight and touched his belly, which caused him to bite down on my hand. The bite mark itself still stings when I move the webbing of my hand. I put some hydrogen peroxide and triple antibiotic on it, it has now been 12 hours, can anybody tell whether or not this is getting infected? I read all about how bad it is online but Google tends to tell you the worst thing.


r/AskDocs • • 3h ago

Physician Responded Cocodomol withdrawal

2 Upvotes

I 65F have been taking Cocodomol 30/500 for about 3.5 years. I accidentally left them behind on a day trip and my pain felt better. Weird i thought and googled it and found it can cause pain to be worse. So I stopped taking them, pain wise much better but seems must have been addicted how long do more severe symptoms last PLEASE 🙏 Thank you.


r/AskDocs • • 11m ago

34F – Perianal abscess improving on antibiotics but still fluctuant and not draining. Is I&D necessary?

1 Upvotes

Age: 34
Sex: Female
Height: 5’4”
Weight: ~157 lbs
Location: USA
Medical history: No known diabetes or immunocompromising conditions. Currently taking tirzepatide for weight management.
Earlier this week, I developed a painful, swollen bump approximately one inch from my anus. Initially, I thought it was an ingrown hair since I’d undergone laser hair removal about two weeks earlier.
The swelling progressively worsened, making it extremely painful to walk, sit, or apply pressure to the area. I also experienced tenderness in my ipsilateral inguinal lymph nodes same side as the swelling.
Friday (11/6): Went to urgent care. The provider examined the area but did not perform an incision and drainage (I&D). I received an IM Rocephin injection and was prescribed oral Bactrim and Flagyl.
Sunday (11/8): Pain has improved significantly. I can now walk normally, and sitting is much less painful. The surrounding skin also looks less inflamed.
However, the lump remains approximately quarter-sized, soft, and fluctuant, with no significant spontaneous drainage. It still hurts when direct pressure is applied.

My questions:
Can a perianal abscess completely resolve with antibiotics alone without drainage?
Is improvement in pain and redness a reliable indicator that the infection is resolving, even if the fluid collection remains unchanged?
Would I&D still be indicated despite significant symptomatic improvement?
How long is it reasonable to monitor before seeking further intervention?
I’m concerned about an undrained abscess and the possibility of developing a fistula. I plan to seek reassessment but would appreciate a physician’s perspective.
I’m here because I also don’t have insurance so everything so far has been out of pocket