OpenHealth Q&A

Seeking Guidance After an Infection on Scrotal Skin: An Unfortunate Journey (Long Read)

Gender: Male Age: 28 Height: 5 feet 11 inches Weight: 173 pounds Smoking Status: Yes **Medical History:** For several years, I have been dealing with a cyst located on/in my scrotum. Prior to its rupture, it exhibited significant redness and increased in size. Around early to mid-January, I began experiencing discomfort upon touching it, which I initially attributed to irritation from scratching in the groin area. After noticing a tiny white spot on the cyst, I mistakenly thought I might be seeing a tear in the scrotal skin exposing the cyst underneath. I tried to dismiss these concerns, as I tend to overanalyze everything. However, upon a subsequent examination, I observed a small amount of greenish fluid surrounding the white spot, leading me to visit the emergency room the following day. At the ER, the physician’s assistant examined the cyst and ordered an ultrasound. The results indicated that the cyst was solid, and I was prescribed antibiotics before being discharged. The next morning, I woke to find a drainage from the cyst, which had noticeably decreased in size. The fluid was thick and yellowish in color but lacked a discernible odor. As drainage continued, the cyst further shrank, prompting me to reflect on the possibility that not all of the fluid was pus, given my long-term experience with the cyst. Doubting the initial diagnosis of infection due to prior unsatisfactory experiences at that hospital, I consulted a doctor through Teledoc, providing images of my cyst. They advised that it likely wasn’t infected and only recommended antibiotics if the redness worsened. Subsequently, I visited a local clinic where I was instructed to take both topical and oral antibiotics (mupirocin and Bactrim). I have emetophobia (fear of vomiting), which led me to procrastinate taking my antibiotics for nearly a month. When I finally began taking them, I didn't adhere to the prescribed dosage—taking a full pill, then a half-pill later, but generally struggling to maintain a consistent regimen. I followed this routine for six days, while I was advised to take the medication twice daily for a total of ten days, before stopping on February 18 due to an unusual episode of stomach upset. Despite my missteps with the antibiotics, I consistently applied mupirocin for a few more weeks. After the cyst mostly drained, I experienced no pain, tenderness, or additional fluid discharge, although I occasionally noticed a minimal amount of fluid that appeared to be leftover keratin/sebum. Since then, there have been no further symptoms, though noticeable redness persisted throughout. I have also experienced intermittent itching, particularly localized to the area of the cyst, which sometimes extends to my penis. I found it challenging to determine whether the itching stemmed from a possible infection or the mupirocin application. About a week ago, seeking closure on this issue, I reconnected with a telehealth doctor, who insisted I visit urgent care for blood tests and a fresh antibiotic prescription. However, the nearest urgent care location does not offer blood tests, so I opted for the same hospital as before, known for its unsatisfactory service. Upon arriving at the ER early and being the first patient, I conveyed the necessity for blood tests as advised. The PA reviewed my condition and determined that it did not appear serious, concluding that I didn’t require the blood tests or oral antibiotics. I was instructed to continue applying warm compresses along with mupirocin. Despite my inquiries regarding the blood tests, they maintained that they weren't necessary. After four days, I find myself in the present situation. Currently, I am still experiencing recurring itchiness, an evolving redness that fluctuates in appearance, and visibly prominent veins in the scrotum that appear under tension—though they do not seem enlarged. I do not feel pain or tenderness in the skin surrounding my scrotum. However, I recently noticed a change; my scrotal skin seems thicker and less sensitive than usual, particularly on the side where the cyst was located. This change is definitely tangible, not imagined, as it feels noticeably less stretchy, compounded by ongoing redness that varies in intensity. I have been documenting the state of the cyst through photos since the day prior to my initial ER visit. If anyone is interested in viewing these images, please express your interest. Feeling lost, anxious, and somewhat helpless, I find myself in a position where financial constraints prevent me from seeking further medical assessments. What I truly need is a knowledgeable medical professional to clarify my situation and suggest potential courses of action, without waiting for a medical emergency to escalate the matter further.

Answers (1)

3/21/2025, 7:30:54 PM

OpenHealth AI

It's understandable to feel anxious and overwhelmed given the ongoing issues with your cyst and the associated symptoms. Here’s a summary and guidance based on your detailed account.

Main Points:

1. You have a history of a cyst on your scrotum that has recently drained but continues to show redness and itchiness.
2. You’ve experienced difficulty adhering to antibiotic treatment and are concerned about the evolving symptoms.
3. Financial constraints complicate accessing further medical testing or consultations.

Explanation:

The cyst you described seems to have caused a secondary infection, which is why you experienced discharge and redness. The persistence of itching and redness, along with the thickening of the skin, can be due to several factors, such as residual inflammation, irritation from topical treatments, or changes in skin texture post-drainage. Since the healthcare professional in the ER deemed it not serious, it’s likely more of a lingering response than an acute infection.

Next Steps:

1. Monitor Symptoms: Continue to keep a close eye on the redness and itchiness. If you notice increased pain, swelling, or discharge that looks different (especially if it's foul-smelling or has changed color), it would require urgent attention.

2. Skin Care: Use mild soap and warm water to gently cleanse the area daily. Avoid aggressive scrubbing or harsh products that may irritate the skin. Also, make sure to keep the area dry and clean whenever possible.

3. Warm Compresses: Continue applying warm compresses several times a day to soothe the area and possibly help with the redness.

4. Topical Treatment: You can continue using mupirocin as directed, but if you notice increased irritation, consider switching to a plain moisturizer that is fragrance-free to help with dryness and itchiness.

5. Avoid Irritants: Be mindful of any clothing or activities that may irritate the area (like tight-fitting underwear or vigorous exercise), as this can exacerbate symptoms.

6. Document Changes: Keep taking photos of the area to track any changes over the next week. This will help you gauge what’s improving or worsening without needing immediate medical intervention.

7. Consult Resources: Given financial constraints, look for low-cost clinics, community health services, or telehealth options that may offer sliding scale fees. Some nonprofits and health organizations may have resources available or can help guide you to affordable care.

8. Mental Health Care: Recognize your feelings of anxiety from these health concerns; considering reaching out to mental health support, as facilities often have options for reduced-cost therapy or support groups.

Conclusion:

Your situation may require ongoing observation, and it’s commendable that you’re advocating for your health. If symptoms worsen or you're feeling extremely anxious, exploring low-cost health care options should be a priority to get proper evaluation and peace of mind. Please continue taking care of yourself, and don't hesitate to reach out again if you need further guidance or support.