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Pus got trapped in parotid abscess, should it be surgically removed?
In early June 2023, a severe swelling occurred at my right parotid gland that looked like mumps with pain and hotness that formed into a severe parotid gland abscess. My family doctor in Niagara Falls Canada said it was parotitis. A few weeks later the large abscess started to drain on its own through an opening in the abscess. A swab from the opening taken by my ENT doctor in Niagara Falls Canada confirmed the pus was staph aureus. There was still a swelling there and there were a few lumps of pus that needed to come out as I pushed one lump out that was round and 1/2 inch in size with a slight yellow greenish color. I'm wondering if this was in fact staph aureus pus? I could feel one last lump of pus needed to come out as I applied hydrogen peroxide and polysporin into and onto the opening of the abscess for 3 days, that caused the opening of my abscess to completely seal by the third day in late June 2023 where I could no longer push the last lump of pus out as it remained trapped. The abscess kept shrinking but very slowly.
One month later in July 2023, it still didn't clear away but became flat and level to the skin and it was still red, warmish hot with an ache or pain. I read online that in order for a severe parotid gland abscess to fully clear away by 7 to 10 days, all the pus must be completely drained out, in my case it was not as it remained trapped but the swelling kept on shrinking ever so slowly month after month.
My first Ultrasound scan in June 2023 showed, directly inside the swelling, an ill-defined fluid collection in the right parotid gland measuring 2.5 cm x 2.5 x 1 cm, Intra-parotid abscess.
Few months later in Aug 2023, my first CT scan showed an ill defined soft tissue and inflammatory changes at the superficial right parotid gland as the swelling on the skin was completely flat and fainted red.
The radiologist of my Oct 2023 Ultrasound questioned if I received treatment for my abscess since the ill-defined area under the skin didn't clear away and did not change much at all in size compared to the Aug CT scan.
My Dec 8 CT showed a non mass ill defined geographic area measuring 2.2 cm x 0.8 cm x 2.3 cm seen in the superficial lobe of the right parotid gland which may represent an area of inflammation or scarring. that only shrunk very slightly compared to Aug of 2023, and there is no focal fluid collection.
There is an indentation where this abscess used to be under my right ear lobe along the upper jaw that seems to be getting longer in length that still may become slightly faint red to the touch, warmish hot and slight ache or slight bruise feeling. I may include a few pictures later.
1). My questions are, back in June 2023 when the pus became trapped, should the trapped pus have been surgically removed as soon as possible?
2). Is it possible this ill defined enhanced area in the superficial parotid gland is the staph aureus that became trapped ever since June 2023? I don't know why they are labelling it as ill-defined when the lump of pus got trapped.
3). Should this now enhanced non mass ill defined area still be removed by surgery 11 months later in May of 2024 or is it safe to live with this for a lifetime even as it still may become slightly warmish hot with a slight ache or slight bruise feeling that comes and goes?
I'm also worried if this might become worse or even serious in time years from now. My ENT doctor in Niagara Falls Canada said this will not become worse and no surgery is needed because its only a scar.
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Here are 2 photos of my right parotid gland. Both photos were taking on the same right side but one was taking by reverse cam and that's why it looks like the left when its actually the right. The first was was taking on Aug 8, 2023 as the swelling became level to the skin but still red with a pain and warmish hot. The next photo was taking in April 2024 of the same right side which has formed an indentation that still becomes faint red to the touch, slight warmish hot with a slight ache or slight bruise feeling that comes and goes or may be continuous.
Hmm, this has been going on for a long time. What does your doc say about it now? If it was in my neck, I would definitely want it evaluated because of the infectious organism .
Sue
In June 2023 when the abscess formed, I did tell my family doctor that I rather not have any surgical procedure and wanted the abscess to drain on its own at home, but when the remaining pus became trapped and the abscess could not clear away, I asked my family doctor if I needed a surgical procedure to clear away the trapped pus and surprisingly he said no. My ENT was then on medical leave until Dec, and I received an Aug CT, Oct Ultrasound and Dec CT and my family doctor still informed me I did not need surgery. When my ENT finally reviewed my Dec CT scan and I saw him in Jan 2024 he said the lesion has cleared and it has become a non mass ill defined area that is a scar and that I don't need surgery at this time.
I think it may be more then just a scar it could be inflammation due to the trapped pus since it still becomes slightly warmish hot at times with a slight bruise feeling. I'll be seeing a new ENT and will ask him for an MRI as well as a needle core biopsy of the actual ill defined enhanced area to confirm exactly what it is.
I forgot to include a few more details about my June 2023 and Oct 2023 Ultrasounds that they showed a sinus tract leading to my skin surface at and coming from the abscess/soft tissue/hypo-echoic
area .
I'm wondering if my family doctor did not provide me proper medical advice when I asked him a number of times through the many months ever since the pus became trapped if I needed surgery to remove the trapped pus and if I needed to see another ENT when my first ENT went on medical leave and he said no to those questions each time I asked.
I'm also wondering if my ENT also didn't give me proper medical advice on July 25, 2nd appointment when after I also explained to him that the abscess didn't fully clear away because the pus got trapped and if I need a surgical procedure which he also said no, but he also mentioned make sure he gets to review my Aug CT ordered by my family doctor which he did in Jan 2024 as well as reviewing my Dec CT, on Jan 2024, 3rd appointment as he also said I don't need surgery at this time, as if he just went along with my family doctor's assessment for a second time that nothing needs to be done.
Why didn't both my doctors treat the trapped pus with much more urgency and care as if both doctors didn't take in consideration the pus became trapped in the parotid gland abscess as if its nothing?
When I google search what will happen if pus becomes trapped in a severe parotid gland abscess, nothing really shows up. It mentions if a severe abscess is not fully drained properly, the pus or bacteria may spread deeper into adjacent tissues. There was something I read about staph aureus pus or bacterial left in the body may eat away at tissue in time or may cause the tissue to go bad in time if this is correct?
Google shows bacterial staphylococcus (which is what became trapped since last year in June), can eat away at tissue and can become serious in time as the bacteria infect the connective tissues below the skin.
This is a new photo I took in May 2024, it seems the indentation became longer and maybe even deeper along the jawbone compared to the other indentation photo on this thread that was taking in Feb 2024 not April as I incorrectly indicated on that other post. And both my ENT and family doctor said I don't need any surgical procedure.
And my ENT said in Jan 2024 I didn't need any surgical procedure as well as my family doctor said the same thing since this all started in late June 2023 (and after up to Jan 2024) when the lump of pus first got trapped in the severe parotid abscess, and it has now become this in May 2024.