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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Diabetic, Lump Near Collar Bone, Fever. ESR High, On Antibiotics. Fever Still Present. Why?

hi, my father is 63 and he is diabetic. around 15 days back he noticed a lump at the neck near the collorbone,he ha s fever too which generally rises in the evening, blood test was done ,the lump was described as supparative lesion ,all other tests are normal except his esr is 86,chest x-ray is also normal.he is on antibiotics for last 15 days ,lump is now smaller in size but he is having high fever which is going up to 102,what can be the reason, please help
Thu, 7 Mar 2013
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Internal Medicine Specialist 's  Response
Hi,
Thanks for posting your query.
Your father 's illness is all because of suppurative lesion.
Suppurative lesion means infected pus collection which is very common in a diabetic patients.
Uncontrolled sugar and associated peripheral artery disease promotes pus collection.
As he is already taking antibiotics and on improvement side, he should continue the same and if size is not decreasing then he must consult with general surgeon for incision and drainage.
ESR is a non specific test which indicates some disease activity is going on in body.
He should also consult with internal medicine specialist / endocrinologist and should go for thorough check up.
His blood sugar and glycosylated hemoglobin must be in controlled range.
Take care,
Dr. Mayank Bhargava
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Cardiologist Dr. Anantharamakrishnan's  Response
Hi friend,
Welcome to Health Care Magic

That means the infection is still present.

The organism may not be sensitive to the particular antibiotic?

The diagnosis may have to be revised - tuberculosis is a common consideration.

Consult your doctor.

Take care
Wishing speedy recovery
God bless
Good luck
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Diabetic, Lump Near Collar Bone, Fever. ESR High, On Antibiotics. Fever Still Present. Why?

Hi, Thanks for posting your query. Your father s illness is all because of suppurative lesion. Suppurative lesion means infected pus collection which is very common in a diabetic patients. Uncontrolled sugar and associated peripheral artery disease promotes pus collection. As he is already taking antibiotics and on improvement side, he should continue the same and if size is not decreasing then he must consult with general surgeon for incision and drainage. ESR is a non specific test which indicates some disease activity is going on in body. He should also consult with internal medicine specialist / endocrinologist and should go for thorough check up. His blood sugar and glycosylated hemoglobin must be in controlled range. Take care, Dr. Mayank Bhargava