What kind of skin infection do I have - pictures included?

Answer 1

Details and photosHere are the pictures: http://www.Flickr.com/photos/13499368@N02/sets/72157602000325986/

This started about 3-4 weeks ago. As you can see in the first few photos, the issue is only a handful of ulcers that were painful when defecating. I cleansed the area frequently with benzalkonium Cl and lidocaine HCl, and then dressed the affect3ed area with triple antibiotic ointment.

I figured it was a fistula that had abscessed, as I have history of hemorrhoids and other fistula. When I was finally able to get access to a hand mirror, I saw what is portrayed by the second pics in the set. Discharge was light, but apparently purulent; bad odor was not present. I went to the local ER, where I had a CBC,a white cell count, and tests for bacteria in my bloodstream. I was told I had only a few extra white cells, so it pretty much couldn't be an abscess. They gave me a powerful antibiotic (Clindamycin) and made me an appointment the next day for a good surgeon. The surgeon said it was fungal and told me to stop the antibiotic and to use a sitz bath, witch hazel, and an anti-fungal powder (Nystop).

Turns out I'm one of those lucky 1 in 1000 who get side effects. I cannot describe the burning sensation, it was so incredibly strong. It was second only to my kidney stones in pain intensity, and despite nearly drowning my wound with the cleanser, it still took 4-6 before I could get any meaningful pain release.

I went back to using the antibiotic, figuring why not and it could only help, not hurt. Pus expression, which was horrible piles of gooey greenish crud (after using the anti-fungal overnight, I awoke to find half a TABLESPOON of pus that needed cleaning). The greenish/yellowish stuff on the wound seems to largely be lymph, perhaps dead bacteria, and a lot of dead white cells, sort of soaked up like a sponge on bits of excoriated skin that is sloughing off (leaving raw red dermis underneath) The borders show raised pustules as well as swelling and tenderness; I am using NSAIDs, my opioid pain killer, and anti-histamines to keep the (very uncomfortable) swelling to a minimum. Standing on my head helped a good bit, too.

So, anyone ever seen anything like this? What is it treated with?