Hmm, it's really swelled up! The right half of your buttocks has swelled up. You said it started to swell this morning, but wasn't there pain from few days before?
Periproctal abscess(57KB)

Oh, there has. And you had a fever last night, and couldn't sleep well because of the pain. This is called periproctal abscess, and to state it simply, it's when pus which formed around the anus collected and swelled up.

You'll feel better after a little incision to take the pus out.

You don't want any incision because you're afraid? But if you leave it like this, the pus will accumulate even more, the swelling will get worse, and the skin will break and pus will come out. If you are put under local anesthesia and have a small incision, you'll feel better in a short time, without having to suffer all that.

Would treatment by antibiotic work? No, not in a situation like this.

Okay, you're willing to do it? Please lie down sideways with your bottom facing this way. You've had anesthetic shot in your gum at the dentist's, and I'm going to use the same anesthetic, so there will be a little sting, then you 'll feel numb.

Does it hurt? Now I'll make a little incision.

Oh, my, a lot of pus is flowing out.
Incision(73KB)

I've heard from Dr.Iwadare that a patient excreted as much pus as would fill up a soda bottle, and this rivals it.

With all this pus out of your body, the pain will be reduced gratly, and you are sure to have a good sleep tonight. I'll prescribe some antibiotics, so be sure to take it after every meal.

There is a high possibility that the opening made by this incision will not patch up quickly, and you suffer from anal fistula. Anal fistula is when what causes priproctal abscess exists inside the anus, and incision from the outside to let the pus out, or applying medication does not work. Look back at the page for anal fistula if you forgot.

If you have anal fistula, leaving it alone will not fix it; it will get more difficult to deal with, or in rare cases, may become a cancer. Do not stop your treatment because the incision made you feel better. Make sure you come see me again in two weeks. We will decide what to do depending on your condition then.

Take care!