carbuncles or boils and the like..

[motherinneed]

Anyone on Atripla suffer from occasional flare ups of one big carbuncle or boil on the face..goes away and another appears? They are painful, sometimes red, not itchy, feel kind of squishy like there is pus inside. It said on line that they are caused by a weakened immune system, so if your numbers are good and you are on your meds, why would this happen? What do you do for these outbreaks?

[Miss Philicia]

What's your son's doctor say? It's impossible for us to diagnose things over the internet, especially something like a skin issue which requires a visual inspection. His ID doctor should evaluate the issue and, if necessary, make a referral to a dermatologist. There are a variety of skin issues that can occur in someone with HIV. I doubt that it has anything to do with his medication unless it's a large rash.

[motherinneed]

thank you. The problem is the single outbreak usually happens well after the ID appointment or is resolved before the appointment happens. As of yet the ID has not been able to see the "bump" .  That is why I was wondering if anyone else has had an experience with a single outbreak that resolves then comes back and then resolves again. The time lapse is usually  a couple of months and it does not happen with any consistent pattern of time. Just happens. Yes it may be a staph infection or a hair follicle infection but that is why I am concerned. If the meds are keeping the immune system working, then does the appearance of these outbreaks mean that at that moment the medicine is not working , or the body is stressed so the immune system is weakened. 

[Miss Philicia]

It's still impossible to say. My doctor would probably have me take pictures of it and email him, or require me to just come into the office during an outbreak regardless of not having an actual appointment.

[jkinatl2]

What you describe could also be an underlying staph infection that would need to be treated topically AND internally using strong antibiotics. I've had this since the boyfriend spent significant time in the hospital - where it's easy to pick up such an infection (though I have been told that the pathogens live on your skin all the time as well.)

If you make an appointment to come in when one of the boils is present, your doctor might lance it to take samples for testing. My doctor did this, but he also gave me a powerful antibiotic ointment for the area (and also the inside of my nose, since staph can manifest there as well,) a medical grade soap (smells VERY medicinal) and a round of antibiotics. Seems to have worked, though I must remain vigilant.

Not saying that this is what it IS, but the symptoms sounded similar.

[motherinneed]

Thank you. Really just wanted to know if this has happened to anyone else. I just bought him hibiclens topical cleanser as that seems to stop these outbreaks.  If it continues I have already advised him to get antibiotics. 

[Ann]

If it continues I have already advised him to get antibiotics. 

I hope that advice included "get an appointment with your doctor (even his GP will do) while you have one of these outbreaks and if necessary get the appropriate antibiotic."

Not all antibiotics will work on all pathogens. He will need a specific type of antibiotic to deal with whatever is going on and only a doctor can know which specific antibiotic to prescribe.

I hope he gets to the bottom of this soon and becomes outbreak-free.

While I'm more than happy that you are being proactive about his health, I hope you're encouraging him to take more responsibility for his health as well. Have you encouraged him to join this forum himself? If not, please do. Not only will he learn a lot about living and dealing with his virus, he just might make a few friends and have some fun too.

Hugs,
Ann
xxx

[mecch]

Is his CD4 in the safety zone, above 200??  Is he on HAART and undetectable? If so.... your worry that the drugs are temporarily "not working" and the sign is the outbreak - is not correct.
The outbreaks could be medicine related, or immune related, or not, at all.  Hard to tell without more information.  Anyway, can he go to a GP or dermatologist the next time it happens?  That seems like the only way to get some answers and relief...