Pilonidal sinus typically presents with localized symptoms in the tailbone area. These include pain, often severe and worsened by sitting, along with redness and swelling in the affected region. A characteristic symptom is the discharge of pus, blood, or a foul-smelling fluid from the cyst or abscess. In more advanced stages, an abscess may form. Less frequently, systemic symptoms such as fever, nausea, and fatigue can occur. When the infection is severe, these symptoms can significantly interfere with daily activities, making walking and sitting difficult. If you experience several of these symptoms, it is recommended to consult a general surgeon.